Strong pills for high blood pressure. Cheap pills for high blood pressure. List of low blood pressure pills

Here is list of medicines for hypertension, their pharmaceutical and "commercial" names. This page will make it easier to find information about drugs of interest to you. To quickly find the medicine you need, use the "find on page" search in your Internet browser.

For detailed information about medicines (indications for use, dosage, side effects, compatibility with other medicines), see separate articles, links to which are given here.

Diuretic drugs for hypertension: a detailed list

Read about diuretics (diuretics):

Popular diuretic pills:

Proven effective and cost-effective blood pressure supplements:

Read more about the methodology in the article "". How to Order Hypertension Supplements from the USA - . Get your blood pressure back to normal without the harmful side effects that chemical pills cause. Improve heart function. Become calmer, get rid of anxiety, sleep like a baby at night. Magnesium with vitamin B6 works wonders for hypertension. You will have excellent health, to the envy of your peers.

Beta blockers

ACE inhibitors

Angiotensin II receptor blockers

calcium antagonists

second-line hypertension drugs

Read about medicines containing aspirin:

Vasodilator drugs

Statins: detailed information

Medicines for hypertension - other

1. Elena

   the doctor prescribed to take Coronal and Diacordin at the same time, and I read in the instructions for Diacordin it says: “Combinations with beto-blockers are potentially dangerous ...” Ie. It turns out that they cannot be taken together. Is it correct?

2. Marina

   The doctor prescribed indapamide, metoprolol and albarel. I drank for 4 years and ended up in the hospital with Quincke's edema, they said that it was a reaction to metopolol. What can I replace?

3. Larisa

   Hello! Tell me, please, what kind of diuretic for hypertension is it better to replace diacarb (it has not been available in pharmacies for a long time)

   1. admin Post author

      Larisa, I recommend to your attention in the article “Beta-blockers: a list of drugs” COMMENTS No. 1 and 2. They answer your question as much as it can be given “in absentia”. Read and see a doctor.

   2. lyudmila

      67 years old, weight 81 kg, height 170 cm, hypertension of the 2nd degree, spinal osteochondrosis, gout.
      I took Coaprovel for 3 months. Analyzes are normal, but uric acid is elevated - 413, abdominal pain, flatulence, constipation appeared. Ultrasound showed cholecystopancreatitis, the spleen was not visible due to flatulence. After the abolition of the diuretic (switched to Aprovel or Irsar without a diuretic) and taking a course of Cholenzym, the signs practically disappeared. Could hypochlorothiazide cause these disorders? Thank you.

4. Marina

   I am 50 years old, hypertension has been prescribed for a long time, different drugs were prescribed, but the pressure did not decrease below 130/90, now it began to jump 120/80 180/100 they prescribed 4 drugs that should be taken together, are they compatible, is it harmful to the liver? in the morning to drink Lozap, Indap, Bidol, in the evening Amlodipine, I also have an allergy and sometimes I take tsetrin. And are these drugs harmful for Arthrosis?

5. anatoly

   I take Cordaflex, it helps me, but in the morning there is still very high pressure. Please advise what medicine you can take or advice. There is no time to go to the doctors.

6. Alexander

   I have hypertension 2st 190\100 prescribed Tritace +, Betak, Enam, Cardiomagnyl, but there is no effect, tinnitus does not go away, I ask for advice.

7. Elena

   Is Teveten compatible with Egilok? Mom is 82 years old, the pressure rises to 220/105. Pulse 52-60. The district police officer prescribed physiotens, egilok, veroshpiron, diuver. Against this background, the pressure rises to the above figures. (no cardiologist). The main increase in pressure is at night and in the morning. Is it possible to use Dibicor? There are chest pains.

8. Ildar

   Hello. I am 21 years old. I know that for the last 4 years there has been an increase in blood pressure on average (140/75), I simply did not measure it before. All this time I was checked and went to the doctors. Perhaps it was checked not there or not from those who need it, since no one can specifically say anything. I go in for sports (at the amateur level) light and not very heavy. Weight is normal (with a height of 180 cm, weight 83 kg). Please help me with advice, what should I do?

9. Olga

   Good afternoon! Please advise medicine for our grandmother, she is 83 years old, I don’t know the exact weight, about 60-70 kg, the pressure is almost constant both in the morning and in the evening, it reaches 200, we bring down Physiotens and Adelfan, it helps for a while, we tried to give her Gizzar, Lozap, Lorista , they don’t help ... there is still one problem, she “sits” on Pentalgin and Phenazepam, although the doses are small, but every day, we can’t convince not to drink these medicines ... she still drinks Baralgin, since she has a stone in the gallbladder and sometimes there are pains , passed tests, there are no deviations, everything is more or less normal and blood and urine and ECG too, even my grandmother gets up to the toilet at night about 5-6 times, urologists said this is already senile and vascular problems. Looking forward to your reply, thanks!

10. Olga

    her kidneys were also checked, everything is fine, just a little sand, or tell me what exactly needs to be checked, what tests to take?

11. inna

    Good afternoon! I really need advice! Mom is 71 years old, has been suffering from hypertension for more than 5 years. The first attacks deprived her of her sight, now she is practically blind, there is no front vision, she can partially see sideways. She was in the hospital, after that she coped with pressure, drank pills and it was more and more normal. Now there are problems again, the pressure is more than 200/110, they called an ambulance, the pressure was brought down, the next day they went to the therapist, wrote out two more names for her pills and sent them to the cardiologist. motivating by the fact that it won’t help, he prescribed more medicines and to pass tests. Now my mother has problems with pressure - it jumps very strongly, from 100/60 to 180/100, and with a short interval back and forth, the readings can change within an hour or five -six times. But the worst thing is that her heart hurts, as mom explains, it’s not pain, but some kind of seizures, bursts or something, as if her heart is pouring and turning over. taking LORISTA 50mg. AMLOTOP 10mg. DILTIAZEM 90mg. also cardiomagnyl. There is still a problem with shortness of breath, she suffocates very much during exercise, they sent her to check her lungs, she did a cardiogram, a fluorography, everything is more or less normal. I wanted to go with her to a cardiologist and insist on hospitalization, I don’t know what to do. Please tell me what should I do, what treatment does my mother need?

12. Vadim

    Good afternoon.
    Thank you for your materials, I think they are very useful.
    I am 50 years old height 176 weight 102.
    I have had hypertension for about 8 years.
    At first, Arifon was prescribed, after 5 years it stopped helping, they prescribed ko-renitek in the morning and in the evening. There were crises knocked down dibazol + papaverine
    Three weeks ago, the pressure again began to rise to 140/100 and 150/100 (normal 120/80). Can it be that the body is just used to them and they do not work, it can take something else to replace it. What are the stronger analogues.
    I eat for two days (after visiting your site) on a low-carb diet, I take magnelis B6, fish oil and taurine.
    Thanks
    Haven't done a blood test yet.

    1. admin Post author

       > Two days of eating (after visiting your
       > site) on a low-carbohydrate diet

       You ruined your health for 30 years with a sedentary lifestyle and inappropriate food. Therefore, it is not possible to restore it in two days.

       > What are the stronger counterparts.

       If you diligently follow a low-carbohydrate diet, as well as take magnesium and taurine, then within 2-3 weeks you will feel the effect, and it will be possible to gradually abandon "chemical" drugs altogether.

       1. Vadim

          Thanks for the answer.
          Has handed over all analyzes recommended by you.
          Raised
          1. The average content of hemoglobin in an erythrocyte is 31.8
          2. Gamma GT 58
          3. C-reactive protein 13.36
          4. creatinase 379
          5. triglycerides 2.82
          6. Total cholesterol 7.0 HDL 1.30 LDL 5.1
          7. Atherogenic coefficient 4.4
          8. homocysten 16.47
          9. Hormones TSH, T-4 total, T-4 free, T-3 total, T-3 free, antibodies to microsomal teroperoxidase EVERYTHING IS NORMAL.
          10. Normal lipoprotein 3
          I did an ultrasound of the kidneys - everything is fine.
          Will it be possible to improve my performance with a diet and magnesium + taurine + fish oil.
          THANK YOU FOR YOUR SITE.

          1. admin Post author

             > C-reactive protein 13.36

             This figure means that you are moving towards a heart attack very quickly. The official norm "C-reactive protein" is up to 3, unofficial - up to 1.5. You have chronic inflammation in your body. It can be teeth, kidneys, joints, chronic colds or something else. Bacteria enter the bloodstream and destroy the walls of blood vessels from the inside. Deal with it.

             > Average content
             > hemoglobin in erythrocyte 31.8

             If elevated, then this may be an indirect sign that you have an excess of iron. It also destroys blood vessels and provokes a heart attack. Get another blood test for iron. If it turns out to be an excess, then you should become a blood donor, donate it several times a year. Jokes aside. To prevent my own heart attack.

             This is written in the book here - - my hands just don’t reach to translate and lay out everything.

             For the rest of your indicators, I now have no time to look for norms and compare. Cholesterol and atherogenic coefficient will improve in 1-2 months with careful adherence to a low-carbohydrate diet. If homocysteine ​​is elevated, then it is recommended to take a complex of vitamins B-50, which is described in the article "Treatment of hypertension without drugs." At first, 1 tablet per day, and after a week, increase the dose to 2 tablets per day. Repeated analysis for homocysteine ​​- in 2-3 months.

             First of all, figure out why C-reactive protein is so elevated. This is usually due to dental problems.

13. Natalia

    For 15 years she was treated with diroton, the pressure is 150/80 now it does not help, please advise which drug is better for me to take. comorbidities MKB sugar. diabetes. 2 types
    height 155 weight 65 64 years

14. Svetlana

    Thank you for your desire to help people live, and special thanks for the properly dosed humor in your answers. I have a very difficult question: try to give a formula for finding a GOOD doctor in St. Petersburg. I realize that it cannot be free by definition.
    I hope for a concrete answer to your e-mail.

15. Naila

    Hello, my mother’s blood pressure rises from 180 to 60, then drops to 90 to 60, sometimes it can be up to 70 to 50, doctors prescribed veroshperon coranal cordiomagnyl enap for high pressure, but they didn’t prescribe it for low pressure. She has no sugar 60. what can you recommend. but tinnitus and heartbeat 85 .

16. Alexei

    Age - 56 years old, height - 170 cm, weight - 78 kg. There was renal colic, pyelonephritis was transferred, a stone in the left kidney 7 mm, chronic prostatitis. Before I started taking the pills, my blood pressure was 170/100. It's hereditary in me. I took various drugs one-time and for a certain period, then Enap-H for about a year, regularly half a tablet in the morning. The pressure was 130-140 over 95-100, but sometimes I felt unwell. Now I have been regularly taking Valsacor 80 mg per tablet in the evening for about a month, but the pressure is kept at 150/100, sometimes 145/95. Feeling better, but sometimes there is some kind of anxiety. Blood test: hemoglobin-149; erythrocytes - 4.10; leukocytes - 5.2; SHOE-23; eosinophils-2; lymphocytes-32; monocytes-6; blood glucose-4.3;. Urinalysis: color-light yellow; protein-negative; reaction-sour; bilirubin-neg.;.

17. Svetlana

    Hello! I am 38 years old, height 173, weight 60 kg. Two years ago I was diagnosed with GB 2 tbsp. risk 3, against the background of a hypertensive crisis with an increase in pressure of 190 to 115 (no increase in pressure was previously noticed). An examination was carried out: kidneys were normal, changes in the fundus, suspicion of coronary artery disease after undergoing a Holter ECG. She was prescribed permanent treatment with Prestarium 2.5 mg. She took everything, the pressure was normal, but after a year and a half, against the background of stress, there was a jump - 150 to 100, which lasted about a week. The local therapist prescribed Coronal 5 mg and Lozap 5 mg. I drank through the packaging of these tablets, and after normalizing the pressure, I constantly take Coronal 2.5 mg, I refused prestarium. I don't particularly trust our therapists, they don't care.
    Tell me, is it enough for me to take only Coronal?

18. Veronica

    Hello! Mom is 62 years old, weight 102kg, height 164, has been suffering from hypertension for many years, plus she is also a type 2 diabetic. For three years she took Lazap in the morning, Egilok in the evening, Siofor, Maninil 5, but the sugar did not decrease. This year there was a jump in pressure and does not stabilize in any way. Analyzes: hemoglobin 151, RBC-5.21, HCT-45.9, RDW-SD-24.6. PDW-51.9. Bilirubin-5.60, cholesterol-7.46. The therapist prescribed an equator 1 tab at night and 1 tab in the morning, and dopiget 1 tab, atervasterol, but the pressure at first decreased, she drank for a month, now weakness, sweating appeared, especially in the morning and an increase in pressure of 190/95mm. Pulse increased 85-100. Please advise what to do? good doctors are a problem...

19. Irina

    Woman 77 years old. I take enalozide 12.5 and bisoprol 10.0. I was also advised to take cardiomagnyl. can they be combined? and in connection with the lack of calcium, especially in winter, what vitamins with calcium would you advise me? Thank you for your attention!

20. Sergei

    Hello! I am 59 years old height 163 weight 76 kg. On January 20, unpleasant pains behind the sternum appeared. pressure was 176 to 98. Pulse 58. I only tested for cholesterol. He was 8.2. They prescribed indapamide, lisinopril, amlodipine, thrombo ass, atoris. Course 3 months. Now the pressure is 115 to 76, but the pain behind the sternum remains. Should I continue treatment or stop? And are these drugs compatible with the fact that I also have gout?

21. Oksana

    Mom is 82 years old. In winter, the pressure rises sharply. The ambulance knocks down the pressure with injections, but after a day or two, the upper jumps up to 220 again begin and the pulse quickens to 140. Nifedipine tablets reduce pressure and metoprolol normalizes the pulse. Tell me, in addition to these drugs, is it possible to take the vasodilating piracezin of Belarusian production, and if so, at what dosage? Thank you.

22. Lena

    Mom is 61 years old, 90 kg weight, 168 cm height. She was in the hospital. A diagnosis of secondary hypertension was made. At night there are severe pains along the spine. Tell:
    1. What painkillers can be taken by hypertensive patients in this case?
    2. He suffers from coughing from one of the drugs of the "ACE inhibitors" group. Will a group of antiallergic drugs help, if so, which of this group can be taken?
    Thanks in advance!

23. Elina

    Hello! My mother is 58 years old, weight 85, height 165. There is obesity, doctors also made many diagnoses: osteoporosis, arterial hypertension, atherosclerosis, type 2 diabetes, kidney stones (2 mm in the left pelvis, there are attacks), vasculitis .
    I accidentally came to this site as I started looking for information on how to help my mother. She drinks a lot of pills and I worry about her. We recently lost our father, he died sitting on the couch in a matter of seconds - his heart stopped, foam came out of his mouth and his eyes rolled back, even the ambulance did not have time. He was diagnosed with coronary heart disease, but our doctors said it was okay, and dad was at home as usual. He worked hard and drank his blood pressure pills. And now I don't want to lose my mom, please help. How and where to start a good treatment? I read about the low carb diet here. But as you can see, mom has a lot of diagnoses and is such a diet suitable for her? She is used to eating fried foods, sweets and canned food, sausages, sausages. I don't know how to wean her and what kind of food to cook for her so that she can be cured. There is a lot of talk about physical activity, but she sits on the couch after work and watches a lot of TV shows. I try to take her out for a walk, but she says that she is tired after work and her legs hurt. Can she get an exercise bike? Please advise. Although in the evenings she has pressure when I measure and then her ears are blocked. To reduce sugar every day in the morning on an empty stomach, she drinks Amaryl, then Siofor after meals. Then from pressure Noliprel. Likewise in the evening. Mom's sugar can reach up to 15. I'm sorry that I painted everything like that, but I will wait for your detailed answer. Thank you!

24. Tatiana

    Hello, I am 47 years old - I was on sick leave, hypertensive crisis. They prescribed Lozap plus, betalok and normodipine at night. Ambulance - nifedipine. I've had high blood pressure since I was young, and my mother also suffered a lot from pressure. I rarely took pills, but not out of ignorance - I am allergic to so many drugs. Food allergies and most importantly an allergy to milk. They prescribed me nifedipine. I always read the composition, showed an analysis for lactose intolerance, to which there was a shrug from the doctor. I tried to find out in pharmacies which medicine for pressure can be taken for lactose intolerance - no one knows. From the aforementioned drugs - she simply survived with difficulty. I was only able to drink for four days. There was a cough and the heart presses. Doctors explain that this is how it should be. I did an EKG and everything is fine. Please answer, are there non-lactose pressure pills? I have now stopped taking the prescribed pills. Slowly I come to my senses, being treated for rash and suffocation with histamine preparations. And yet - is it right to take such drugs immediately if you have not taken pills before? It seems to me, it is necessary to begin at least with one medicine? Thank you in advance.

25. Nicholas

    Hello! Tell me, please, did the sanctions affect Russian banks? I need to order and receive a plastic card to buy American supplements from the iHerb online store. Now I take our supplements, but not in shock doses. I am 67 years old, weight 90 kg, which is decreasing little by little. I have been on a low carb diet for six months. For the last six months, I did not begin to control the pressure, but it jumped the upper 160-205, the lower 85-125. My lumen in the aorta of the left ventricle was 60% 4 years ago and ultrasound showed that the heart was deployed with the left ventricle forward. Please advise what action I should take. Thank you very much for the articles, they opened my eyes to a lot.

    Good afternoon! The doctor prescribed drugs lerkamen, cardosal and physiotens. I have been taking these drugs for a year now, but for the last month the pressure has started to jump - it reaches 150/95. I told the doctor about pressure surges - she replied that this could not be, these are the best drugs. As a result, you have to drink lerkamen, cardosal, and then after 1-2 hours take more physiotens. I don't even know what to drink. Maybe leave one physiotens?

26. Dmitry

    For many years, my wife took Adelfan from pressure. Now this drug has disappeared from pharmacies. They say it has been discontinued. And what can replace it? We have hypertension of the second degree. By evening, the pressure is constantly 180-200 / 80-90 mm Hg. Art. Thank you. Height 164 cm, weight 62 kg, age 73 years.

27. Pyatkin Sergey

    I am 77 years old, height 173 cm, weight 98 kg. Hypertension, coronary artery disease, CHF, atrial fibrillation. Associated: gout. Appointed: Atoris, Warfarin, Lisinopril, Hypothiazid. Against the background of taking these drugs, gout worsened. What antihypertensive drugs can be taken for gout?

28. Elena

    I am 58 years old, height 152 cm, weight 64 kg. Upper pressure is high, lower pressure is low. Sometimes 160/60, 170/70, today 163/67. I took Enap - the pressure did not decrease. I am now taking Diroton 0.5 tablets in the morning and in the evening - there is no result. The cardiogram shows dystonia of the left ventricle, and everything is within the normal range. Cholesterol 56. Sugar 4.8. Help me find a medication to lower my blood pressure. Thank you!

    Hello!
    Mom was discharged with a diagnosis of CVD, acute ischemic stroke, atherosclerosis of the BCA, stenosis of the right RCA up to 30%. Moderate tortuosity of both VAs in the first and second segments. Hypoplasia of the right PA. IHD, cardiosclerosis, angina pectoris, NRS - extrasystoles, retinal sclerosis, difficulty in speech, smoothed n / g fold on the left side, feelings are preserved, walks independently, there is weakness in the left arm and leg.
    Appointment of a cardiologist at discharge: diroton, bisoprolol, amlodipine, memoplant, thrombo ass at night.
    While drinking diroton and metoprolol in the morning, amlodipine, ginkgo biloba, thrombo ass at night, magnelis B6, kudesan, 1 teaspoon of fish oil in the evening.
    As prescribed by the cardiologist - bisoprolol, but so far we are gradually increasing the dosage, we started with metoprolol. And the dosage of diroton was lowered on the advice of a cardiologist due to a decrease in pressure. I think to remove it completely if the pressure stays 110-120 by 60-70.
    Biol (bisoprolol) tablets come in 5 mg - can it be chopped into 4 parts if the dosage is not suitable?
    And is it possible to refuse thrombo ass instead of fish oil and ginkgo biloba?

29. Radim

    I am 55 years old, weight 90 kg, height 173 cm. I have been suffering from hypertension for seven years. Now the pressure is holding 150-180/90-115. Took diroton, equator. Now something doesn't work at all. The pressure does not drop. In addition, there was also gout. It seems that he is athletic, I don’t smoke, I don’t drink alcohol, I’m fond of swimming, I ride a bike, I do dumbbells, I box a pear, I do qigong exercises in the morning. Was under the care of a cardiologist. I was examined, but no special sores were found in me. Slightly elevated uric acid. The left ventricle of the heart is enlarged, there are no kidney stones. I work as a driver. Can you recommend any medicine for hypertension? Thank you!

30. Nina Victor ovna

    I am 72 years old, weight 82 kg. Hypertension for a long time, about 15 years. Now there is also an arrhythmia. I take propanorm, concor or valz n. Valz was recently replaced with edarbi clo due to addiction. After that, the pressure dropped to 90-100, although she was already taking up to a quarter of a 40 mg tablet. I tried to cancel edarbi klo - I got a hypertensive crisis with a pressure of 170 and vomiting. Advise on what to replace? The arrhythmologist does not allow to remove propanorm and bisoprolol.

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How to cure hypertension on your own
in 3 weeks, without expensive harmful drugs,
"hungry" diet and heavy physical education:
free step by step instructions.

More than half of the adult population suffer from hypertension (AH). This number increases sharply after age 60. If in the West 70% of the population – sometimes they control their disease, then in the countries of the post-Soviet space, the picture is inversely proportional, about 60% do not achieve control, someone does not try to do it, others fail.

To show the importance of the problem, to help people choose the right drug, we have prepared useful information with a list of the most effective drugs for high blood pressure, we hope that with their help it will be possible to lower blood pressure on their own.

Main:

1. Diuretics (indapamide and chlorthalidone)
2. ACE inhibitors (act on renin –
3. Calcium channel blockers (CCBs)
4. Angiotensin II receptor blockers (act on renin – angiotensin-aldosterone system)
5. Beta blockers.

Minor:

1. Alpha blockers.
2. Means of central action.
3. Direct acting vasodilators.
4. Direct renin inhibitors (act on renin – angiotensin-aldosterone system)

They begin treatment with uncomplicated GB (first - second stage of hypertension). The tablets are ideal for patients over 60 years of age, young women, with the exception of those with diabetes or gout.

Low-dose thiazide diuretic implies the use of low daily doses – hydrochlorothiazide, chlorthalidone, indapamide, which do not exceed 12.5 mg, 12.5 mg and 1.5 mg, respectively.

With their use, side effects, metabolic disturbances are minimal compared to other groups.

Main advantages: efficiency, availability, low cost.

ACE inhibitor

Uncomplicated and mild hypertension responds better to diuretics. In complicated hypertension (diabetic nephropathy or left ventricular wall thickening with impaired function), there is a need for more rational therapy.

ACE inhibitors reduce peripheral vascular resistance without affecting the activity of the heart and heart rate, reduce the progression of damage to the kidney vessels within three months by about 30%, reduce the mass of the left ventricle in severe cardiac hypertrophy. Read more about ACE inhibitors in our section.

Pros: well tolerated, do not affect the level of uric acid and glucose, recommended for patients with diabetes and gout, affordable. In all international recommendations for the treatment of arterial hypertension (AH) are in the first place.

Flaws. In some patients, they cause a constant dry cough, which forces them to abandon the ACE inhibitor, then you can switch to a similar group - blockers angiotensin II receptors (ARBs). Review of recent ACE inhibitors.

Calcium channel blockers (CCBs)

They are suitable for all hypertensive patients, they are the best choice for people with impaired cerebral circulation, with a normal or low pulse.

The decrease in CCB pressure is based on various mechanisms: vasodilation, a decrease in the force of contraction of the heart, a slowing of the heart rate, and a decrease in the production of aldosterone. They serve as a better option than taking high doses of diuretics, but this does not apply to all subtypes of calcium channel blockers. Learn more about calcium channel blockers.

Pros: patients taking CCBs are less likely to have a stroke than those in the beta group – blockers or thiazide diuretics.

Flaws. Tolerability depends on the type of drug used. Patients taking dihydropyridine blockers may develop headache, flushing, or swelling of the extremities (peripheral edema). Non-dihydropyridines (diltiazem, verapamil) lead to slow heart rate, headache, nausea on diltiazem, or constipation (on verapamil). Review of the latest BPC.

Sartan group or angiotensin II receptor blockers (ARBs)

The mechanism of action of ACE inhibitors and ARBs is the same and at the same time different. Both classes act on the renin system – angiotensin – aldosterone. ACE inhibitors block the formation of angiotensin II and, therefore, remove vasospasm, excess water retention, and sympathetic activation.

Pros: have fewer side effects than ACE inhibitors (cough, angioedema), have a stronger blocking of angiotensin II. Do not affect biochemical parameters – cholesterol, glucose, uric acid levels. They are the best choice for kidney disease . Detailed information about BRA.

Flaws: high price. It is impossible to use ACE inhibitors and other sartans at the same time, this combination is dangerous for the kidneys. Review of the latest sartans.

Beta blockers

In recent years, this group has lost its leading position in the recommendations. They are not as effective in preventing stroke, cardio – vascular events. Learn more about beta blockers.

Pros: they are preferred for people with an increased tone of the sympathetic system (tachycardia, heart failure, trembling, agitation).

Flaws: reduce sexual function, cause fatigue, weight gain, increase blood sugar. Undesirable in heart failure. With an incorrectly chosen dosing regimen, they can cause a slowdown in the heart rate up to fainting. Overview of the latest beta blockers.

Alpha blockers

They can quickly, effectively relax and reduce the tone of the involuntary muscles of blood vessels, thereby lowering blood pressure. There are only 3 drugs in this group: doxazosin, prazosin and terazosin.

Main advantages: strong drugs, quickly reduce pressure. It is indicated for older men with prostatic hyperplasia because it relaxes the smooth muscles surrounding the prostate, making it easier to urinate. They are useful for hypertensive patients with high cholesterol levels. Learn more about alpha blockers.

Flaws: may cause dizziness, especially when standing, increase the risk of heart failure, therefore not suitable for continuous long-term use.

Direct vasodilators

They expand arterioles well, without dilating the venous system. The group is represented by two drugs – hydralazine and minoxidil. Minoxidil is often used for persistent high blood pressure that does not respond to other agents.

Advantages: successfully control hypertension. They are still useful in patients with renal dysfunction, persistent hypertension, in pregnant women with high blood pressure (hydralazine). Hydralazine is also used to treat heart failure along with isosorbide. Learn more about direct vasodilators.

Flaws. It has a fairly short half-life, which requires frequent doses throughout the day. Cause headache, constipation, swelling of the lower leg, palpitations. These effects are usually minimized when a vasodilator is combined with a beta – blocker.

Central sympatholytics

Increased pressure is often accompanied by excitation of the sympathetic nervous system. Medicines in this group block substances that activate it. You can get an idea about this group if you remember the old, "good" – clonidine, which is now rarely used.

Pros: are powerful agents. Can hypertension in pregnancy be treated? – methyldopa). They relieve palpitations, anxiety, improve kidney function, thinking in elderly patients, reduce hot flashes during menopause, and have a sedative effect.

Flaws: cause a sharp drop in blood pressure, especially when standing up, dry mouth, depression, erectile dysfunction. Not recommended for long-term permanent treatment. More about central sympatholytics.

Direct renin inhibitors

Under normal physiological conditions, renin is released in response to a decrease in blood pressure. ACE inhibitors and ARBs interrupt its formation when blood pressure rises, but renin can still be released, then direct renin blockers come to the rescue. Learn more about direct renin inhibitors.

Pros: blocks the renin-angiotensin-aldosterone system at the starting point of its activation. Not bad stabilize the pressure throughout the day.

Disadvantages: So far, there is only one Aliskiren (Rasilez) drug on the market at a high price.

Rating of the most effective drugs for high blood pressure with a brief description

There is no "best" hypertension medication that works well for almost everyone. Even each doctor uses his own list of prescribed drugs based on practical experience and purchasing power.

It is important to maintain adherence to therapy. Therefore, the medicine should have a minimum of undesirable consequences, stop the progression of the disease, work quickly and for a long time, be affordable, given that you need to be treated for life, even perfectly matched pills stop working over time.

A fairly wide selection of drugs allows you to choose the ideal therapy regimen on your own or together with your doctor. The main thing is not to lose hope, to continue the search for an effective remedy, not to let the disease take its course.

To1 10 best pills:

1. Indapamide

Indapamide (Arifon-retard)

Belongs to the group of diuretics. In terms of risk – benefit" is the ideal medicine. Minimum harm to the body with a reliable reduction in high blood pressure. It is a pity that doctors rarely prescribe this group, because they seek help belatedly, when hypertension has already managed to change many organs and has acquired a complicated course.

Therefore, indapamide fits perfectly into combination therapy with other antihypertensive agents. Tablets should be drunk in small doses, you should not expect a pronounced diuretic effect, it is taken for another purpose - to stabilize blood pressure, to protect target organs from damage.

pros

• Well stabilizes pressure, treats hypertension.
• Single dose - 2.5 mg before meals
• Can be taken by patients with diabetes, obesity, the elderly
• Can be combined with all groups of antihypertensive drugs.

special instructions

• It is not recommended to take with a low level of potassium, sodium in the blood, with severe insufficiency of the kidneys, liver
• It is used in the treatment of uncomplicated hypertension 1-2 degrees (mild hypertension)

Indapamide is sold under different names (analogues):

• Indapamide №30 (Serbia) – 91 rubles.
• Indopamide No. 30 (Alsi Russia) - 26 rubles.
• Akripamid Akrikhin (Russia)
• Lorvas SR Torrent (India) - 92 rubles.
• Arifon – retard Servier (France) – 365 rub.
• Indapamide – Verte (Russia)
• Acripamide – retard (Russia)
• Indap Promed (Czech Republic) - 2.5 mg No. 30 - 106 rubles.
• Ravel SR (prolonged) KRKA (Slovenia) 1.5 mg №20 – 139 rub.

Belongs to the ACE group. It is the most prescribed drug in the world among all medicines. In second place after him is aspirin. The safety and efficacy of ramipril has been confirmed in numerous studies.

pros

• Good for stabilizing pressure
• Single dose, the first dose is best taken at bedtime. Start with 2.5 mg, then gradually increase to 5-10 mg.
• Widely used in the prevention of stroke, kidney failure, heart failure
• Available in tablets, capsules.
• It is the most studied drug.

special instructions

• Not to be taken by lactating and pregnant women, persons under 18 years of age.
• Possible cough, may lower blood sugar levels
• Tablets are recommended to be taken constantly, even after normalization of blood pressure.
• It is used in the treatment of uncomplicated and complicated hypertension 1-2 degrees.

Analogues:

• Ramipril 5 mg No. 30 Akrikhin (Russia) - from 177 rubles.
• Ramipril 5 mg No. 30 North Star (Russia) - 109 rubles.
• Hartil Egis (Hungary) from 397 to 505 rubles. depending on the dose
• Amprilan KRKA (Slovenia) - 5mg No. 30 - 407 rubles.
• Tritace Sanofi (France), 5 mg No. 28 - 986 rubles.
• Ramilong Lek farm (Belarus)
• Ramkor Ipka (India).

The drug blocks angiotensin II receptors, belongs to the group of sartans. Does not block the enzyme that destroys bradykinin, which reduces the undesirable manifestations of sartans (inflammation of the pancreas).

Systolic and diastolic blood pressure decreases after the first dose of Losartan, reaching a maximum after 6 hours. The effect persists for a day, but stable pressure stabilization will occur in 3-6 weeks.

pros

• Works fast and long
• A single dose of tablets - 25 mg - 50 mg - 100 mg per day until stable pressure stabilization.
• Good tolerance, minimal side effects
• Can be taken by patients with diabetes, gout, obesity, the elderly.
• Gradually reduces the wall thickness of the left ventricle, reduces cardiac weakness.
• Does not cause sexual dysfunction.

Cautions

• Nevertheless, minor adverse reactions are noted (up to 1%) - headache, dryness and nasal congestion, dizziness, heart rhythm disturbance, weakness.
• Released by prescription
• If it causes dizziness, then driving is limited.
• Tablets are recommended to be taken constantly, even after normalization of blood pressure.
• It is used in the treatment of complicated hypertension 1-2 degrees.

He has more than 50 analogues, produced under one (Losartan) or different names:

• Lozap 100 mg No. 90 Zentiva (Czech Republic) - 606 rubles
• Presartan 50 mg No. 30 - 149 rubles,
• Losartan 50 mg No. 30 Gedeon Richter (Hungary) - from 156 - 204 rubles.
• Kardomin-Sanovel,Turkey
• Lorista, KRKA (Slovenia)
• Blocktran, Pharm standard (Russia)
• Cozaar, Merck (Great Britain) - original (brand) 100 mg No. 14 - 140 rubles.
• Presartan, Ipka (India)
• Lozarel, Sandoz, (Slovenia)
• Agilosartan (India)
• Renicard, (India)
• Losacor Adifarm (Bulgaria)

Amlodipine is a dihydropyridine calcium channel blocker. Used alone or with other medicines to treat angina (chest pain) and high blood pressure (hypertension). In terms of popularity, it ranks seventh in the world among all medicines.

• Works for a long time
• A single dose - from 5 mg to 10 mg per day until stable pressure stabilization.
• Good tolerance.
• It is recommended for patients with cerebrovascular accident (MIC), the elderly.
• Patients with heart failure, after a stroke. Relieves angina (pain in the heart)
• Very often combined with other groups of antihypertensive drugs, it cannot be combined with non-dihydroperidine calcium channel blockers (verapamil, diltiazem).

special instructions

• Often causes swelling of the legs, headache, gum growth, palpitations, shortness of breath.
• Released by prescription
• Not to be taken by lactating and pregnant women, children under 6 years of age.
• May increase heart rate.
• Tablets are recommended to be taken constantly, even after normalization of blood pressure.

List of analogues:

• Norvasc Pfizer (USA) original drug 10 mg No. 30 - 890 rubles, 5 mg No. 14 - 249 rubles.
• Normodipin, Gedeon Richter (Hungary) - 5 mg No. 10 - 196 rubles.
• Tenox, KRKA (Slovenia)
• Amlotop, Nizhpharm (Russia) 5 mg No. 30 - 80 rubles.
• Vero-Amlodipin, Veropharm (Russia)
• Kalchek, Ipka (India)
• Cardilopin, Egis (Hungary) 5 mg No. 30 - 253 rubles.
• Amlovas, Unique (India)
• Amlodak Kadila (India)
• Stamlo, Doctor Reddis (India) 5 mg No. 14 - 126 rubles.
• Amlorus Synthesis (Russia) 5 mg №10 - 62 rubles.

Recently, a new generation of amlodipine has appeared - levamlodipine or S – amlodipine (Eskordi Kor), it is stronger than amlodipine, it controls pressure better. You will have to pay for 2.5 mg No. 30 – 282 rub.

Modern ACE inhibitor. It has the longest duration of action among ACE inhibitors, thus preventing the morning "splash" of pressure increase.

pros

• Start with 2.5 mg, then gradually increase the dose to 5-10 mg
• Widely used in the prevention of stroke, kidney and heart failure, after myocardial infarction.
• Patients with diabetes, obesity, the elderly can take. Patients with impaired cerebral circulation.
• Does not affect the activity of the heart, does not change the pulse
• It is used in the treatment of complicated grade 1-2 hypertension and severe hypertension in combination with other drugs.

special instructions

• May cause cough, bronchospasm, rarely rash
• Not recommended for narrowing of the renal arteries.
• Not to be taken by lactating and pregnant women and persons under 18 years of age.
• Indicated for all patients with stable coronary heart disease, as it significantly reduces the risk of developing a heart attack (EUROPA study)
• Tablets are recommended to be taken constantly, even after normalization of blood pressure.

• Prestarium Servier (France) 5 mg No. 14 - 154 rubles, 10 mg No. 30 - 583 rubles.
• Perineva - Slovenia, (KRKA) 4 mg No. 30 - 210 rubles, 8 mg No. 90 - 900 rubles.
• Parnavel - (Russia, Ozone) 5 mg No. 30 - 124 rubles.
• Coverex Egis (Hungary)
• Arentopres, Torent (India) 4 mg №10 - 109 rubles.

Moxonidine has been used for over 20 years. The drug acts on the central mechanisms of the development of hypertension, more precisely on the brain structures.

Despite the fact that it does not apply to first-line drugs, it is considered an indispensable tool in the first-aid kit of hypertension for stopping the crisis. Handles high blood pressure quickly. At the same time, it positively affects the level of glucose, lipid profile.

The combination of moxonidine with other antihypertensive agents (ACE inhibitors, sartans, CCBs, and diuretics) may be ideal in the long-term management of severe hypertension.

Do not use moxonidine if your heart rate is low (below 45 – 50 strokes), A-B blockade of the 3rd degree, severe cardiac weakness; you can easily lose consciousness.

pros

• Quickly reduces pressure (within an hour), the effect persists for a long time (24 hours)
• Start with 0.2 mg, then gradually increase the dose to 0.4 mg
• It is widely used in the prevention of stroke, kidney and heart failure, after myocardial infarction.
• Can be taken by patients with diabetes, obesity, cerebrovascular accident, the elderly. It reduces bad fats, in menopause, enhances the breakdown of fats, therefore it is indicated for obese people.
• Unlike clonidine, it does not cause rebound hypertension, there is no sedative effect, especially when prescribed at night.

Special instructions:

• Contraindicated in sick sinus syndrome, severe bradycardia (pulse below 50 beats), A-B blockade of 2-3 degrees, heart failure of 3 degrees. Cannot be combined with beta blockers.
• May reduce cough from ACE inhibitors
• Not to be taken by lactating and pregnant women, persons under 18 years of age and over 75 years of age.
• Often there is dry mouth, headache, dizziness. Dry mouth can be treated with amlodipine at night
• Tablets are recommended to be taken to stabilize blood pressure during a crisis or in combination with other first-line drugs (diuretic, CCB)

• Moxonidine SZ (Russia) - 0.2 mg No. 14 - 121 rubles, 0.4 mg No. 14 - 202 rubles.
• Physiotens Abbott (France) - 0.2 No. 14 - 211 rubles.
• Moxogamma Verwag Pharma (Germany)
• Moxonitex Sandoz (Slovenia) 0.2 No. 14 - 200 rubles.
• Moxarel Vertex (Russia) 0.2 No. 14 - 107 rubles, 0.4 No. 30 - 426 rubles.
• Tenzotran Actavis (Iceland) - 0.2 No. 14 - 138 rubles.

This angiotensin II receptor blocker is a leader in prescriptions from physicians around the world. If you were forced to give up ACE inhibitors because of a cough, then you should pay attention to valsartan - an excellent modern representative of this group.

pros

• Works efficiently and for a long time
• Single dose - 160 mg per day. After 2 hours, the medicine begins to act. Monotherapy for mild to moderate hypertension is 320 mg daily, better than 160 mg daily.
• Good tolerance, minimal side effects. Increasing doses does not increase side effects.
• Can be taken by patients with diabetes, gout, obesity, the elderly
• Gradually reduces the wall thickness of the left ventricle, reduces cardiac weakness
• Can be combined with other groups of antihypertensive drugs, except for ACE inhibitors and sartans.
• Positive effect on sexual function. Improves the cognitive abilities of the elderly.

Cautions

• Minor adverse reactions are noted (up to 1%) - upper respiratory tract infection, sinusitis.
• Released by prescription
• Not to be taken by lactating and pregnant women, children under 6 years of age.
• Tablets are recommended to be taken constantly, even after normalization of blood pressure.
• It is used in the treatment of complicated grade 1-2 hypertension and in combination with other antihypertensive drugs, especially diuretics.

• Valsartan Vertex (Russia) - 160 mg No. 30 -316 rubles.
• Valz, Actavis (Iceland)
• Valsakor KRKA, (Slovenia) - 80 mg No. 28 - 383 rubles, 160 mg No. 90 - 850 rubles.
• Diovan, Novartis (Switzerland) - 160 mg No. 28 - 2383 rubles.
• Nortivan, Gedeon Richter (Poland)
• Valsafors, Pharmaplant (Germany)
• Tontordio, Torrent (India)
• Artinova Ranbaksi (India)
• Sartavel Ozon (Russia)
• Valaar (Russia).

Cardioselective beta – blocker. It comes in two forms: metoprolol tartrate and succinate. Of interest is metaprolol succinate, because it has a long-term effect (for example, Betalok ZOK or Egilok S), which allows you to eliminate sharp fluctuations in blood pressure, tartrate has a shorter effect.

Metoprolol will perfectly replace anaprilin, while it will last longer and cause less harm to the body.

pros

• It works for a long time when prescribing prolonged (retard) forms (metoprolol succinate).
• Tablets of 25-50-100 mg. Double dose - 100-200 mg 2-3 times a day until stable pressure stabilization. For retard forms (Betalok ZOK) - 1 time per day.
• Good tolerance, metoprolol succinate can be used in patients with diabetes, it also has an anti-atherosclerotic effect
• It is recommended for patients with pain in the heart (angina pectoris), arrhythmias, long QT syndrome, hyperthyroidism, for the prevention of migraine.
• Relieves social anxiety and other types of anxiety.
• Patients with congestive heart failure. Relieves an attack of angina pectoris (pain in the heart). Has antiarrhythmic properties.
• Very often combined with other groups of antihypertensive drugs.

special instructions

• Causes dizziness, fatigue, sleep problems, depression, cold extremities - at high doses. It is impossible with bradycardia (pulse up to 50 beats per minute). Not recommended for patients with diabetes.
• Released by prescription
• Cannot be prescribed for sick sinus syndrome, A-B blockade, bradycardia (pulse less than 55 beats per minute)
• Tablets are recommended to be taken constantly, even after normalization of blood pressure.
• In the treatment of hypertension complicated both in monotherapy of 1-2 degrees, and in combination with GB of 3 degrees

• Betaloc ® (metoprolol tartrate) Astra Zeneca (England) - 100 mg No. 100 - 420 rubles.
• Betaloc ® ZOK (Metaprolol succinate), Astra Zeneca (England) - 100 mg No. 30 - 424 rubles.
• Vasocardin (metoprolol tartrate), Zentiva (Slovenia), 100 mg No. 50 - 45 rubles.
• Vasocardin retard, Zentiva (Slovenia)
• Corvitol ® 100 (Metoprolol tartrate), Berlin Chemie (Germany)
• Metoprolol (tartrate), Organics (Russia) - 50 mg No. 30 - 30 rubles.
• Serdol (tartrate), Labormed Pharma (Romania)
• Egilok (metaprolol tartrate) Egis (Hungary) - 100 mg No. 30 - 135 rubles.
• Egilok ® Retard (metoprolol tartrate) Egis (Hungary) - 50 mg No. 30 - 135 rubles.
• Egilok S (metoprolol succinate) Egis Hungary - 100 mg No. 30 - 232 rubles.
• Emzok (metoprolol tartrate), Ivaks (Czech Republic)
• Azoprol retard (metoprolol succinate), Emkyor, India

Bisoprolol is the most cardioselective beta-blocker, well tolerated, has a low incidence of side effects such as bronchospasm, sleep disturbance, erectile dysfunction. Bisoprolol can be an excellent alternative to anaprilin (an old remedy), which is taken once a day.

pros

• Works for a long time
• Tablets of 5-10 mg, with increasing doses, the high selectivity of the action is lost.
• Good tolerance, bisoprolol can be used in patients with diabetes, glaucoma, bronchial asthma, obesity, does not cause sexual dysfunction.
• Recommended after a heart attack, arrhythmia, angina pectoris (heart pain), with chronic heart failure
• Patients with weakness of the heart and edema. Has antiarrhythmic properties.
• Very often combined with other groups of antihypertensive drugs. Do not combine with verapamil and diltiazem.

Cautions

• Causes dizziness, fatigue. It is impossible with bradycardia (pulse up to 60 beats per minute).
• Released by prescription
• Not to be taken by lactating and pregnant women, children under 18 years of age.
• It should not be prescribed for sick sinus syndrome, A-B blockade, bradycardia (pulse less than 60 beats per minute), psoriasis.
• Tablets are recommended to be taken constantly, even after normalization of blood pressure.
• In the treatment of hypertension complicated both in monotherapy of 1-2 degrees, and in combination with GB of 3 degrees

• Concor Merck (Germany) 10 mg No. 30 - 280 rubles.
• Coronal Zentiva (Slovakia) 10 mg №30 - 200 rubles.
• Biol Sandoz (Slovenia) 10 mg No. 30 - 207 rubles.
• Bidop Nish Generic (Ireland) 10 mg No. 28 - 247 rubles.
• Aritel Canon Pharma (Russia) 10 mg No. 30 - 133 rubles.
• Biprol Chemo Pharm (Russia) 10 mg No. 30 - 189 rubles.
• Tirese Alkaloid (Macedonia) - 5 mg No. 30 - 117 rubles.

The very first representative of the ACE. It remains popular at the present time, because it copes with its tasks, but at the same time it costs a penny, which suits many, given the need for lifelong admission.

pros

• Pressure decreases gradually
• Start with 5 mg, then gradually increase the dose to 10-20 mg. You can up to 80 mg per day.
• Widely used in the prevention of stroke, kidney and heart failure, after myocardial infarction, but better in combination therapy.
• Eating does not affect the effect of the medicine.
• It is a cheap drug.

special instructions

• Short period of action. Must be taken twice a day.
• Not recommended for narrowing of the renal arteries. You need to control the picture of blood and sugar.
• Not to be taken by lactating and pregnant women and persons under 18 years of age.
• Often there is a cough, rash, nausea. At high doses - impotence.
• Tablets are recommended to be taken constantly, even after normalization of blood pressure.
• It is used in the treatment of uncomplicated hypertension, in combination with other pressure drugs in complicated hypertension.
• Does not affect the activity of the heart, does not change the pulse.

Analogues of Enalapril:

• Berlipril Berlin Chemie (Germany) 20 mg No. 30 - 112 rubles.
• Invoril Ranbaxi (India)
• Renipril Pharm standard (Russia)
• Renitek Merck (Netherlands)
• Ednit Gedeon Richter (Hungary)
• Enalapril Ozone (Russia) 10 mg No. 30 - 20 rubles.
• Enap KRKA (Slovenia) 10 mg №20 - 52 rubles.
• Enal (India)
• Enam Doctor Reddis (India)

Pills for hypertension with a quick effect (table)

For effective management of arterial hypertension, it is desirable to have antihypertensive drugs with a quick effect in the first-aid kit. They will help relieve the growing pressure, prevent the occurrence of a hypertensive crisis.

Short-acting, fast-acting drugs are not suitable for long-term use, they can be taken occasionally as an "ambulance". It is best to put the tablet under the tongue, so it will begin to act faster.

The decrease in pressure should not be aggressive, it is recommended to gradually reduce it by 25% of the initial level within a few hours, focusing on the general condition, then switch to the planned intake of long-acting drugs.

Pills for hypertension prolonged action (table)

These drugs can be used for long-term use, they are applied once a day. The effect is cumulative, persistent normalization of blood pressure occurs by the end of 4 weeks.

Combined means to reduce high blood pressure (table)

When it is not possible to reduce pressure with a single prolonged agent, a combination of two or three antihypertensive drugs in low doses is resorted to. This approach is safer than prescribing a single drug at a higher dose.

Rating of effective combined drugs for high blood pressure with their description

At one time, many appreciated the effective combination of 3 drugs of reserpine, hydrochlorothiazide and hydralazine called Adelfan.

Indeed, the combination of drugs increases the strength of action, reduces undesirable consequences.

Ideal combinations of the following antihypertensive groups:

1. Diuretic (thiazide) + angiotensin-II receptor blocker;
2. Diuretic (thiazide) + CCB (calcium antagonists);
3. Diuretic (thiazide) + ACE inhibitor;
4. Calcium antagonist + Angiotensin-II receptor blocker;
5. ACE inhibitor + calcium antagonist.

They are safe and quite effective, all other combinations are either contraindicated or undesirable.

1. triplixam
2. Ko exforge (Ko Vamloset)
3. Tarka
4. Prestans or Bee prestarium
5. Equator
6. Equapress
7. Enziks.

Edarbi Clo Takeda (USA)

Diuretic + Angiotensin Receptor Antagonist
Edarbi Clo Takeda (USA)
Azilsartan medoxomil 40 mg + Chlorthalidone (12.5 to 25 mg)
Once a day
One of the most modern combinations

Adenosine converting enzyme inhibitor (ACE inhibitor) + diuretic + calcium channel blocker
Triplixam Perindopril arginine 5 mg
Indapamide 1.25 mg
Amlodipine 5 mg
Has a triple action, one tablet a day in the morning before meals
It is used in the treatment of severe GB.

The cost in pharmacies from 674 rubles. (low doses), 846 rubles. - high doses.

Calcium channel blocker
angiotensin II receptor blocker
diuretic
Co exforge Amlodipine 5 mg
Valsartan 160 mg
Hydrochlorothiazide 12, 5
once
A new triple action drug.

• Co exforge (low dosage) No. 28 - 1700 rubles, high dose - 2567 rubles.
• Ko Vamloset KRKA (Slovenia) - (low dose) #30 – 640 rubles, high – 732 rub.

prestance

Amlodipine ACE inhibitor
calcium channel blocker (CCB)
Proven, state-of-the-art

Prestans No. 30 from 596 rubles, high doses No. 30 – 762 rub.

Dalneva KRKA (Slovenia) No. 30 - from 372 rubles. up to 900 rubles for 90 high dose tablets.

Equator Gedeon Richter (Hungary)

Calcium channel blocker
ACE inhibitor Equator amlodipine 5 mg
lisinopril 10 mg;
Once a day
Effective remedy
suitable for the elderly

Price in pharmacies:

• Equator Gideon Richter #30 – from 492 rub. up to 633 rub. (high doses)
• Tenliza KRKA (Slovenia) №30 – 499 rub.
• De-crisis Medisorb (Russia) from 179 rubles. (low doses), 320 rubles. (high doses).

Tarka
calcium channel blocker
ACE inhibitor
Verapamil prolonged
trandolapril
One capsule in the morning after meals.
Not possible with a low heart rate (less than 55 beats)

Tarka №28 – from 660 rubles up to 737 rubles.

Equapress
ACE inhibitor
diuretic
calcium channel blocker

Indapamide + lisinopril
Triple combination drug

The cost of Equapress No. 28 in pharmacies is from 532 rubles. up to 739 rubles. (high doses)

Enziks
ACE inhibitor + diuretic
Enalapril + indapamide
Good quality + affordable price

• Enziks Hemofarm Serbia №30 from 150 rub. (low dose), 320 rubles. (high doses).
• Enziks duo №45 from 199 rubles. (low doses) up to 335 rub. (high dose)
• Enziks duo forte №45 – 424 rub.

How to choose the right antihypertensive drug

Choosing the right drug is an equally important part of treatment. It is necessary to understand what is happening in the body, causing a persistent increase in blood pressure.

Our goal- choose the right medicine, taking into account the damage to target organs, strive to restore them, reduce pressure smoothly, realize and accept the fact that treatment should be carried out for life.

At the first stage We will try to find out the specific reason for the increase in blood pressure. The table discusses the main causes, indicates the optimal drug for this pathology.

Choice depending on the reason:

In order to determine which organs – targets are affected, it is necessary to undergo an examination: ECG, echocardiography, radiography (reveals myocardial hypertrophy, rhythm disturbance), ultrasound of the walls of arteries, great vessels, look at the presence of protein in the urine, nitrogen and creatinine in the blood (for kidney damage), check the fundus ( hemorrhages, swelling of the nipple).

Groups of preferred drugs to protect affected organs

Arterial hypertension, or hypertension, is one of the most common cardiovascular diseases. According to statistics, about 22% of the population suffers from it. There are many reasons why blood pressure increases in the arteries. Among them are hereditary predisposition, and age (over the years, the likelihood of “earning” hypertension, of course, increases), and unbalanced nutrition, for example, excessive salt intake, and obesity, and decreased physical activity, and many other factors. In general, among people over the age of 40, hypertension is the rule rather than the exception. This disease has become so commonplace that many people perceive it calmly and without panic, and often do not even go to the doctor, noticing a steady increase in tonometer readings. And absolutely in vain.

Despite the fact that arterial hypertension is often asymptomatic and can indeed be well tolerated and even sometimes not noticed by patients, it deals a devastating, powerful blow to human health. The risks associated with untreated high blood pressure are large and varied. Among them:

• increased risk of premature death. Hypertension is known to be the most important preventable risk factor for premature death in the world;
• increased risk of coronary heart disease;
• increased risk of peripheral vascular disease;
• a sharp increase in the likelihood of heart failure, atherosclerosis, chronic kidney disease, pulmonary embolism;
• increased risk of dementia - mental decline and other diseases.

All these facts eloquently indicate that ignoring high blood pressure is a gross mistake that can cost health, and sometimes life.

Fortunately, modern (new, as consumers call them) antihypertensive drugs allow you to tightly control this disease: according to studies, a permanent decrease in pressure of only 5 mm Hg. in hypertensive patients reduces the risk of stroke by 34%, coronary heart disease by 21% and significantly reduces the likelihood of developing most complications of hypertension.

Now it's time to tell what the modern pharmaceutical industry offers to hypertensive patients, and which pressure pills really work and save lives.

old guard

And first, we will pay a little attention to the long-known very inexpensive drugs for high blood pressure, which are often preferred by older people, considering them "good", including Adelfan, Andipal, Papazol, Dibazol. It should be noted that only the first drug, Adelfan, differs in sufficient power from the above list. The rest of the drugs have an extremely slight hypotensive effect, and “pressure pills” can only be called conditionally - they slightly dilate the blood vessels and show an antispasmodic effect.

But Adelfan can be fully attributed to the means of high pressure of the "old formation". It is a combination of three antihypertensive drugs at once:

• reserpine;
• dihydralazine sulfate;
• hydrochlorothiazide.

The first reduces blood pressure and heart rate, and also has some sedative effect. The second lowers the tone of the muscles of small arteries - arterioles, and the third shows a diuretic effect, which also helps to reduce pressure after taking the pills. Such a powerful combination allows you to really reduce high blood pressure in a short time, and that is why Adelfan, despite his advanced age and many competitors, is still in demand among a certain circle of patients. However, it is actually a very unsafe drug.

First, it dramatically lowers blood pressure. Imagine constricted blood vessels, which literally expand dramatically in a few tens of minutes. If this experiment is repeated many times (and this is exactly what the fans of Adelfan do, and sometimes several times a day), the vessels quickly lose their inherent elasticity. This contributes to a sharp increase in the risk of developing atherosclerosis and, as a result, an increase in the likelihood of cardiovascular accidents, and not a decrease!

Secondly, a sudden and powerful decrease in blood pressure, which can occur after taking even half or less of an Adelfan tablet, is accompanied by extremely unpleasant clinical symptoms, including headache, dizziness, angina pectoris, and an increase in the number of heart contractions (tachycardia). In addition, the drug has a very solid list of other, often severe side effects.

Throughout the civilized world, combinations like Adelfan have not been used for many decades. And only in the territory of the post-Soviet space are these pressure pills still not only sold, but also in demand.

This is largely due to the ability to purchase antihypertensives and many other prescription drugs without a doctor's prescription. At the same time, the reviews of doctors and consumers, as well as data from clinical studies confirm that there are really safe and effective drugs for pressure in the pharmacy range, which not only stop the symptoms of hypertension, but also reduce its risks.

Classification of tablets from pressure

Throughout the civilized world, six different groups of drugs that reduce blood pressure are used. Let's say right away that it is not so easy for a person who is not versed in medicine to understand their features, but Russian consumers, who are ready to penetrate deeply into pharmacological details and carefully study the instructions for drugs, if desired and well served, can definitely cope with this task.

We list the same six groups of drugs used for high blood pressure:

• diuretics, or diuretics. Here it is immediately necessary to make a reservation that diuretics are different for diuretics, and it is definitely not worth rushing to take, for example, the powerful diuretic drug Furosemide, to reduce pressure;
• beta-blockers, or beta-adrenergic blockers;
• calcium channel blockers;
• angiotensin-converting enzyme (ACE) inhibitors;
• antiotensin II receptor blockers;
• alpha blockers.

The World Health Organization experts say that there is no data that would indicate a difference between various means of pressure in terms of effectiveness, safety and tolerability. But it is reliably known that antihypertensive drugs of different groups have different effects on the risks of hypertension, in particular, the risk of cardiovascular accidents, stroke and myocardial infarction. Some drugs significantly reduce it, while others have little or no effect.

How should blood pressure pills be prescribed?

Separately, I would like to draw the attention of readers to the fact that there are a number of principles according to which antihypertensive therapy is prescribed. These principles are accepted by the World Health Organization and are recognized throughout the world. It is on them that the attending physician should rely, who prescribes pills for high blood pressure. Let's list them.

1. Treatment of hypertension is always started with the lowest doses of drugs, with a minimum. If it is possible to achieve a positive result, continue therapy with low doses, if the pressure still remains above normal, the dosage of the drugs is increased. At the same time, attention is paid to the tolerance of drugs (if side effects appear, either reduce the dosage or change the drug).
2. One drug for adequate pressure reduction is often not enough. To increase the effectiveness of treatment, combinations of pressure pills from various (!) Groups are most often prescribed. It is much more correct to add one more medicine for hypertension to the treatment regimen than to increase the dose of a single drug. Thanks to this simple rule, you can take high blood pressure pills at the lowest dosages, which is much safer and comes with a minimum of side effects. We note right away that there are no remedies for high blood pressure without side effects at all, however, it is possible and necessary to minimize such manifestations.
3. If the treatment fails, it makes sense to switch to drugs from another group, rather than hoping for an improved response by increasing the dose.
4. Of all the drugs prescribed for pressure, it is better to choose those that act within 24 hours. This technique ensures the stability of pressure indicators and makes life easier for the patient himself, since it is enough to take such medicines only once a day.

When a patient with hypertension first visits a doctor, he is faced with the choice of a specific drug among a fairly large number of groups and a much larger number of active substances. What should the doctor's decision be based on?

First of all, on the economic possibilities of the patient. It is no secret that pressure pills vary greatly in price, and not all patients can afford to buy expensive drugs. In addition, the doctor takes into account the ability of drugs to reduce the risk of heart attack, the presence of other diseases in the patient, which may be an obstacle to prescribing a particular drug.

Table 1. General indications and contraindications for prescribing drugs for pressure

And now let's move on to a detailed description and list of drugs that are taken at high pressure, various pharmacological groups.

Diuretics like high blood pressure pills, or Diuretics

We will make a reservation right away that diuretics are rightfully considered one of the most important groups of antihypertensive drugs. Among their positive qualities:

• low price;
• high efficiency;
• good tolerance at recommended dosages (i.e., low chance of side effects);
• ability to reduce the risk of cardiovascular events.

List of diuretics, doses

For the treatment of high blood pressure, the so-called thiazide diuretics are used:

• hydrochlorothiazide, the maximum dose is 25 mg per day, and preferably 12.5 or 6.25 mg;
• indapamide (synonyms Arifon retard, Arifon, Indap, Ravel SR). The maximum daily dose is 2.5 mg, the optimal one is 1.25 mg.

It should be noted that thiazide diuretics exhibit a slight diuretic effect, but they have a powerful hypotensive effect.

In recent years, the loop diuretic torasemide (analogues Diuver, Britomar, Trigrim) has been used as a remedy for high blood pressure. It is prescribed at a dose of 5-10 mg per day.

According to the recommendations from 2014, thiazide diuretics should be prescribed to the majority of patients with uncomplicated hypertension. They are preferred in the treatment of elderly patients with systolic hypertension.

Side effects

Diuretics are generally well tolerated when used in minimal or moderate doses. Exceeding the recommended dosages can lead to a decrease in the level of potassium in the blood and an increase in the content of glucose and uric acid. The latter factor is a good reason not to use diuretics for pressure in patients with gout, which is characterized by an increase in the level of uric acid in the blood.

Beta-adrenergic blockers

Benefits of beta blockers include:

• Safety - they are well tolerated in most cases and when the dose is observed
• Cost-effective, as a rule, the cost of beta-blockers is quite affordable
• Efficiency.

However, it should be remembered that beta-blockers are categorically contraindicated in heart failure.

How do they work?

Beta-blockers block special receptors located in the heart. This leads to a decrease in the strength and frequency of heart contractions both at rest and during physical exertion, a decrease in myocardial oxygen demand and a decrease in blood pressure.

The decrease in pressure against the background of the appointment of most modern beta-blockers lasts for 24 hours after a single daily dose. It is important that pressure stabilization, that is, the achievement of a permanent hypotensive effect that provides normal performance, occurs only by the end of the second week of regular treatment. This must be remembered by patients who want to see an instant effect and complain about the lack of results after a few days of taking pills for high blood pressure.

Beta-blockers, according to studies, increase the survival of patients who have had a myocardial infarction by reducing the frequency of ventricular arrhythmias and angina attacks. Therefore, they are preferred in the treatment of hypertension after myocardial infarction.

Beta-blockers are prescribed not only for arterial hypertension, but also for a number of other diseases of the cardiovascular system, including:

• angina;
• acute myocardial infarction;
• tachycardia (increased heartbeat);
• flutter and atrial fibrillation and some others.

List of beta-blockers and their dosages

It should be noted that propranolol, which many "cores" with experience know as Anaprilin, blocks not only beta-1-adrenergic receptors of the heart, but also beta-2-adrenergic receptors, which are located in the smallest branches of the bronchi - bronchioles. Because of this, the drug can cause bronchospasm, shortness of breath or cough, and today it is practically not used to lower blood pressure.

Side effects

The main side effect of beta-blockers is erectile dysfunction and fatigue.

Calcium channel blockers

Calcium channel blockers can successfully control blood pressure and are well tolerated. They also reduce the risk of heart failure by almost a fifth (20%), but in this context they are still much inferior to diuretics, beta-blockers and ACE inhibitors. According to the recommendations of world communities, including WHO, with high blood pressure, it is better to prescribe long-acting calcium channel blockers.

How do they work?

The mechanism of their action is reflected in the name of the group: these pressure drugs block special, calcium channels and do not allow calcium ions to enter the smooth muscle cells of blood vessels and heart cells - cardiomyocytes.

There are two types of calcium channel blockers:

• Dihydropyridines - they dilate only the arteries and thus provide only a decrease in blood pressure;
• Non-dihydropyridines - dilate arteries, reduce myocardial contractility and heart rate, which is used in the treatment of angina pectoris.

The degree of pressure reduction when taking pills is directly related to the level of hypertension: if you have normal pressure, it will drop very slightly, but with an increased drop it will be significant.

Calcium channel blockers are prescribed for angina pectoris and arterial hypertension, including after myocardial infarction (though only when beta-blockers are contraindicated).

List of calcium channel blockers and their dosages

Side effects

The classic side effects of calcium channel blockers are tachycardia, facial flushing, swelling of the ankles, and constipation.

Popular remedies for high blood pressure: ACE inhibitors

The drugs of this group can be safely attributed to one of the most common drugs for high blood pressure. They have a powerful hypotensive effect and are well tolerated. In addition, ACE inhibitors occupy a leading position among antihypertensive drugs in reducing morbidity and mortality from heart failure. And one more plus: the means of this group from pressure slow down the progression of the classic complication in diabetes mellitus - kidney damage. This is an important aspect that gives reason to prefer ACE inhibitor tablets for the treatment of hypertension in diabetic patients.

The features of these drugs also include their ability to increase serum creatinine levels by as much as 30%.

If you are taking ACE inhibitors and blood tests show an increase in blood creatinine, do not worry - this phenomenon is not dangerous and is reversible.

It is also important to remember that when adding drugs of this series to diuretics, temporary hypotension is possible, that is, a decrease in pressure below normal. To avoid this, it is recommended that ACE inhibitors be carefully introduced into the diuretic regimen, namely, skipping the last dose of diuretics before the first dose of inhibitors.

How do they work?

ACE inhibitors block a special enzyme, with the participation of which the hormone angiotensin I, which does not show a vasoconstrictor effect, is converted into angiotensin II, which has a powerful vasoconstrictor effect. As a result, blood pressure (both systolic and diastolic) decreases.

It should be noted that in some cases, in order to achieve optimal pressure indicators, long-term therapy with ACE inhibitors is necessary, for several weeks. Therefore, the absence of the desired result at the very beginning of treatment does not mean that the treatment is ineffective.

ACE inhibitors are prescribed for the following purposes:

• treatment of hypertension of any severity;
• treatment of heart failure, also at any stage;
• prevention of the development of heart failure (in patients with dysfunction of the left ventricle);
• prevention of myocardial infarction;
• reduction in the frequency of hospitalizations from the hospital due to unstable angina.

List of ACE inhibitors and their dosages

Side effects

The most common side effect of ACE inhibitor pressure pills that makes patients anxious is a dry cough. At the same time, its intensity and probability of occurrence do not depend in any way on the dosage of tablets on pressure. This phenomenon is caused by the fact that the angiotensin-converting enzyme (ACE) is present in large enough quantities in the respiratory tract. Its blockage can lead to contraction of the respiratory muscles and, as a result, a dry, unproductive cough. This effect, alas, is permanent, and it is not necessary to expect that its intensity will decrease over time, or it will disappear altogether.

If you develop a dry cough while taking ACE inhibitors, ask your doctor to choose a pressure medicine from a different pharmacological group.

Fortunately, this list of common side effects of this group of drugs is almost exhausted. I would like to add that ACE inhibitors should not be taken during pregnancy, and especially in the second and third trimesters, since these drugs for high blood pressure adversely affect the development of the child.

Angiotensin receptor blockers

This is the most modern group of new generation drugs for high blood pressure. It is very similar to the previous one, ACE inhibitors. Angiotensin receptor blockers are quite economical and effective, and can also be used in patients with heart failure. However, unfortunately, there is still no evidence of their beneficial effect on the risk of cardiovascular accidents, and this is a rather serious drawback.

According to some reports, angiotensin receptor blockers, together with diuretics, can contribute to a too strong drop in blood pressure, so combining tablets of these two groups is not recommended.

How do they work?

Drugs of this series block the receptors of the hormone angiotensin II, which helps to relax the smooth muscle muscles of the vessels and lower blood pressure. Interestingly, angiotensin II receptor blockers increase the body's resistance to physical activity in patients with heart failure.

Those who take these pills for high blood pressure should remember that after the first single dose, systolic and diastolic pressure decreases as much as possible only within 24 hours. Stable results, that is, normalization of pressure indicators, can be seen only after 3-6 weeks of continuous treatment.

Angiotensin II receptor blockers, like many other modern drugs for pressure, are prescribed not only for hypertension, but also for a number of other diseases, and among them:

• chronic heart failure;
• high risk of stroke in patients with hypertension or left ventricular hypertrophy;
• protection of the kidneys in type 2 diabetes mellitus, which is often accompanied by a violation of their function.

List of drugs, doses

Side effects

Angiotensin receptor blockers are well tolerated. Unlike ACE inhibitors, they never cause a dry cough. But during pregnancy, drugs from the pressure of this group are contraindicated.

Alpha blockers: another group of drugs for high blood pressure

The drugs of this series have two positive qualities: safety and efficacy. Unfortunately, they do not have an impact on cardiovascular risks, in any case, there is no evidence to the contrary yet.

Alpha-blockers are most effective when combined with diuretics.

How do they work?

Alpha blockers, respectively, block alpha-1-adrenergic receptors, which are located in small arteries, arterioles. Due to this, the walls of the vessels relax, expand, and the blood pressure in them rises. In addition, these agents reduce myocardial oxygen demand.

The "non-standard" effects of alpha-blockers include their ability to reduce the level of total and increase the content of "good" cholesterol.

And one more thing: alpha-blockers reduce the tone of the bladder neck and cells of the prostate capsule. The latter property has found application in urology, for the treatment of adenoma.

The action of alpha-blockers begins to appear quite quickly, within 1-2 hours after ingestion, reaching a peak by 5-6 hours. The effect of pressure reduction persists for 24 hours after taking the pill.

Preparations of this group are used to treat hypertension and benign hyperplasia (adenoma) of the prostate. Moreover, with adenoma, they are prescribed both to men with high blood pressure, and to those who do not have hypertension.

List of drugs, dosages

Side effects

In general, alpha blockers are well tolerated. At the beginning of treatment, hypotension (too sharp a drop in pressure) may occur.

Combined remedies for high blood pressure

Combined treatment of hypertension with two or more drugs reduces blood pressure more effectively than therapy with one drug of any group. However, not all combinations of antihypertensive drugs are effective.

• diuretic and beta-blocker;
• a diuretic and an ACE inhibitor (or angiotensin receptor blocker);
• calcium channel blocker (dihydropyridine) and beta-blocker;
• calcium channel blocker and ACE inhibitor;
• alpha blocker and beta blocker.

Important: Combinations must include blood pressure medications from different groups!

Ambulance for high blood pressure: which pills to take?

Unfortunately, many patients with hypertension do not follow the doctor's recommendations or do not treat at all. No wonder that their blood pressure rises regularly, sometimes to very significant numbers. In such cases, an emergency pressure reduction may be necessary, and then a reasonable question arises: what drug can cope with this task? Indeed, what antihypertensive drug can quickly reduce high blood pressure?

Today, in cardiology practice, two antihypertensive drugs are widely used to urgently reduce high blood pressure at home:

1. ACE inhibitor captopril

This is one of the few representatives of high blood pressure drugs that can give a quick and fairly powerful effect. According to the instructions for use, these tablets reduce pressure within 15-60 minutes after ingestion. After 60-90, the effect of the drug reaches a peak and lasts for 6-12 hours. In addition, Captopril reduces the heart rate.

Captopril is rarely used as a permanent therapy today: like other ACE inhibitors, it often contributes to the development of a dry cough, and also has a quite impressive list of other side effects. But as an ambulance, Captopril is very valuable.

To quickly reduce pressure, Captopril is recommended to be taken not traditionally, by mouth, but to dissolve the tablet under the tongue. There are many blood vessels located close to the mucous membrane, which allows the drug to be absorbed immediately into the blood within a few minutes after ingestion. Due to the fact that Captopril begins to act quickly and powerfully, you need to be careful with the dosage: as a rule, already half a tablet provides a decrease in pressure to normal numbers. In some cases, ¼ tablet of Captopril is enough.

2. Calcium channel blocker nifedipine

Nifedipine (the most popular analogue of Corinfar) is another representative of pressure drugs that can quickly show a pronounced hypotensive effect. With normal ingestion, the pressure during treatment with Nifedipine decreases after 30-60 minutes, and if the tablet is dissolved under the tongue (this method of administration is called sublingual in the instructions for use), the effect is achieved within 5-10 minutes, reaching a peak within 15- 45 minutes after taking. The average dose for high blood pressure is 10 mg.

Serious problem: pressure pills and erections

Erectile dysfunction, or potency disorders in general, often accompanies cardiovascular diseases. Even when it appears in a healthy man, he needs to visit a cardiologist, since it is generally accepted that intimate problems precede heart problems. With hypertension, the likelihood of erectile dysfunction is much higher than in men with normal pressure. According to some reports, the longer a person suffers from hypertension, the higher the risk of impotence and the more pronounced negative changes in this area occur. The appointment of some tablets from pressure can further exacerbate the problem.

The reason for the effect of high blood pressure drugs on potency is simple: the mechanism of erection is associated with a sharp increase in blood flow to the cavernous bodies of the penis, and pressure pills that dilate blood vessels can contribute to the reverse process.

Among the huge number of drugs that reduce pressure, there is a small list of drugs that most often lead to the development of erectile dysfunction. And hypertensive men who have problems with potency should remember this list by heart.

List of drugs for high blood pressure that can lead to erectile dysfunction:

• thiazide diuretics (hydrochlorothiazide, indapamide);
• diuretic Spironolactone (by the way, it is extremely rarely used to reduce pressure);
• Clonidine, known as Clonidine;
• Methyldopa (Dopegyt);
• Reserpine (attention - one of the three components of the "famous" Adelfan "!);
• Beta-blockers, including atenolol, bisoprolol, nebivolol, carvelilol and others.

Fortunately, as you can see from the list, not all pressure remedies are "involved" in unpleasant "intimate" side effects. The list of drugs that do not affect erectile function is much higher, and the choice is quite large. You need to be careful when taking combined pressure medications, which very often contain a diuretic component or a beta-blocker.

But even if you have been prescribed a drug that includes a substance from our "black" list, this does not mean that you will certainly encounter lesions in bed. The key to success is following the doctor's recommendations and low dosages. If, nevertheless, you notice a deterioration in potency, consult a doctor and ask to replace the pressure medication with a safer one in this regard.

If blood pressure pills don't help...

And the last question that I would like to raise is the problem of "inefficiency" in the treatment of hypertension. Imagine: you go to the doctor with complaints of high blood pressure, he prescribes a medicine, you even take it for a while, but there is no effect. What's happening?

In fact, the selection of effective therapy for high blood pressure is a serious task and sometimes requires quite a long time. You have already seen for yourself how many nuances the prescription of drugs for pressure is fraught with. Of course, it is difficult to find a treatment that will help you the first time. To be successful, you must:

1. Follow all the recommendations of the doctor regarding the intake of medications and their doses.
2. Regularly measure the pressure (preferably in the morning and evening) and keep a diary of changes. Only with its help it is possible to adequately assess the effectiveness of treatment.
3. Warn doctors about all side effects, and do it on time.
4. Never stop taking medication without the permission of your doctor.

Remember: modern drugs for high blood pressure can provide stable performance in any, even the most difficult case. All that is needed is the desire of the patient, time and the help of a knowledgeable doctor.

Important! Read about the principles and modern standards for the treatment of high blood pressure in the article "".

Hypertension and arterial hypertension- this is a persistently elevated blood pressure: systolic or diastolic. This diagnosis is made on the basis of the results of repeated pressure measurements. If the indicators for the systolic state each time exceed the figure of 140, and for the diastolic state - 90, this is an alarm signal.

Hypertension is dangerous for the occurrence of complications in the form of strokes, heart attacks and serious disorders of the kidneys. To avoid this, it is necessary to take drugs, which are pills for high blood pressure.

Who should take high blood pressure pills

Often, among patients who need long-acting pressure pills, the majority are people of retirement age, whose medical history is associated with age-related processes.

Antihypertensive drugs are prescribed only in cases where the risk of complications outweighs the risk of side effects from taking these drugs.

Taking into account the destructive effect on the body of the side effects of antihypertensive drugs, their appointment by a doctor is made only in cases of stable retention of blood pressure at around 160/100.

In other cases, doctors recommend a healthy diet for hypertensive patients, excluding salty, fatty and fried foods from food. Also among the recommendations of the specialist will be quitting smoking and alcohol, moderate exercise to lose weight and avoid stressful situations.

The principle of choosing tablets from pressure

If all the doctor's recommendations are fulfilled, and the pressure does not normalize, specialized drugs are prescribed. Since antihypertensive drugs have a purely individual effect, those pills that are effective in the case of one patient may not bring relief to another.

The principle of their appointment is a complex list of items:

Classification of tablets from pressure

Diuretics

Diuretics or diuretics are divided into loop, thiazide and potassium-sparing agents:

1. Loop agents, such as furosemide- pills that quickly lower blood pressure during attacks and crises, due to their powerful action, but their long-term use can lead to a deficiency of potassium and sodium, which is fraught with arrhythmia and other disorders of the heart;
2. Thiazide diuretic preparations, such as arifon or indapamide - tablets for long-term pressure, prescribed in the initial stages of arterial hypertension, have a positive effect on the body, on the contrary, with prolonged use, without removing beneficial trace elements from the body;
3. The third subgroup of diuretics potassium-sparing drugs: spironolactone, veroshpiron. These funds are not used as independent diuretic tablets, due to their mild hypotensive effect and are prescribed only in combination with antihypertensive drugs of other classes.

Contraindications: diuretics, with the exception of furosemide, should be avoided in concomitant acute renal failure.

Furosemide, along with uregitum, in turn, is contraindicated in anemia and hypovolemia. Veroshpiron contraindicated in high blood potassium and atrioventricular blockade, and hypothiazide is forbidden to prescribe in diabetes mellitus.

Antiadrenergic drugs

This group of drugs is dangerous for use without a doctor's prescription and is not suitable for all patients.

Antiadrenergic drugs or sympatholytics are divided into 5 main groups that differ in their action:

• Means of central action manifesting itself inside neurons. They give a central sedative effect and prevent the deposition of catecholamines in the hypothalamus. A striking example of sympatholytics is reserpine. In the form of tablets, the hypotensive effect begins on the 5-6th day, intravenously - after 2-3 hours.

Side effect: often there is difficult to eliminate nasal congestion, diarrhea, bradycardia, possibly redness of the eyes, weakness, dizziness and shortness of breath. There are cases of a negative impact on the psyche of patients, manifesting itself in the form of neurosis or depression.

Before prescribing reserpine the medical history of both the patient and close relatives is studied in detail for mental disorders. Reserpine is not available without a prescription.

This group of drugs softer action are raunatin and rauvazan. In addition to their hypotensive action, they calm the nervous system, restore heart rhythm and increase renal circulation.

Guanedin, ismelin, isobarine, belonging to the same group of central action, show a slow effect in lowering blood pressure, showing it no earlier than 7 days after the start of the course of treatment, but after the end of their intake, it lasts up to 14 days.

Side effects of these drugs: diarrhea, orthostatic hypotension - impaired coordination of movements when getting up from a sitting or lying position and in the heat, weakness, decreased performance. Drugs in this group are contraindicated in myocardial infarction, renal failure and pheochromocytoma. Also, they are unacceptable in atherosclerosis of the cerebral and coronary arteries.

They are not available without a prescription and are dangerous. not only for health, but also for human life, if the dosage is not observed or a combination of some of them with alcohol. They also have a criminal record.

Methyldopa- fast action when administered intravenously, the effect lasts up to 2 days. The action is based on a decrease in peripheral resistance without a change in cardiac output.

Side effect: drowsiness, drying of the mouth, impaired coordination, possibly a negative effect on the immune system and cause complications in the form of hepatitis or myocarditis.

Contraindicated during pregnancy and liver disease. Drugs belonging to the clonidine subgroup have a similar effect, with the difference that the hypotensive effect does not manifest itself immediately: after the administration of the drug, a sharp jump in pressure is observed, then a gradual decrease and the effect persists for up to 3 days.

These drugs used for immediate response in case of a possible stroke or other complications associated with hypertension. When taking tablets, the improvement of the condition appears after 30 minutes, intravenously - up to 5 minutes. Side effects are the same as from methyldopa.

Caution must be shown with clonidine, because when it is canceled, an abstinence syndrome is often observed, manifesting itself in tachycardia, agitation and anxiety. Cancellation is made gradually over several days. Clonidine leads to death in combination with alcohol.

Contraindications: depression, acute heart failure, alcoholism and atherosclerosis of the coronary and cerebral vessels.

• Peripheral alpha receptor blockers reduce the total peripheral resistance, increase the venous bed, relax the walls of blood vessels, reducing hypertension. Therapy is prescribed for at least 2 weeks, since their hypotensive effect begins to appear no earlier than 7-8 days.

The advantage over other drugs that lower blood pressure is a meager list of side effects: dizziness, headaches.

• Beta blockers- drugs that specialize not only in lowering blood pressure, but also in cardiovascular pathologies: angina pectoris, arrhythmia, etc.

Their similarity to endogenous catecholamines allows them to neutralize their negative impact on the cardiovascular system. Hypotensive effect, prevention of tachycardia, prevention of hypertension due to stress or excessive physical exertion. Also used to prevent myocardial infarction and cardiac arrhythmias due to hypertension.

Beta blockers are categorized into non-selective (propranolol, obzidan) and selective (cordanum, talinolol). Applicable for long-term use, subject to the correct dosage, which is prescribed after careful examination.

Side effects: sleep disorders, weakness and decreased performance, the appearance of atrioventricular blockade, withdrawal syndrome, accompanied by tachycardia, cardialgia, stress and headaches with a sharp discontinuation of the drug.

Contraindications: sinus bradycardia, cardiogenic shock, gastric ulcer, diabetes mellitus, congestive heart failure.

• Blockers of α- and β-adrenergic receptors.
  They reduce peripheral resistance, reduce renin resistance in the blood, and normalize cardiac output.

characteristic preparations subgroups are considered as follows: labetolol, trandate, albetol.

Quick Action: when administered intravenously, the effect appears after 2 minutes. Contraindications: pregnancy, atrioventricular block and lung disease.

Peripheral vasodilators

Such drugs are divided into 3 types:

1. Arteriolar peripheral vasodilators (PV): hydralazine, apressin, diazoxide, hyperstat. They help to reduce the total peripheral resistance, but cause a homeostasis reaction, which partially neutralizes the effect of the drug. The sympathoadrenal system begins to activate renin.
2. Mixed vasodilators: isosorbide dinitrate, sodium nitroprusside. They act by dilating blood vessels. The negative effect is the additional expansion of the veins, reducing the volume of blood returning to the heart, leading to stagnation of blood.
3. PV soft action: papazol, dibazol, papaverine,. Until recently, it was used in emergency care in cases of hypertensive crises and was included in the list of necessary drugs in ambulances. Drugs cope with isolated cases of hypertension, but do not cure it.

Let's take a closer look at the drugs, their side effects and contraindications:

• Hydralazine has side effects in the form of headaches, tachycardia, angina pectoris may develop. Contraindications: SLE, hepatitis, stomach ulcer.
• Diazoxide has the property of lowering the pressure within 2 minutes, but has the form of release only in ampoules.
• Nitroprusside sodium increases stroke volume, lowers pre- and afterload. Rapid action is used to eliminate hypertensive crises or acute left ventricular failure.

calcium antagonists

The hypotensive effect of these drugs is based on their ability to block the flow of calcium ions into the muscles of the heart and arteries, due to which they relax. They also serve as prophylactic agents for blood circulation disorders.

Side effects: dizziness, weakness, headache, swelling of the extremities.

Angiotensin converting enzyme (ACE) inhibitors

Drugs specializing in suppressing the production of renin by the kidneys, which contributes to an increase in pressure.

Their ability to improve peripheral circulation and dilate coronary vessels makes them effective in the treatment of concomitant cardiac disorders.

They are prescribed for heart failure and past heart attacks. Contraindicated in renal failure, hyperkalemia.

You will find a big one here.

Angiotensin-2 receptor blockers (ARBs)

Due to the similarity in their effect on blood vessels with the effect that ACE inhibitors have, these drugs are often prescribed instead of the latter, with individual intolerance to their constituents by the patient.

Possible combinations of different classes of pressure tablets

Antihypertensive drugs have different effects on the body and have different side effects.

For greater efficiency, and sometimes in order to reduce the negative impact on the patient's health, such funds are prescribed in the following permissible complexes:

Pills for pressure during pregnancy

Despite the fact that high blood pressure- a phenomenon common in women during pregnancy, and complications are dangerous not only for the expectant mother, but also for the fetus.

The appointment of antihypertensive drugs is approached with extreme caution and only after attempts to lower arterial parameters in all sorts of other ways: diet and adherence to the regimen, folk remedies.

If all the means are exhausted, and they did not give a hypotensive effect, drugs from the following list are carefully administered, but mainly intravenously, and not in the form of tablets:

• Nifedipine applied for rapid pressure relief in emergency situations.
  It is used only intravenously, since resorption of the tablet can drastically lower arterial parameters, which will inevitably lead to disturbances in placental blood flow. The hypotensive effect occurs in 30-40 minutes.
• Clonidine preparations are prescribed in dosages not exceeding 0.6 mg per day.
• Diazoxide is dangerous possible side effects: increased blood sugar, fluid retention in the body and inhibition of labor.
  Therefore, the drug is administered intravenously only in cases of hypertensive crises in a small dosage - 15-45 mg. The effect comes in 5 minutes.
• Sodium nitroprusside dangerous by possible intoxication of the fetus with cyanide products, therefore it is used extremely rarely as an emergency drug, only in cases of ineffectiveness of all other means. Assign intravenously through a dropper. The effect occurs within 2-3 minutes. Dosage: per 250 ml of glucose 0.25 mcg.
• labetalol intravenously. There have been cases of distress in the fetus, as well as bradycardia in the newborn. Contraindications: bronchial asthma, heart failure. 25-50 grams are given as a bolus.
• Hydralazine is more harmful than labetalol and nifedipine. It is dangerous for possible heartbeat disorders in the fetus and an excessive drop in pressure in the mother. There is also a risk of developing eclampsia.

Prices for drugs

• Clonidine (active ingredient - clonidine) - 26.2-32.4 r.
• Moxonidine - 136–161.08 r.
• Moxonitex - 290–391.8 r.
• Physiotens - 245.6–304.9 p.
• Albarel (active substance - rilmenidine) - 161.35-271 rubles.

A short list of antihypertensive drugs in alphabetical order

• Acridilol;
• bisoprolol;
• Valsartan;
• Hydrochlorothiazide;
• Quadropril;
• Lotensin;
• metoprolol;
• Niperten;
• Prestarium;
• Trandolapril;
• Furosemide;
• Hortil;
• Eprosartan.

Folk remedies for pressure

Along with the above drugs, there are a number of folk remedies that help keep blood pressure normal. Their action extends only to the early stages of the disease or its mild forms.

Arterial hypertension is a common problem of the present time. At the moment, not only the elderly, but also middle-aged people suffer from it. Cases of pressure surges among young people have become more frequent. This problem can be solved by using antihypertensive drugs of various groups. Only a doctor who has studied the full picture of the course of the disease should prescribe drugs of this kind. Self-administration of cheap drugs for pressure can lead to bad consequences. Each sharp jump in pressure causes a heavy blow to the vessels. Incorrect treatment of hypertension increases the risk of heart attacks and strokes, and can lead to coronary heart disease.

In the treatment of arterial hypertension, it is important not only to reduce pressure once, but also to prevent the occurrence of this problem in the future. A timely visit to the doctor will help to choose the right therapy and avoid the occurrence of complications of the disease. Many people try to save on their health by choosing cheap blood pressure pills. Of course, they can be no less effective than expensive ones, but only a competent selection of the drug can save you from negative consequences.

Effective cheap remedies for pressure

There are several drug groups of drugs that quickly help reduce blood pressure. In some cases, it is recommended to use several types of drugs at the same time to enhance the effect. As a rule, this happens when the disease has passed into a deep stage and one medicine is not effective enough. Pressure tablets are divided into the following groups:

• angiotensin-converting enzyme inhibitors;
• diuretics (diuretics);
• beta-blockers;
• sartans.

In each group there are fairly inexpensive pills to get rid of this problem.

ACE inhibitors or pills that reduce blood pressure within half an hour

Often these drugs are used when the pressure reaches the limit and it needs to be reduced for a limited time. They literally in 20 minutes can significantly reduce blood pressure and slow down the heart rate. Continuous use of such drugs is not recommended. Their action is to prevent vasoconstriction and reduce blood flow to the muscle. Cheap tablets of this group are:

1. Captopril (from 7 to 9 rubles for a blister of 10 tablets).
2. Enalapril (7 rubles - 10 tablets).
3. Renipril (63 rubles - 20 tablets).
4. Enam (from 18 to 22 rubles for 20 tablets).

Only a doctor can pick up cheap pressure pills. Do not use drugs of this group on the advice of friends, this can lead to serious consequences. After all, each of the drugs has side effects and contraindications.

Captorpril is not used in the treatment of long-term heart failure. Tablets are given to the elderly when diuretics are ineffective. The dosage depends on many factors. Often, inexpensive tablets from other groups are used with Captopril.

Enalapril is often used in medical practice. Cheap pills are prescribed for various forms of hypertension. There are contraindications for use. If side effects occur, the drug should be discontinued immediately.

The effect of the use of Renipril persists for a day. On the recommendation of a doctor, it can be taken as a course, but not exceeding the indicated dosage.

As part of Enam, in addition to enalapril, there are other substances that accelerate its action. Tablets are cheap, but not suitable for everyone, there are contraindications.

Diuretics (diuretics)

Diuretic tablets remove fluid from the human body, thereby reducing swelling of the walls of blood vessels. The gap between the walls increases, the pressure decreases. cheap diuretic pills are good when indicators need to be reduced slightly. In other cases, they are used mainly for complex therapy. Popular diuretics include:

• Indapamide (18 rubles for 30 tablets).
• Acripamide (36 - 41 rubles for 30 tablets).
• Furosemide (23 rubles for 20 pieces).

The diuretic should be prescribed by a specialist. An incorrectly chosen medicine can not only have no effect, but also harm other organs.

Indapamide is effective in hypertension and heart failure. It is prescribed to elderly patients who have increased mainly systolic (blood) pressure. It increases the elasticity of blood vessels and arteries, which, when taken regularly, improves the picture of the course of the disease.

The action of Acripamide begins 1-2 hours after ingestion. Often it is prescribed for a course of 1-2 weeks. The positive effect after treatment lasts up to 3 months.

Furosemide is a loop diuretic with a very rapid onset of action. It is used not only for hypertension, but also for other diseases, when it is necessary to speed up the process of fluid exit from the body. Furosemide is classified as a cheap drug.

Beta blockers

The drugs in this group are highly effective. They are used in severe cases after heart attacks, with heart failure and angina pectoris. The cost of these tablets is higher than that of the drugs of the previous groups, it is worth highlighting the cheapest of them:

1. Cordinorm (from 115 to 126 rubles for 30 pieces).
2. Biprol (105 rubles - 30 tablets).
3. Bisogamma (107 - 119 rubles - 30 tab.).

Cordinorm is effectively used in hypertensive crises and angina pectoris. It acts quite quickly, within 2 hours it significantly reduces the values ​​on the tonometer.

Biprol has strict contraindications. You can take it only after consulting a doctor at a strictly prescribed dosage. Side effects and allergic reactions are possible.

When taking the drug Bisogamma, it is necessary to regularly monitor the level of blood pressure. The active substance - bisoprolol - in many cases causes allergic reactions. Then the drug should be stopped.

Sartans

In most cases, doctors prescribe drugs of this particular group. Cheap tablets of this type have practically no contraindications, act quickly and do not cause side effects. The price for them is higher than for the previous groups. It is worth considering the most inexpensive of them:

• Blocktran (142 rubles for 30 tablets).
• Losartan (from 103 to 110 rubles for 30 pieces).

After taking Blocktran, the pressure decreases gradually, the maximum occurs after six hours. To achieve a therapeutic effect, it must be taken in courses. Blocktran is effective in chronic heart failure. Has contraindications.

Losartan is the most inexpensive drug of the sartans group. Used for heart disease. Losartan is contraindicated in case of intolerance to its components. It is effective in complex treatment with drugs of other groups.

There are many cheap drugs that can reduce blood pressure in a short time, but you should consult a doctor before using them. Therapeutic treatment is prescribed only after examination and establishment of the cause that became the impetus for hypertension.