High Blood Pressure Treatment (cont.)
Medical Author:
John P. Cunha, DO, FACOEP
John P. Cunha, DO, FACOEPJohn P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey. Medical Editor:
Jay W. Marks, MD
Jay W. Marks, MDJay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles. In this Article
 MinoxidilMinoxidil is the most potent of the drugs that lower blood pressure by dilating the peripheral arteries. This drug does not work through the peripheral sympathetic nervous system as do the alpha and beta blocker drugs, or through the control center in the brain, as does clonidine. Rather, it is a muscle relaxant that works directly on the smooth muscle of the peripheral arteries throughout the body. Minoxidil is used for patients who have not responded to other medications. It must be combined with a beta blocker or clonidine to prevent an increase in the heart rate and with a diuretic to prevent retention of fluid (swelling). Minoxidil may also increase hair growth. Renin inhibitorsAliskiren (Tekturna) is in a class of antihypertensive drugs called renin inhibitors. Renin is an enzyme in the chain of blood pressure regulating hormones referred to as the renin-angiotensin-aldosterone (RAA) hormonal system. The first step in the chain is the production of renin in the kidneys when the kidneys detect lower blood pressure. The renin stimulates the formation of a protein called angiotensin I, which is then converted to angiotensin II by angiotensin-converting enzyme (ACE) in the lungs, the same ACE targeted by ACE inhibitors. Angiotensin II is the most powerful constrictor of blood vessels known. This effect of constricting blood vessels tends to elevate the blood pressure. Angiotensin II also causes the secretion of an additional blood pressure elevating hormone in the adrenal glands called aldosterone, which helps the body retain sodium. Aliskiren inhibits the effects of renin and angiotensin so that blood pressure does not go up. Aliskiren should not be combined with ARB or ACE drugs in patients with diabetes because of the risk of renal impairment, hypotension, and hyperkalemia. Reviewed by Jay W. Marks, MD on 10/11/2012 Patient CommentsViewers share their comments
High Blood Pressure Treatment - Smoking
Question: Are you a smoker or former smoker undergoing treatment for high blood pressure? After diagnosis, did you quit smoking?
High Blood Pressure Treatment - Alcohol
Question: Do you have hypertension and also drink alcohol? Have you cut back since receiving a diagnosis?
High Blood Pressure Treatment - Coffee and Caffeine
Question: In what ways do coffee and other caffeinated beverages affect your blood pressure?
High Blood Pressure Treatment - Medications
Question: What medications and other types of treatment do you receive for hypertension?
High Blood Pressure Treatment - Diet
Question: Did you add or eliminate certain foods from your diet to control your high blood pressure? Did it help?
High Blood Pressure Treatment - Experience
Question: What kinds of treatments have been effective for your high blood pressure?
High Blood Pressure Treatment - Alternative Medicine
Question: Describe any alternative or complementary medicine you use to treat your high blood pressure.
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