The pooled data of 10 medical studies indicates that telmisartan/amlodipine drug combination was associated with a smoother blood pressure control over 24 hours compared to monotherapy. This would mean a change in practice especially by general practitioners for better long term outcomes of their patients. Currently, the international trend has been to treat new patients who have moderate blood pressure with one drug (or monotherapy) and, in the follow up if the blood pressure is not well controlled, to add another drug.
As the heart pumps the blood, the blood pushes against the wall of the arteries creating a pressure. This is called blood pressure. If the blood pressure rises and stays high for long time, it may cause health problems such as heart failure, coronary artery disease, stroke, and kidney failure to name a few.
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Blood pressure is called the silent killer because it rarely shows any signs or symptoms. So the only way you know you have high blood pressure is if your systolic (upper reading) blood pressure is higher than 140 and diastolic (lower reading) is higher than 90. You tend to get the symptoms only when your blood pressure readings soar to very high levels (systolic - 180 or more and diastolic - 110 or more). Then you may experience -
Shortness of breath
Here's the blood pressure chart for easy reference.
Average blood pressure for young people - 120 / 80 mmHg
Average blood pressure for older people - 140 / 90 mmHg
|Severity of blood pressure||Systolic blood pressure reading (mmHg)||Diastolic blood pressure reading (mmHg)|
|Mild hypertension||140 - 160||90 - 100|
|Moderate hypertension||160 - 200||100 - 120|
|Severe hypertension||Above 200||Above 120|
Drugs for high blood pressure
There are different classes of high blood pressure medications that include a number of drugs. Here's the list -
1. Diuretics: This class of drugs reduces high blood pressure by removing excess sodium (salt) and water from the body. Examples - chlorthalidone, chlorothiazide, hydrochlorothiazide, furosemide, amiloride hydrochloride etc.
2. Beta blockers: These drugs reduce the heart rate thus lowering blood pressure. Examples - acebutolol, bisoprolol fumarate, metoprolol tartrate, penbutolol sulphate, propranolol hydrochloride, etc.
3. ACE (Angiotensin Converting Enzymes) inhibitors: These drugs help the narrowed blood vessels to relax and open up, thereby lowering blood pressure. Examples - benazepril hydrochloride, enalapril maleate, ramipril, etc.
4. Angiotensin II receptor blockers: Angiotensin is a chemical in the body that narrows the blood vessels. It requires a sort of 'slot' called receptor where it binds to have its effect. This class of drugs blocks the receptor so that angiotensin cannot act. Examples - candesartan, telmisartan, losartan potassium, and other such drugs.
5. Calcium channel blockers: These drugs stop calcium from entering the smooth muscles of the heart and arteries. Calcium helps the heart to contract, causing the heart rate to increase and arteries to narrow. Examples - amlodipine besylate, bepridil, etc.
6. Alpha blockers: These drugs relax and open up the arteries. Examples - doxazosin mesylate, prazosin hydrochloride, etc,
7. Alpha 2 receptor agonist: This drug decreases the activity of the adrenaline producing portion of the nervous system, thus lowering blood pressure. This is the first line of hypertensive given to pregnant woman, as it has generally been found to be safe for the mother and her fetus. Example - methyldopa.
8. Other classes of drugs include peripheral adrenergic inhibitors, and direct vasodilators.
Sometimes monotherapy cannot lower the blood pressure successfully, then a combination therapy is used in hypertensive people. This has many advantages. For example, a combination of two drugs, such as an angiotensin II receptor blocker and a calcium channel blocker, will act on two different sites and effectively reduce high blood pressure. Also a combination pill turns out to be more cost effective than single pills and more convenient. The telmisartan-amlodipine drug combination for quick control of high blood pressure as evidenced by the review study published in the Journal of Hypertension can thus be an important advancement in hypertension therapy.