antihypertensiva

Antihypertensiva are medicines used to treat high blood pressure (hypertension) and to reduce the risk of cardiovascular events. They work by lowering blood pressure through different mechanisms, such as reducing blood volume, widening blood vessels, decreasing heart rate and cardiac output, or blocking the renin-angiotensin-aldosterone system.

The major classes include diuretics (thiazide, loop, and potassium-sparing), ACE inhibitors, angiotensin II receptor blockers (ARBs), calcium channel blockers, beta-blockers, alpha-blockers, central nervous system–acting agents (such as alpha-2 agonists), and direct vasodilators. Many patients require combination therapy; drug choice is guided by the patient’s blood pressure level and coexisting conditions.

Indications primarily include essential hypertension, but antihypertensiva are also used in hypertension with comorbidities such as heart failure, ischemic heart disease, diabetes, chronic kidney disease, or cerebrovascular risk. In pregnancy, some agents (notably ACE inhibitors and ARBs) are avoided because of fetal risk; alternatives are chosen based on safety data.

Adverse effects and monitoring vary by class. Common issues include dizziness and hypotension. ACE inhibitors can cause cough and hyperkalemia; diuretics can lead to electrolyte disturbances and dehydration; calcium channel blockers may cause edema; beta-blockers can cause fatigue and bradycardia. Regular monitoring of blood pressure, renal function, electrolytes, and, for women of childbearing potential, pregnancy status is recommended.

Safety and usage considerations include adherence, potential drug interactions (for example with NSAIDs or excessive alcohol), and caution in the elderly or those with kidney disease. Treatment is individualized according to each patient’s profile and risk factors.