High Blood Pressure Treatment (cont.)
John P. Cunha, DO, FACOEP
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
In this Article
- What is high blood pressure (hypertension)?
- Which lifestyle modifications are beneficial in treating high blood pressure?
- Coffee and caffeinated beverages
- Other dietary considerations
- Exercise and stress reduction
- How is high blood pressure treated?
- Starting treatment for high blood pressure
- Treatment with combinations of drugs for high blood pressure
- Emergency treatment for high blood pressure
- Treatment during pregnancy
- Which medications are used to treat high blood pressure
- Angiotensin converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers
- Beta blockers
- Calcium channel blockers (CCBs)
- Alpha blockers
- Renin inhibitors
- Aldosterone blockers
- Combining agents
- What about the patient's compliance with medication regimens?
- Is alternative medicine used to treat high blood pressure?
- What are the complications of high blood pressure?
- Can high blood pressure be prevented?
- What's new in high blood pressure?
- Find a local Internist in your town
The sympathetic nervous system is a part of the nervous system that helps to regulate certain involuntary (autonomic) functions in the body such as the function of the heart and blood vessels. The nerves of the sympathetic nervous system extend throughout the body and exert their effects by releasing chemicals that travel to nearby cells in the body. The released chemicals bind to receptors (molecules) on the surface of the nearby cells and stimulate or inhibit the function of the cells. In the heart and blood vessels, the receptors for the sympathetic nervous system that are most important are the beta receptors. When stimulated, beta-receptors in the heart increase the heart rate and the strength of heart contractions (pumping action). Beta-blocking drugs acting on the heart slow the heart rate and reduce the force of the heart's contraction.
Stimulation of beta-receptors in the smooth muscle of the peripheral arteries and in the airways of the lung causes these muscles to relax. Beta blockers cause contraction of the smooth muscle of the peripheral arteries and thereby decrease blood flow to body tissues. As a result, the patient may experience coolness in the hands and feet. In response to the beta blockers, the airways are squeezed (constricted) by the contracting smooth muscle; this squeezing (impingement) on the airway causes wheezing, especially in individuals with a tendency for asthma.
Beta blockers remain useful medications in treating hypertension, especially in patients with a fast heartbeat while resting (tachycardia), cardiac chest pain (angina), or a recent heart attack (myocardial infarction). Beta blockers appear to improve long-term survival when given to patients who have had a heart attack. Whether beta blockers can prevent heart problems (are cardioprotective) in patients with hypertension any more than other antihypertensive medications is uncertain. Beta blockers may be considered for treatment of hypertension because they also may treat co-existing medical problems, such as chronic anxiety or migraine headaches. Common side effects of these drugs include depression, fatigue, nightmares, sexual impotence in males, and increased wheezing in people with asthma.
The beta blockers include:
- atenolol (Tenormin),
- propranolol (Inderal),
- metoprolol (Toprol),
- nadolol (Corgard),
- betaxolol (Kerlone),
- acebutolol (Sectral),
- pindolol (Visken),
- carvedilol (Coreg)
- penbutolol (Levatol), and
- bisoprolol (Zebeta).
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