Antihypertensor

The antihypertenseurs are a class of drugs which are managed to reduce the arterial Hypertension.

The diurétiques ones

The Diurétique S act by elimination of part of water and sodium contained in blood: this induces a reduction in blood volume and thus a fall of the blood-pressure.

There exist three families of diuretic: thiazidic (and related) , diuretic of the handle of Henlé and finally the anti-aldosterone . The first two families offer kaliuretic molecules (increase the urinary elimination of potassium and thus support the hypokaliemy) while the anti-aldosterones contrary retain urinary potassium (and thus support the hyperkaliemy).

Beat-blockings

The Bêta-bloquant S act mainly by reducing the activity of the Catécholamine S on the Cœur and by decreasing the secretion of Rénine (they thus act also against the System Renin Angiotensin Aldosterone). At the hypertensive one, it is preferable to call upon the molecules known as selective which present less side effects.

It is necessary to respect the Contre-indication S (absolute at the hypertensive one): Asthma, turbid severe of conduction, Cardiac failure, Acrosyndrome (blue and painful fingers cold)-->

Inhibiters of the enzyme of conversion

The inhibiting of the enzyme of conversion (IECA, IEC) fight the stimulation of the system Rénine - Angiotensine - Aldostérone and reduce the circulating rates of angiotensin II and aldosterone. Bradykinine, substance vasodilatatrice. The inhibiters of the enzyme of conversion are all the more effective as the system renin-angiotensin-aldosterone is stimulated: strong falls of pressure can be thus observed in certain circumstances: preliminary containing soda déplétion (lack of sodium in blood), contracting of the renal artery.

Good performances are in particular obtained by using weak amounts of inhibiters of the enzyme of conversion, associated with a hyposodé mode, even with weak amounts of Diurétique (the latter increasing the sodium escape in the urines and thus stimulating the system renin-angiotensin-aldosterone).

The inhibiters of the enzyme of conversion are contra-indicated in the event of Grossesse and among patients consuming:

of potassium salts,
of the Immunosuppresseur S or
of the Lithium. -->

Antagonistic of the receivers of angiotensin II

The antagonists of angiotensin II (ARA-II or sartans) are a relatively new therapeutic class which causes a great interest by its very good tolerance and an original mechanism of action (direct blocking of the receivers of angiotensin II). They are very close to the IEC.

Calcic inhibiters

The calcic inhibiting reduce the tonicity of the arteries by decreasing the capacities vasoconstrictrices (calcium-dependant) of arterial smooth muscle fibers by inhibiting the transmembrane transfer Calcium.

Other antihypertenseurs

They are rather used as auxiliary treatment.

central antihypertenseurs
1. central alpha-stimulants: They decrease tonicity sympathetic nerve vasoconstrictor. Their undesirable effects limit their employment of it (dryness of the mouth, somnolence, orthostatic hypotension, nauseas…).
Alpha-blocking S peripherals
the Vasodilator S

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