Antihypertensives (from other gr. hypo decrease and lat. tensio tension, pressure) are medications that lower blood pressure and are used primarily for the treatment of hypertension. Therefore, they are also called antihypertensive drugs.
Arterial hypertension is distinguished as primary (hypertension or essential hypertension) and secondary (symptomatic).
The causes of hypertension are not completely known. An important role in the development of the disease is played by prolonged psycho-emotional stress, chronic stress, age-related decrease in vascular elasticity, excessive consumption of table salt and a sedentary lifestyle.
Secondary (symptomatic) arterial hypertension occurs due to an adrenal tumor. The tumor secretes large amounts of adrenaline, which is released into the blood, causing an increase in blood pressure. Also, symptomatic arterial hypertension can occur with kidney disease. In such cases we talk about renoprival hypertension. Secondary hypertension can be a symptom of other diseases.
Classification of antihypertensive drugs
Blood pressure is maintained by several physiological mechanisms: peripheral vascular resistance, heart rate and circulating blood volume. Antihypertensives usually affect one or more mechanisms of blood pressure maintenance.
Drugs that reduce the activity of the sympathetic nervous system
- Central type of action (clonidine, methyldopa, guanfacine, moxonidine)
- Beta-blockers (metoprolol, nebivolol, bisoprolol, atenolol, betaxolol, talinolol, carvedilol)
- Alpha blockers (prazosin, doxazazin, terazosin)
- Gagnlioblockers (hexamethonium benzosulfonate, azamethonium bromide, etc.)
Peripheral vasodilators (peripheral vasodilators)
- Angiotensin-converting enzyme inhibitors (enalapril, lisinopril, ramipril, captopril, perindopril, moexipril, spirapril)
- Angiotensin II receptor antagonists (valsartan, irbesartan, losartan, telmisartan, eprosartan)
- Calcium ion antagonists (nifedipine, amlodipine, lacidipine, isradipine, verapamil, diltiazem)
- Antispasmodics of myotropic type of action (papverine, bendazole)
Agents affecting water and electrolyte balance
- Diuretics (hydrochlorothiazide, indapamide, torsemide, chlorthalidone, spironolactone)
In addition to the drugs listed in the classification, blood pressure can be lowered by drugs that reduce psycho-emotional stress. For example, sedatives or tranquilizers.
Basics of treatment of hypertension
Arterial hypertension is a dangerous disease that requires treatment. High blood pressure damages the vessels of the brain, heart and kidneys, overloads the heart, and leads to the progression of atherosclerotic changes in blood vessels. These disorders lead to heart failure and so-called cardiovascular disasters - stroke and heart attack.
When treating arterial hypertension, one always strives to act primarily on the cause that causes it. If the cause is unknown or cannot be eliminated, symptomatic treatment is performed.
The main goal of treating hypertension is to reduce blood pressure to the so-called target (safe) numbers. Most experts in the field of cardiology consider systolic (upper) pressure above 140 mm dangerous. rt. Art.
The selection of an antihypertensive drug by a doctor is usually carried out empirically (experimentally). One of the so-called drugs of choice is prescribed in a minimum dose with constant monitoring of blood pressure. If the selected dose is ineffective, it is increased to the next dose of this drug. If the target blood pressure figures cannot be achieved, a second antihypertensive drug with a different mechanism of action and a different point of application of physiological blood pressure maintenance is prescribed in parallel. This type of therapy for hypertension is called combination therapy.
Prevention of hypertension
Every adult should monitor their blood pressure. In case of high blood pressure, you should consult a doctor.
People with high blood pressure who also have high blood sugar, high blood cholesterol or kidney problems are at increased risk of heart attack and stroke. Therefore, it is important to regularly check your blood sugar levels, blood cholesterol levels and urine protein levels.
There are a number of specific steps everyone can take to minimize the risk of developing high blood pressure and its adverse effects:
Mental balance
Mental well-being and a positive emotional state are essential conditions for maintaining health. What is especially important for patients with hypertension or predisposed to its development, because the disease is directly related to an inadequate response to stress.
It is necessary to learn how to manage stress in healthy ways such as meditation, various types of psychotherapy and positive social contacts.
Specialists of the Peredelkino Cardiological Sanatorium Center: neurologists, psychotherapists, cardiologists will give you comprehensive recommendations and teach you how to resist stress.
Walking in the fairytale forest surrounding the sanatorium and active recreation in nature will give you a good boost of energy. Getting to know the local attractions will give you peace of mind.
Physical activity
The second component of the prevention of hypertension is sufficient physical activity, without which we all suffer to varying degrees from manifestations of physical inactivity.
For a city dweller, it would be optimal to walk for at least 1 hour every day in a forested area.
At the Peredelkino Cardiological Sanatorium Center, as part of the Cardioprevention program, dosed walking classes are held in Meshchersky Park, mechanical therapy in the gym, group water aerobics in the pool, and city sports competitions are held.
Patients with an already manifested disease should engage in physical therapy.
It is necessary to adhere to a regime of rational alternation of work and rest. Overwork of any type, both mental and physical, should not be allowed. Healthy physiological sleep is of great importance, during which the body rests from all stress. Patients at the initial stage of hypertension should sleep at least 8-9 hours a day.
Healthy eating
In the prevention of hypertension, proper nutrition or diet in clinically pronounced forms of the disease is of great importance.
Carbohydrates
Here you should give preference to vegetables and fruits, as this will allow you to get a sufficient amount of fiber, vitamins and minerals.
Squirrels
When choosing proteins, you should avoid or limit meat products in favor of dairy and plant-based ones.
Fats
Total fat intake should be reduced. Try to replace animal fats with vegetable fats, and among animal fats there should be more fish fats.
A diet with limited salt can be a cure for patients with hypertension. No more than 5 g (slightly less than one teaspoon) is allowed per day, which makes control over blood pressure levels much easier.
Maintain a normal weight
Reducing excess weight or treating obesity is the main factor that can lead to satisfactory control of blood pressure and even, in some cases, abandon drug correction of the latter.
An effective means for normalizing weight is diet therapy and various types of physical activity.
Rejection of bad habits
If a person is prone to drinking alcohol in large doses or smoking, then the risk of hypertension increases many times over.
Alcohol intake promotes spasm of peripheral vessels and increased blood pressure due to increased vascular resistance.
After smoking, cholesterol levels increase, which is due to the release of large amounts of adrenaline and norepinephrine from the adrenal glands. There is even such a medical term - nicotine hypertension.
Features of the treatment of hypertension
Therapy for hypertension is not carried out periodically, but with the constant use of an antihypertensive drug.
It is an extremely dangerous misconception to use the drug only “when there is pressure.” If hypertension is diagnosed, there is a tendency for a persistent increase in systolic pressure above 140 mm. rt. Art., an antihypertensive drug is taken daily, preferably at the same time, under constant monitoring of blood pressure, for life.
Choosing a remedy for osteoarthritis: which components are especially important?
When osteoarthritis and the symptoms that accompany it appear or worsen, a logical question arises - which remedy should be preferred in order to slow down the destruction of joints, reduce discomfort and pain. What is the difference between the products presented on pharmacy shelves and what exactly should you look for in their composition?
Osteoarthritis and its treatment
According to ICD-10, the disease is called osteoarthritis. This affects mainly large joints - most often the hip and knee. But this does not exclude the involvement of smaller joints, for example, in the hand area.
A group of drugs used to combat changes in joints due to osteoarthritis are called chondroprotectors. These are components that are used as a building material to renew and improve the structure of cartilage tissue. Cartilage covers the surfaces of the bones that form the joint, cushioning it during movements and ensuring full gliding of moving parts. Damage to cartilage in osteoarthritis leads to disruption of the structure and function of the joints and the appearance of symptoms characteristic of the disease. Taking chondroprotectors helps slow down the development of osteoarthritis, influencing not only the symptoms, but also the trigger mechanisms.
Chondroprotectors come in different forms:
o Solution for intramuscular injection is a prescription drug prescribed by a doctor;
o Tablets or capsules;
o Gels or ointments for external use.
The composition can contain either one active substance or a combination: two or three active components.
Today there are three most studied chondroprotectors:
· NEM® complex – a new generation chondroprotector;
chondroitin sulfate;
glucosamine
Let's take a closer look at these substances.
NEM ®
for joints
The abbreviation NEM ® comes from the English name – Natural Eggshell Membrane, which means “natural eggshell shell”. The complex was the result of innovative scientific development by ESM Technologies LLC (USA). The components are obtained using a specific patented technology of partial hydrolysis with gentle fermentation of the substance.
The NEM® complex is a natural source of substances essential for joints - glycosaminoglycans. They make up the matrix of cartilage tissue. The complex contains chondroitin sulfate, elastin, hyaluronic acid, collagen. These substances ensure the formation of a supporting frame. In addition, the complex contains minerals – magnesium, calcium [8,9].
During the 15-year period of studying the effectiveness of the NEM® complex, 16 experimental and clinical studies were published. They were published in different countries - Italy, USA, Germany, Canada, Turkey [10]. According to scientific works, it has been determined that NEM® has anti-inflammatory [11], immunomodulatory [12] effects, and helps slow down destruction processes [13].
Main effects of the NEM complex®:
· reduction in the level of compounds that provoke the inflammatory process [8];
Reducing the severity of pain in the joints caused by physical activity;
· reduction in the intensity of pain, as well as stiffness due to osteoarthritis [14];
· improvement of flexibility, mobility [15];
· inhibition, reduction in the severity of age-related changes in cartilage tissue in osteoarthritis [16];
During the study of the NEM® complex, its high safety profile was proven [17].
Chondroitin sulfate for joints
The substance that makes up the cartilage matrix, its frame. This is one of the most thoroughly studied chondroprotectors. Its use is included in clinical recommendations for the treatment of osteoarthritis, developed by domestic and European professional associations [1-4]. The body uses chondroitin as a building material necessary to renew cartilage and repair its damage. Due to a sufficient supply of chondroitin, it is possible to maintain the necessary viscosity of the intra-articular fluid and inhibit the activity of enzymes - hyaluronidase, elastase, which destroy the structure of cartilage. Plus, chondroitin has analgesic properties, suppressing the concentration of compounds that provoke inflammation and pain [5,6].
Due to its complex action, taking chondroitin helps [5,6]:
· reduce the intensity of pain and reduce the need for painkillers;
· improve mobility;
· slow down destruction.
In joint products, chondroitin sulfate can be either the sole component or combined with other compounds.
Glucosamine for joints
A natural compound necessary for the production of synovial fluid, especially its components such as proteoglycans and hyaluronic acid. The effectiveness of this substance has been confirmed through numerous studies.
Glucosamine helps [7]:
· reduce the intensity of pain;
· inhibits the activity of destruction processes in cartilage;
· stimulates the synthesis of polysaccharides that are present in the joint fluid under normal conditions.
Often, several components are combined in the complexes: glucosamine, chondroitin and other chondroprotectors, which mutually enhances their effect.
MUCOSAT capsules®*
All three described components are included in the composition of MUCOSAT® capsules. This drug is classified as a new generation of chondroprotectors. The composition of the capsules is supplemented with harpagophytum root extract (also called fragrant martinia) and manganese.
Harpagophytum root extract is a natural anti-inflammatory substance studied by specialists. Its use helps reduce pain and improve mobility [18,19].
Manganese for joints helps protect and renew cartilage, and our body also uses this mineral to produce collagen [20].
MUKOSAT® capsules can be used as an addition to a complex regimen for osteoarthritis and osteochondrosis [21].
The components of the capsules contribute [21]:
· reducing pain and inflammation;
· increased mobility;
· protection of cartilage tissue of joints and spine.
Detailed information, including the regimen and mode of administration, can be found in the instructions for use of MUKOSAT® capsules.
All about MUKOSAT® capsules on mukosat.ru
* BIOLOGICALLY ACTIVE SUPPLEMENT. NOT A MEDICINE.
Sources:
*Contains NEM® complex exclusively in Mucosat® capsules
1. Clinical recommendations “Osteochondrosis of the spine”, All-Russian public organization Association of Traumatologists and Orthopedists of Russia, 2021.
2. Kloppenburg M, Kroon FP, Blanco FJ, et al2018 update of the EULAR recommendations for the management of hand osteoarthritis Annals of the Rheumatic Diseases 2019;78:16-24.
3. Olivier Bruyère et al. An updated algorithm recommendation for the management of knee osteoarthritis from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), Seminars in Arthritis and Rheumatism, Volume 49, Issue 3, 2021, Pages 337-350.
4. Federal clinical guidelines for the diagnosis and treatment of osteoarthritis. Association of Rheumatologists of Russia. 2016
5. Mezenova T.V. Boosted therapy for osteoarthritis: expanding the boundaries of what is possible. Surgery. Journal named after N.I. Pirogov. 2018;(5): 91-95
6 Fedotova A. V., Mironova O. P. Chondroprotector mucosat in an integrated approach to the treatment of patients with nonspecific back pain. Journal of Neurology and Psychiatry. S.S. Korsakov. 2018;118(9):133-137.
7. Lopes Junior, Osmar Valadao, & Inacio, Andre Manoel. (2013). Use of glucosamine and chondroitin to treat osteoarthritis: a review of the literature. Revista Brasileira de Ortopedia, 48(4), 300-306.
8. Naumov A.V., Khovasova N.O., Tkacheva O.N. Chondropenia at the forefront of the osteoarthritis epidemic: from aging joints to the clinical manifestation of the disease // Attending physician, 2021. No. 12. P. 69-69.
9. Ruff KJ, DeVore DP, Leu MD and Robinson MA. (2009) Eggshell Membrane: A Possible New Natural Therapeutic For Joint & Connective Tissue Disorders. Results From Two Open-label Human Clinical Studies. Clinical Interventions in Aging 4:235–240.
10. URL: stratumnutrition Access date 04/07/2021
11. Wedekind KJ, Ruff KJ, Atwell CA, Evans JL and Bendele AM. (2016) Beneficial Effects of Natural Eggshell Membrane (NEM) on Multiple Indices of Arthritis in Collagen-Induced Arthritic Rats. Modern Rheumatology, 27(5):838-848.
12. Ruff KJ. Eggshell membrane hydrolyzates activate NF-κB in vitro: possible implications for in vivo efficacy. J Inflamm Res. 2015.
13. Sim BY, Bak JW, Lee HJ, Jun JA, Choi HJ, Kwon CJ, Kim HY, Ruff KJ, Brandt K and Kim DH. (2015) Effects of natural eggshell membrane (NEM) on monosodium iodoacetate-induced arthritis in rats. Journal of Nutrition and Health, 48(4):310-318.
14. Ruff KJ, Winkler A, Jackson RW, DeVore DP and Ritz BW. (2009) Eggshell Membrane in the Treatment of Pain and Stiffness from Osteoarthritis of the Knee: A Randomized, Multicenter, Double Blind, Placebo Controlled Clinical Study. Clinical Rheumatology 28:907–914.
15. Brunello E and Masini A. (2016) NEM® Brand Eggshell Membrane Effective in the Treatment of Pain and Stiffness Associated with Osteoarthritis of the Knee in an Italian Study Population. International Journal of Clinical Medicine, 7:169-175
16. Eskiyurt et al. (2019) Efficacy and Safety of Natural Eggshell Membrane (NEM®) in Patients with Grade 2/3 Knee Osteoarthritis: A Multi-Center, Randomized, Double-blind, Placebo-Controlled, Single-crossover Clinical Study. Journal of Arthritis, 8(4):1000285
17. Ruff KJ, Endres JR, Clewell AE, Szabo JR and Schauss AG. (2012) Safety evaluation of a natural eggshell membrane-derived product. Food and Chemical Toxicology 50:604–611.
18. Ribbat JM, Schakau D. Tratamiento de los dolores crónicos activos en el sistema de locomoción // Natura Med. - 2001. - V. 16, No. 3. - P. 23-30.
19. Chrubasik JE, Roufogalis BD, Chrubasik S. Evidence of the effectiveness of herbal anti-inflammatory drugs in the treatment of painful osteoarthritis and chronic low back pain // Phytother. Res. - 2007. - V. 21. - P. 675-683.
20. Delmas PD Treatment of postmenopausal osteoporosis. The Lancet. 2002;359(9322):2018–2026. doi: 10.1016/s0140-6736(02)08827-x
21. Biologically active food additive Mucosat® capsules. Certificate of state registration No.RU. 77.99.88.003.E.001059.03.18 dated 03/15/2018
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