INFORMATION

The changes in the life style, including the dietetic changes and exercise, are with much the most important thing in the control of the TA, but often it is necessary to have a therapies combination, including the medicines. Independently of the cause of the HTA, there is a wide medicines fan to treat it, that are used usually in stages, up to finding the personal plan of medicines that works in every hypertense patient.

DIURETICS

Generally, the first election medicine in the HTA is a diuretic. The elimination of urine increases and go out of the organism, what it serves to lower the TA, so much for the lost liquid as because this way it diminishes the resistance to the blood flow of the glasses of the organism. [Nevertheless, the tiazidas can increase the level of blood cholesterol].

• DIURETICS TIAZÍDICOS

They think of the first election, although it has not despicable long-term side effects (increase of the uric acid in the blood, descompensación of electrolytes you (go out), etc.). The tiazidas are not effective in case of advanced renal insufficiency (creatinina sérica> 2,5 mg/dl). In this case there are used usually the metolazona, the indapamida or diuretics of high roof (furosemida). The thrifty potassium diuretics are not used for the HTA.

With the diuretics, one notices that one urinates much more often and more rapid after the liquids ingestion. Apart from it, the collateral effects of the diuretics are small, emphasizing the loss of potassium or hipopotasemia, that forces to continue the potassium levels in blood by means of analysis and to take potassium supplements, since it is not enough usually with the ingestion of fruits rich in potassium (orange, banana) to correct the deficits of potassium caused by diuretics. If little salt takes, the diuretic will be more effective and the loss of potassium will be minor.

Indications of the diuretics:

Classification of the Diuretics, dose and duration of his action.

BETABLOQUEANTES

They act blocking many effects of the adrenaline in the body, in particular the stimulant effect on the heart. The result is that the heart beats more slowly and with less force.

Effects of those of the betabloqueantes in the arterial hypertension

• They reduce the cardiac expense.
• They reduce the volume sistólico.
• They reduce the cardiac frequency.
• They inhibit the regirl's secretion.
• They possess central antinice effect.
• They stimulate the cininas production.
• They stimulate the liberation of the péptido natriurético atrial.

They can produce a fatigue sensation, diminish the aptitude to do exercise, powerlessness, produce asthma, weariness and litany that limits very much his use. Some of them can diminish the levels of the "good" cholesterol or HDL.
They are more indicated in the cases of HTA with tachycardia, in cardiopatía isquémica, in the partner to migraine and glaucoma.

CALCIUM - ANTAGONISTS

The bloqueantes of the channels of the calcium prevent the entry of calcium in the cells. This diminishes the tendency of the small arteries to become closer, they diminish the contractilidad miocárdica and diminish the peripheral vascular resistances.

As side effects owe to describe the edemas maleolares, the facial flush and migraine, the low blood pressure ortostática, the constipation and the bradicardias.

Principal indications of the antagonists of the calcium.

Classification of the calcioantagonistas, dose and duration of the action.

INHIBITING OF THE ENZYME CONVERTIDORA OF ANGIOTENSIA (IECAS)

Like the previous ones, they diminish the tendency of the small arteries to become closer, but for a different mechanism. They prevent from being generated a product of the organism that is called angiotensina II, and without which it is not possible to produce the regirl (who raises the TA and presses the glasses hard).

Indications of the IECAs are:

The side effects that more describe sound, the cough, the low blood pressure, migraines, angioneurótico edema, exanthemas in the skin, and the elevation of the urea.

Classification with dose and duration of the action of the IECAs.

OTHER MEDICINES ANTI-HTA

Vasodilatadores. (Hidralazina, Minoxidilo, Diazóxido, Nitroprusiato sódico)

They produce the dilation of the arteriolas for direct action on the smooth musculature (relax). This dilation causes tachycardia reflects and saline retention for what associates they usually use a diuretic and a Betabloqueante that the above mentioned effects resist.

The hidrazalina is used like third medicine in hypertension. It is necessary to be careful with the dose. If this one is major than 200 mg there exists the risk of a syndrome similar to the lupus eritematoso.

The minoxidilo produces hipertricosis (increase of the hair), but it is effective in many cases refractory to another treatment.

The nitroprusiato sódico and the diazóxido are used exclusively in hypertense crises. For the severe HTA Hidralazina and Diazóxido have been used. The Nitroprusiato is used in situations of urgency (hypertensive Crises), when an extremely high TA can put in danger the life.

Entire alkaloids, Reserpina, Bietaserpina.

His effect is based on the emptying of the deposits of catecolaminas (mediators of the autonomous - involuntary nervous answer) at central and peripheral level.

They use usually always associated with diuretics, as what they usually have side effects at gastrointestinal level and of the S.N.C. (depression). Enough is used in elders (his effect does not get lost too much for his irregular capture and there are only one dose a day).

The reserpina, the rauwolfia, the guanetidina, and some alkaloids are other used substances. Each of them has situations that make her useful and others that limit his use.

• CONCOMITANT ILLNESSES TO HTA and indications of the medicines.

TO SEE ALSO

• Arterial hypertension. General Informaciónn
• Complications of the HTA
• Since the Tension Takes
• Treatment of the Arterial Hypertension
• Medicines for the HTA TV/radio commercials
• Medicines for the Generic HTA
• Handling of the Arterial Hypertension

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