- Side Effects
- Drug Interactions
What is the difference between ACE inhibitors vs. beta-blockers?
- ACE inhibitors (angiotensin converting enzyme inhibitors) and beta-blockers are used to treat high blood pressure (hypertension) and congestive heart failure, to prevent kidney failure in patients with high blood pressure or diabetes, and to reduce the risk of stroke.
- ACE inhibitors are also used to improve survival after heart attacks.
- Beta-blockers are also used to treat abnormal heart rhythms, chest pain (angina), tremors, pheochromocytoma, hypertrophic subaortic stenosis, and to prevent migraines.
- Examples of ACE Inhibitors include benazepril hydrochloride (Lotensin), captopril (Capoten), enalapril maleate (Vasotec), fosinopril sodium (monopril), lisinopril (Prinivel, Zestril), moexipril (Univasc), moexipril (Univasc), perindopril (Aceon), quinapril hydrochloride (Accupril), ramipril (Altace), and trandolapril (Mavik).
- Examples of beta-blockers include acebutolol (Sectral), atenolol (Tenormin), betaxolol (Kerlone), bisoprolol fumarate (Zebeta), carteolol hydrochloride (Cartrol), metoprolol tartrate (Lopressor), metoprolol succinate (Toprol-XL), nadolol (Corgard), penbutolol sulfate (Levatol), pindolol (Visken), propranolol hydrochloride (Inderal), solotol hydrochloride (Betapace), and timolol maleate (Blocadren).
- Common side effects of ACE inhibitors include:
- Serious side effects of ACE inhibitors include:
- Common side effects of beta-blockers include:
- Both ACE inhibitors and beta-blockers are not recommended for use during pregnancy. They may cause low blood pressure, excess potassium in the blood (hyperkalemia), kidney failure, and harm to a fetus.
What do ACE inhibitor drugs and beta-blockers do?
ACE inhibitors (angiotensin converting enzyme inhibitors) work by preventing a natural body substance called angiotensin I from converting into angiotensin II, which cases blood vessels to narrow and constrict. By preventing this change, the blood vessels remain relaxed and blood pressure decreases.
Beta-blockers, also known as beta-adrenergic blocking agents, block norepinephrine and epinephrine (adrenaline) from binding to beta receptors on nerves. This helps reduce the heart rate and lower blood pressure.
What are the side effects of ACE inhibitors and beta-blockers?
ACE Inhibitor side effects
ACE inhibitors are well-tolerated by most individuals. Nevertheless, they are not free of side effects, and some patients should not use ACE inhibitors. ACE inhibitors usually are not prescribed for pregnant women because they may cause birth defects.
Individuals with bilateral renal artery stenosis (narrowing of the arteries that supply the kidneys) may experience worsening of kidney function, and people who have had a severe reaction to ACE inhibitors probably should avoid them.
The most common side effects are:
- Elevated blood potassium levels
- Low blood pressure,
- Abnormal taste (metallic or salty taste)
- Chest pain
- Increased uric acid levels
- Sun sensitivity
- Increased BUN and creatinine levels
It may take up to a month for coughing to subside, and if one ACE inhibitor causes cough it is likely that the others will too. The most serious, but rare, side effects of ACE inhibitors are:
- Kidney failure
- Allergic reactions
- Liver dysfunction
- A decrease in white blood cells
- Swelling of tissues (angioedema).
Beta blocker side effects
Beta blockers may cause:
Other important side effects include:
- Central nervous system effects of beta blockers include:
Beta blockers that block β2 receptors may cause shortness of breath in asthmatics. As with other drugs used for treating high blood pressure, sexual dysfunction may occur. Beta blockers may cause low or high blood glucose and mask the symptoms of low blood glucose (hypoglycemia) in people with diabetes.
Other serious side effects of beta-blockers include:
What are drugs interact with ACE inhibitors and beta-blockers?
ACE Inhibitor drug interactions
ACE inhibitors have few interactions with other drugs.
- Since ACE inhibitors may increase blood levels of potassium, the use of potassium supplements, salt substitutes (which often contain potassium), or other drugs that increase the body's potassium may result in excessive blood potassium levels.
- ACE inhibitors also may increase the blood concentration of lithium (Eskalith, Lithobid) and lead to an increase in side effects from lithium.
- There have been reports that aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever etc.), indomethacin (Indocin, Indocin-SR), and naproxen (Anaprox, Naprelan, Naprosyn, Aleve) may reduce the blood pressure lowering effects of ACE inhibitors.
- Patients receiving diuretics may experience excessive reduction in blood pressure when ACE inhibitors are started. Stopping the diuretic or increasing salt intake prior to taking the ACE inhibitor may prevent excessive blood pressure reduction. Close supervision for at least two hours after the start of ACE inhibitors and until blood pressure is stable is recommended if the diuretic cannot be stopped.
- ACE inhibitors should not be combined with ARBs because such combinations increase the risk of hypotension, hyperkalemia, and renal impairment.
- ACE inhibitors should not be combined with aliskiren (Tekturna), another class of drugs that is used to treat high blood pressure because such combinations increase the risk of kidney failure, excessive low blood pressure, and hyperkalemia.
- Nitritoid reactions (symptoms include facial flushing, nausea, vomiting and low blood pressure) may occur when injectable (gold sodium aurothiomalate [Myochrysine]), used in the treatment of rheumatoid arthritis, is combined with ACE inhibitors.
Beta-blocker drug interactions
- Combining propranolol (Inderal) or pindolol (Visken) with thioridazine (Mellaril) or chlorpromazine (Thorazine) may result in low blood pressure (hypotension) and abnormal heart rhythms because the drugs interfere with each other's elimination and result in increased levels of the drugs.
- Dangerous elevations in blood pressure may occur when clonidine (Catapres) is combined with a beta-blocker, or when clonidine or beta-blocker is discontinued after their concurrent use. Blood pressure should be closely monitored after initiation or discontinuation of clonidine or a beta-blocker when they have been used together.
- Phenobarbital and similar agents may increase the breakdown and reduce blood levels of propanolol (Inderal) or metoprolol (Lopressor, Toprol XL). This may reduce effectiveness of the beta-blocker.
- Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) (for example, ibuprofen) may counteract the blood pressure reducing effects of beta-blockers by reducing the effects of prostaglandins, which play a role in control of blood pressure.
- Beta-blockers may prolong hypoglycemia (low blood sugar) and mask symptoms of hypoglycemia in diabetics who are taking insulin or other diabetic medications.
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What are the different types of ACE inhibitors and beta blockers?
ACE inhibitors list
The following is a list of the ACE inhibitors that are available in the United States:
- benazepril (Lotensin)
- captopril (Capoten- discontinued brand)
- enalapril (Vasotec, Epaned, [Lexxel- discontinued brand])
- fosinopril (Monopril- Discontinued brand)
- lisinopril (Prinivil, Zestril, Qbrelis)
- moexipril (Univasc- Discontinued brand)
- perindopril (Aceon)
- quinapril (Accupril)
- ramipril (Altace)
- trandolapril (Mavik)
Beta blockers list
The following is a list of the Beta blockers that are available in the United States:
- acebutolol (Sectral)
- atenolol (Tenormin)
- betaxolol (Kerlone)
- betaxolol (Betoptic S)
- bisoprolol fumarate (Zebeta)
- carteolol (Cartrol, discontinued)
- carvedilol (Coreg)
- esmolol (Brevibloc)
- labetalol (Trandate [Normodyne - discontinued])
- metoprolol (Lopressor, Toprol XL)
- nadolol (Corgard)
- nebivolol (Bystolic)
- penbutolol (Levatol)
- pindolol (Visken, discontinued)
- propranolol (Hemangeol, Inderal LA, Inderal XL, InnoPran XL)
- sotalol (Betapace, Sorine)
- timolol (Blocadren, discontinued)
- timolol ophthalmic solution (Timoptic, Betimol, Istalol)
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Related Disease Conditions
What Is the Normal Blood Pressure Range?
Blood pressure is the force applied by the blood over the inner walls of the arteries. Although the average blood pressure for a person remains constant, it shows minor fluctuations throughout the day—declining while relaxing and momentarily increasing while being excited or under stress. An increase in the resting blood pressure can scar, stiffen, or harden the arteries.
Why Is My Bottom Blood Pressure Number High?
Isolated diastolic hypertension (IDH) occurs when your systolic blood pressure is normal, and only your diastolic blood pressure is high (over 80 mm Hg). Causes of high diastolic blood pressure include a high-sodium diet, obesity, lack of physical activity, excessive alcohol consumption, stress and anxiety.
How to Lower My Blood Pressure Immediately
If you face any complications of high blood pressure such as a stroke or heart attack, contact your physician without any delay. Do not attempt home remedies in such grave situations. If you have high blood pressure, without any complications, the first thing to do is to calm down and lie flat.
How Can I Lower My Blood Pressure in Minutes?
Learn how to lower your high blood pressure quickly and how to better manage this condition.
High Blood Pressure (Hypertension)
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million people in the US have hypertension (1 in 3 adults), and only half of them are able to manage it. Many people do not know that they have high blood pressure because it often has no has no warning signs or symptoms. Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure. The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater. If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
What Causes Your Blood Pressure to Suddenly Get High?
Hypertension or high blood pressure (high BP) is a medical condition where the pressure in the arteries is persistently elevated. The heart pumps blood into the arteries, and it is circulated to all parts of the body. Hypertension develops when the heart constantly needs to exert higher force to deliver the blood to the organs through the arteries.
What Is Considered Stroke-Level High Blood Pressure?
Blood pressure readings above 180/120 mmHg are considered stroke-level, dangerously high and require immediate medical attention.
Can Drinking Water Lower Your Blood Pressure?
Keeping well hydrated by drinking six to eight glasses of water daily (even more if working in hot and humid conditions) is beneficial for the blood pressure. High blood pressure (BP) or hypertension is a condition caused by the persistent high pressure of blood against the walls of arteries. It is also called systolic pressure (constantly greater than 139 mmHg) or diastolic pressure (constantly more than 89 mmHg).
Is 120 Over 60 a Good Blood Pressure Reading?
If your systolic blood pressure is normal (between 100-120), and your diastolic blood pressure is lower (60 or below), you are considered to have low blood pressure, or isolated diastolic hypotension. Low diastolic blood pressure should be monitored closely.
What Does it Mean When the Bottom Number of Your Blood Pressure is Over 100?
Diastolic blood pressure (DBP) is the pressure exerted on the walls of the arteries when the heart muscle relaxes between beats. When the bottom number of blood pressure (diastole) is over 100 mmHg, it may be called diastolic hypertension (DHT).
How Do You Check Your Blood Pressure With Your Fingers?
Most doctors recommend the use of a blood pressure machine to check blood pressure. An individual may check heart rate with their fingers, but not blood pressure.
Can You Take Turmeric if You Take Blood Pressure Medicine?
Turmeric is one of the most used spices in Asian cuisine. This yellow spice has been hailed for its healing properties for centuries. A turmeric latte is touted for its myriad health benefits. Turmeric contains several anti-inflammatory compounds collectively called curcuminoids.
High Blood Pressure Treatment (Natural Home Remedies, Diet, Medications)
High blood pressure (hypertension) means high pressure (tension) in the arteries. Treatment for high blood pressure include lifestyle modifications (alcohol, smoking, coffee, salt, diet, exercise), drugs and medications such as ACE inhibitors, angiotensin receptor blockers, beta blockers, diuretics, calcium channel blockers (CCBs), alpha blockers, clonidine, minoxidil, and Exforge.
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Which Is More Important: Systolic or Diastolic Blood Pressure?
Systolic blood pressure is often given more attention as a risk factor for heart disease. However, both systolic and diastolic blood pressure are equally important in monitoring the health of your heart.
What Is the Blood Pressure of a Very Fit Person?
Studies show that a very fit person who exercises regularly will have a lower resting blood pressure (usually below 120/80 mm Hg) than someone who leads a sedentary lifestyle.
How Do You Get the Bottom Blood Pressure Number Down?
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Which Blood Pressure Number Is the Most Important?
The blood that flows through the arteries (blood vessels carrying blood from the heart to other parts of the body) exerts pressure against the arterial walls. The number above (120) is called the systolic blood pressure and the number below (80) is called the diastolic blood pressure. Though both readings are important, many doctors believe that systolic blood pressure is a better predictor of complications of hypertension, such as heart disease or stroke.
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Is A Manual Blood Pressure More Accurate?
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Hypertension-Related Kidney Disease
Second Source WebMD Medical Reference
What Are the Signs Your Blood Pressure Is Too High?
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Is a Diastolic Blood Pressure of 64 mmHg too Low?
Diastolic blood pressure means the blood pressure reading during the phase when your heart relaxes (diastole). Force of the blood against the walls of the arteries (the blood vessels carrying blood from the heart to other sites) in the body is called blood pressure. The heart pumps the blood into the arteries as it contracts (systole).
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Portal hypertension is most commonly caused by cirrhosis, a disease that results from scarring of the liver. Other causes of portal hypertension include blood clots in the portal vein, blockages of the veins that carry the blood from the liver to the heart, and a parasitic infection called schistosomiasis. Symptoms of portal hypertension include varices (enlarged veins), vomiting blood, blood in the stool, black and tarry stool, ascites (abnormal fluid collection within the peritoneum, the sac that contains the intestines within the abdominal cavity), confusion and lethargy, splenomegaly or enlargement of the spleen, and decreased white blood cell counts.
How Can I Lower My Blood Pressure Immediately?
High blood pressure (BP) is dangerous. It can lead to many health problems, including heart disease, brain stroke, kidney disease, vision loss, sexual dysfunction, and more.
Pulmonary hypertension is elevated pressure in the pulmonary arteries that carry blood from the lungs to the heart. The most common symptoms are fatigue and difficulty breathing. If the condition goes undiagnosed, more severe symptoms may occur. As pulmonary hypertension worsens, some people with the condition have difficulty performing any activities that require physical exertion. While there is no cure for pulmonary hypertension, it can be managed and treated with medications and supplemental oxygen to increase blood oxygen levels.
What Is Normal Blood Pressure by Age?
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Hypertensive Kidney Disease
High blood pressure can damage the kidneys and is one of the leading causes of kidney failure (end-stage renal kidney disease). Kidney damage, like hypertension, can be unnoticeable and detected only through medical tests. If you have kidney disease, you should control your blood pressure. Other treatment options include prescription medications.
Will Drinking Water Lower Blood Pressure?
High blood pressure, or hypertension, is when the force of blood flowing through your blood vessels is consistently too high. Simply drinking more water without making other diet changes won't lower blood pressure.
What Are the New Blood Pressure Guidelines for Seniors?
Hypertension or high blood pressure (high BP) is a medical condition where the pressure in the blood vessels is persistently elevated. The heart pumps blood into the arteries, which circulate blood to all parts of the body. In cases of high blood pressure, the heart has to work harder to push the blood column ahead.
What Will Happen if Your Blood Pressure is Too High?
High blood pressure, also known as hypertension, can have negative consequences on your health. Learn what happens if your blood pressure is too high, the causes of high blood pressure, and what you can do to treat it.
How Do I Know If I Have High or Low Blood Pressure Numbers?
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Can High Blood Pressure Hurt My Eyes?
Unfortunately, yes. Suffering from untreated or poorly controlled high blood pressure for a long time can be detrimental to your eyes. Several eye diseases are directly or indirectly caused by high blood pressure (hypertension).
What Are Abnormal Blood Pressure Number Ranges?
Abnormal blood pressure, especially high blood pressure, is a common issue with no initial symptoms. Learn how to keep your blood pressure in the normal range.
Can I Check My Blood Pressure With My Phone?
The force of the blood against the walls of the blood vessels carrying blood from the heart to other sites in the body (the arteries) is called blood pressure. The heart pumps blood into the arteries as it contracts (systole).
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What Can I Eat To Lower My Blood Pressure Immediately?
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What Is “Normal” Blood Pressure?
Normal blood pressure is when the pressure is less than or upto 120/80 mmHg. The value 120 denotes the systolic pressure, and the value 80 denotes the diastolic pressure.
Preeclampsia (Pregnancy Induced Hypertension)
Preeclampsia is related to increased blood pressure and protein in the mother's urine. Preeclampsia typically begins after the 20th week of pregnancy. When preeclampsia causes seizures, it is termed "eclampsia" and is the second leading cause of maternal death of in the US. Preeclampsia is the leading cause of fetal complications. Risk factors for preeclampsia include high blood pressure, obesity, multiple births, and women with preexisting medical conditions such as diabetes, kidney disease, rheumatoid arthritis, lupus, or scleroderma. Pregnancy planning and lifestyle changes may reduce the risk of preeclampsia during pregnancy.
How Does High Blood Pressure Affect Pregnancy?
High blood pressure during pregnancy can cause serious complications. Learn more about the signs of and risks associated with the condition.
High Blood Pressure Symptoms
Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels. In some patients, symptoms may include fatigue, headaches, dizziness, confusion, sweating, chest pain and vision problems.
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What Is High Blood Pressure (Hypertension)?
High blood pressure or hypertension is when the blood pressure readings consistently range from 140 or higher for systolic or 90 or higher for diastolic. Blood pressure readings above 180/120 mmHg are dangerously high and require immediate medical attention.
What Is the Proper Way to Take Your Blood Pressure?
Nowadays, you can easily measure your blood pressure at home using an automated blood pressure machine or sphygmomanometer. Here’s how to do it step-by-step to make sure you’re doing it the right way.
Treatment & Diagnosis
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Medications & Supplements
- quinapril - oral, Accupril
- atenolol - oral, Tenormin
- lisinopril (Zestril, Prinivil, Qbrelis) ACE Inhibitor
- labetalol, Normodyne, Trandate
- metoprolol (Lopressor, Toprol XL)
- carvedilol (Coreg)
- enalapril (Vasotec, Epaned)
- captopril (Capoten)
- ramipril (Altace)
- benazepril (Lotensin HTC)
- trandolapril (Mavik)
- nadolol (Corgard)
- perindopril - oral, Aceon
- quinapril (Accupril)
- fosinopril sodium, Monopril
- atenolol and chlorthalidone, Tenoretic
- moexipril - oral, Univasc
- betaxolol ophthalmic (Betoptic S, Betoptic)
- carteolol solution - ophthalmic, Ocupress
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