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These studies suggest that blood pressure medicines can cause side effects such as orthostatic hypotension, increased blood pressure, treatment discontinuations due to adverse events, and interactions with other drugs, while also highlighting the benefits of low-dose and combination therapies in reducing cardiovascular risks.
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Antihypertensive medications, while effective in managing high blood pressure, often come with a range of side effects. These side effects can vary depending on the class of medication used.
Thiazide diuretics are commonly used as a first-line treatment for hypertension. They have been shown to reduce mortality and cardiovascular events significantly. However, they can cause adverse effects such as electrolyte imbalances, dehydration, and increased urination. High-dose thiazides, in particular, have been associated with a higher rate of adverse effects leading to treatment discontinuation .
Beta-blockers are another class of antihypertensive drugs that can reduce the risk of stroke and cardiovascular events. However, they are associated with a range of side effects, including fatigue, depression, and sexual dysfunction. They also have a higher rate of treatment discontinuation due to adverse effects compared to other antihypertensive drugs .
ACE inhibitors are effective in reducing mortality and cardiovascular events. Common side effects include a persistent dry cough, elevated blood potassium levels, and, in rare cases, angioedema. Despite these side effects, ACE inhibitors are generally well-tolerated, with a lower rate of treatment discontinuation compared to beta-blockers and thiazides .
Calcium channel blockers are effective in reducing blood pressure and the risk of stroke. However, they can cause side effects such as peripheral edema, constipation, and dizziness. These side effects are dose-dependent, and higher doses are associated with a higher rate of adverse effects .
ARBs are generally well-tolerated and have a lower rate of treatment discontinuation due to adverse effects compared to other antihypertensive drugs. They do not significantly increase the risk of adverse events over placebo, making them a preferred option for many patients.
Managing high blood pressure during pregnancy is crucial for the health of both the mother and the baby. Hydralazine is commonly used, but it can cause maternal hypotension. Diazoxide and ketanserin are less effective and associated with more side effects, making them less ideal choices.
Antidepressant drugs can influence blood pressure. Selective serotonin reuptake inhibitors (SSRIs) are generally safe, but serotonin-norepinephrine reuptake inhibitors (SNRIs) like venlafaxine can increase the risk of hypertension. Tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs) can also cause significant blood pressure changes, including hypertensive crises.
Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause small but significant increases in blood pressure, particularly in patients already on antihypertensive medication. This effect is due to their action on the renin-angiotensin pathway and sodium retention . Other drugs, such as steroids and certain antidepressants, can also affect blood pressure and should be used cautiously in hypertensive patients.
While antihypertensive medications are essential for managing high blood pressure, they come with a range of potential side effects. Understanding these side effects and considering individual patient characteristics can help in selecting the most appropriate treatment and managing any adverse effects effectively.
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