High blood pressure: the first treatment can have side effects

Cough, fluid retention, inflammation of the pancreas: some treatments for high blood pressure can cause more side effects than others, says the Federation of American Cardiology.

According to Public Health France, more than 30 million French people suffer from hypertension. And even if half of them ignore it because they have never been tested, the other half must follow a daily treatment to avoid developing cardiovascular disease (heart failure, stroke, arrhythmia …).

The first treatment is not always the right or the most suitable. And according to the American Heart Foundation, while two types of treatments are favored by cardiologists for treating newly diagnosed patients, one of the two seems to have more unwanted side effects.

Medicines that decrease blood vessel contraction

Currently, drugs called ACE inhibitors, who decrease the contraction of the vessels, are more frequently prescribed than the so-called drugs angiotensin II receptor antagonists (ARBs), who directly oppose the action of a substance called angiotensin which promotes the contraction of the vessels. However, “this second class of hypotensive drugs works just as well and would cause fewer side effects” underlines the American Heart Association, in his journal Hypertension.

Their assertions are based on medical monitoring of 3 million patients taking blood pressure medication for the first time, with no history of heart disease or stroke, in the United States, Germany and South Korea. The researchers compared the occurrence of cardiac events and strokes in 2,297,881 patients treated with ACE inhibitors to those of 673,938 patients treated with ARBs. They found no significant difference in the frequency of heart attacks, strokes, or any other cardiac event. But they found differences in the occurrence of some side effects.

Compared to people taking ARBs for the first time, people taking (also for the first time) ACE inhibitors were:

  • 3.3 times more likely to develop fluid buildup and swelling of deeper layers of skin and mucous membranes
  • 32% more likely to develop a cough (which can be dry, persistent and bothersome)
  • 32% more likely to develop sudden inflammation of the pancreas (pancreatitis).

Hypertension: 3 other classes of drugs

  • Beta blockers slow down the heart rate and thus limit the intensity of the blood pressure on the artery walls.
  • Calcium channel blockers promote the dilation of the arteries and therefore the drop in blood pressure.
  • Thiazide diuretics act on the kidneys and promote the elimination of water and salt.

Hypertension: it is better to take the treatment in the evening

Usually, hypertension treatments are taken in the morning when you wake up. However, a Spanish study suggests that antihypertensives would be more effective if they were taken at night before going to bed.

For this study, researchers at the University of Vigo, Spain, randomly assigned 19,000 adults (including 8,400 women) to take blood pressure medications prescribed by their doctor, either upon waking or at bedtime. These patients were followed by Prof. Ramón Hermida, main author of the study, for 6 years. The results of this study have just been published in the European heart journal.

“Morning ingestion is the most common physician recommendation, based on the misleading goal of reducing morning blood pressure,” observes the physician. “But our findings show that patients who regularly take their antihypertensive drugs at bedtime have a 45% lower risk of dying or suffering from cardiovascular events. They even have a 66% lower risk of dying from a stroke or stroke. heart attack”.

Sources :

Read also :

Hypertension: what to do … or not

How not to become hypertensive

Hypertension: why screen for it in young adults?

5 ways to normalize your blood pressure naturally

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