Welcome back to our weekly educational sessions.
Last week, we discussed a little bit of the science behind hypertension and the major hormones / organs that take part in the process.
Here’s a little test: Of these three hormones, which one
comes earliest in the RAAS
pathway?
A) Aldosterone
B) Angiotensinogen
C) Angiotensin II
D) Angiotensin I
This week, we want to build on last week by discussing some of the major blood pressure medications that are prescribed (and what part of the pathway) they effect. On the resources tab of our website, we have a wonderful resource prepared by Dr. Kristin Watson from the University of Maryland .
We will help break down some of the drugs here. It may be helpful to reference this image of the RAAS pathway form last week as you review!
Our first class of drugs are called : Angiotensin-converting enzyme-inhibitors or ACE-Inhibitors
– Recognize them with the “-pril” ending ie. Benazepril, Lisinopril, Perindopril
– These drugs act by inhibiting the conversion of Angiotensin I to Angiotensin II meaning the effects of angiotensin II (vasoconstriction, formation of aldosterone) will decrease
-– Two side effects of ACE-inhibitors are dry cough (remember ACE enzyme acts in the lungs) and a rare reaction called “Angio-edema” which causes swelling of your upper airway. Be sure to contact your healthcare provider if you or a family member ever experienced a reaction to ACE-inhibitors.
Our second class of drugs are called : Angiotensin II receptor blockers or ARBs
– These drugs can be recognized with the
“-artan” ending ie. Azilsartan , Telmisartan , Losartan
– Like the name implies, these drugs act to directly block the effects of angiotensin II , meaning they will also decrease vaso-constriction and aldosterone
– They have similar side effects to ACE-inhibitors and your doctors may routinely order lab work to monitor your salt, potassium and kidney functions.
Next, we have beta-blockers
– These drugs can be recognized with the “-ol” ending ie. Carvediolol , Labetalol , Metoprolol and they work to in two large ways:
Beta blockers have a “calming” effect on the heart, causing decreased heart rate and force of pumping which help lower blood pressure throughout the system.
Some Beta-blockers may also directly inhibit the release of the hormone renin from the kidneys which stops the RAAS pathway early in its course.
Some side effects include tiredness, dizziness, sexual dysfunction , and shortness of breath.
Finally, for this week we have aldosterone antagonists
– These drugs can be recognized by their “-one” ending :
Spironolactone , Eplerenone
– These drugs work later in the RAAS pathway to oppose the effects of aldosterone released from the adrenal glands, meaning they will stop the kidneys form absorbing water and salt.
– Your doctors may routinely order lab work to monitor your salt, potassium and kidney functions.
– Some side effects include dizziness for both and breast/tenderness or menstrual irregularities for sprinolactone.
And that wraps up this week’s session! Be sure to check out our resources tab for more amazing educational material and join us next week as we discuss some more hypertensive drugs including - diuretics! Thank you to everyone who tuned in and as always our family here thanks you for taking this journey with us. Until next time, remember to Think Aorta!
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