Antihypertensive Drugs

Hypertension, commonly known as high blood pressure, is a chronic cardiovascular disorder in which the blood pressure remains persistently elevated. It is one of the major risk factors for stroke, coronary artery disease, heart failure, chronic kidney disease, and other cardiovascular complications. Since hypertension may remain asymptomatic for many years, it is often called a “silent killer.” Proper management of blood pressure is therefore essential to reduce long-term complications.

Antihypertensive drugs are medicines used to lower elevated blood pressure and maintain it within a desirable range. They act through different mechanisms, mainly by reducing blood volume, decreasing cardiac output, or lowering peripheral vascular resistance.

The major classes of antihypertensive drugs include:

1. Diuretics—increase the excretion of sodium and water, thereby reducing blood volume. Examples: hydrochlorothiazide, furosemide.

2. ACE inhibitors – inhibit the formation of angiotensin II and reduce vasoconstriction. Examples: enalapril, lisinopril.

3. Angiotensin II receptor blockers (ARBs)—block the action of angiotensin II. Examples: losartan, valsartan.

4. Calcium channel blockers—reduce calcium entry into vascular smooth muscle and/or cardiac muscle, producing vasodilation. Examples: amlodipine, verapamil.

5. β-Adrenergic blockers – reduce heart rate and cardiac output and suppress renin release. Examples: propranolol, atenolol.

6. α-Adrenergic blockers and centrally acting drugs – reduce sympathetic activity and vascular resistance. Examples include prazosin and clonidine.

7. Direct vasodilators—directly relax vascular smooth muscle. Examples: hydralazine and minoxidil.

The choice of antihypertensive therapy depends on factors such as the severity of hypertension, age, associated diseases, cardiovascular risk, kidney function, and response to treatment. In many patients, more than one drug may be required to achieve adequate blood pressure control.

Antihypertensive drugs mainly lower blood pressure by reducing blood volume, cardiac output, or peripheral vascular resistance.

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