Combination Therapy for High Blood Pressure

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Hypertension, the medical term for high blood pressure, is a chronic condition where the blood pressure in the arteries is too high. This condition is now considered a part of metabolic syndrome co-existing with chronic conditions such as diabetes, chronic kidney disease and cardiovascular disease.

The commonly used anti-hypertensive agents that treat high blood pressure include -

• Diuretics - work in the kidney and flush excess water and sodium from the body.
• Beta-blockers - reduce nerve impulses to the heart and blood vessels making the heart beat slower and with less force. This causes lowering of blood pressure.
• ACE (Angiotensin converting enzyme) inhibitors - prevent the formation of a hormone called angiotensin II that narrows blood vessels and causes high blood pressure.

• Angiotensin antagonists or angiotensin receptor blockers (ARBs) - shield the blood vessels from angiotensin II, thus making them more relaxed.
• Calcium channel blockers (CCBs) - do not allow calcium to enter the muscle cells of the heart and blood vessels, thus causing the blood vessels to relax and reducing the force of contraction of the heart.
• Alpha-blockers - lower blood pressure by reducing nerve impulses to blood vessels and allow blood to pass more easily.
• Alpha-beta-blockers - reduce nerve impulses to blood vessels and also slow the heartbeat to lower blood pressure.
• Nervous system inhibitors - relax blood vessels by controlling nerve impulses.
• Vasodilators - open blood vessels by relaxing the muscle in the vessel walls.

References:

1. Combination therapy in hypertension: An update - (http://www.dmsjournal.com/content/2/1/44)
2. Cardiology - (http://www.theheart.org/article/1171441.do)
3. Initial Monotherapy and Combination Therapy and Hypertension Control the First Year - (http://hyper.ahajournals.org/content/early/2012/05/07/HYPERTENSIONAHA.112.194167.abstract)

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