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- What are angiotensin receptor blockers (ARBs? How do they work (mechanism of action)?
- What are the uses for ARBs?
- What are the side effects of ARBs?
- List of generic and brand names for ARBs
- Are there any differences among the different types of ARBs?
- What drugs and supplements cause drug interactions with ARBs?
- Are ARBs safe to take if I'm pregnant or breastfeeding?
What are angiotensin receptor blockers (ARBs? How do they work (mechanism of action)?
Angiotensin II is a very potent chemical formed in the blood that causes muscles surrounding blood vessels to contract, thereby narrowing the vessels. This narrowing increases the pressure within the vessels and can cause high blood pressure (hypertension). Angiotensin II receptor blockers (ARBs) are medications that block the action of angiotensin II by preventing angiotensin II from binding to angiotensin II receptors on the muscles surrounding blood vessels. As a result, blood vessels enlarge (dilate) and blood pressure is reduced. Reduced blood pressure makes it easier for the heart to pump blood and can improve heart failure. In addition, the progression of kidney disease caused by the high blood pressure or diabetes is slowed. ARBs have effects that are similar to angiotensin converting enzyme (ACE) inhibitors, but ACE inhibitors act by preventing the formation of angiotensin II rather than by blocking the binding of angiotensin II to muscles on blood vessels.
What are the uses for ARBs?
- ARBs are used for controlling high blood pressure, treating heart failure, and preventing kidney failure in people with diabetes or high blood pressure.
- ARBs also may prevent diabetes and reduce the risk of stroke in patients with high blood pressure and an enlarged heart.
- ARBs also may prevent the recurrence of atrial fibrillation.
Since ARB medications have effects that are similar to those of ACE inhibitors, they often are used when ACE inhibitors are not tolerated by patients (for example, due to excessive coughing).
Quick GuideHow to Lower Blood Pressure: Exercise Tips
What are the side effects of ARBs?
ARBs are well tolerated by most people. The most common side effects are
- elevated potassium levels in the blood (hyperkalemia),
- low blood pressure,
- abnormal taste sensation (metallic or salty taste),
- orthostatic hypotension (low blood pressure upon standing),
- increased blood glucose levels,
- flu-like symptoms,
- sinusitis (sinus infection),
- bronchitis, and
- upper respiratory tract infections.
Compared to ACE inhibitors, cough occurs less often with ARBs.
Serious side effects of ARBs
- The most serious, but rare, side effects are
- There have been reports of rhabdomyolysis (destruction of skeletal muscle) in patients receiving ARBs.
- Individuals who have narrowing of both arteries that supply the kidneys or have had a severe reaction to ARBs should avoid them.
- Like other antihypertensives, ARBs have been associated with sexual dysfunction.
List of generic and brand names for ARBs
The ARBs that are currently available are:
Are there any differences among the different types of ARBs?
ARBs are similar in actions and side effects. They differ in how they are eliminated from the body and the extent to which they are distributed throughout the body.
- Some ARBs need to be converted to an active form in the body before they can lower blood pressure. In addition, some ARBs are better at lowering blood pressure.
- In some studies, irbesartan (Avapro) and candesartan (Atacand) reduced blood pressure better than losartan (Cozaar).
What drugs and supplements cause drug interactions with ARBs?
- ARBs have few interactions with other drugs.
- Since ARBs may increase blood levels of potassium, the use of potassium supplements, salt substitutes (which often contain potassium), or other drugs that increase potassium may result in excessive blood potassium levels and cardiac arrhythmias.
- ARBs may also increase the blood concentration of lithium (Eskalith, Lithobid) and lead to an increase in side effects from lithium.
- Rifampin (Rifadin) reduces the blood levels of losartan, and fluconazole (Diflucan) reduces the conversion of losartan to its active form. These effects could decrease the effects of losartan.
- ARBs should not be combined with ACE inhibitors because such combinations increase the risk of hypotension, hyperkalemia, and renal impairment.
- ARBs should not be combined with aliskiren (Tekturna) because such combinations increase the risk of kidney failure, excessive low blood pressure, and hyperkalemia.
Are ARBs safe to take if I'm pregnant or breastfeeding?
ARBs are not prescribed for women during pregnancy because they may cause a serious condition called oligohydramnios, which may result in injury and even death of the fetus.
Angiotensin II receptor blockers (ARBs) are a class of drugs prescribed to control blood pressure, treat heart failure, and prevent kidney failure in people with diabetes or high blood pressure. Examples of ARBs include candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), telmisartan (Micardis), valsartan (Diovan), losartan (Cozaar), and olmesartan (Benicar). Side effects, drug interactions, and patient safety information should be reviewed prior to taking any medication.
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Blood Pressure PictureThe blood pressure is the pressure of the blood within the arteries. See a picture of Blood Pressure and learn more about the health topic.
Chronic cough is a cough that does not go away and is generally a symptom of another disorder such as asthma, allergic rhinitis, sinus infection, cigarette smoking, GERD, postnasal drip, bronchitis, pneumonia, medications, and less frequently tumors or other lung disease.
Chronic cough treatment is based on the cause, but may be soothed natural and home remedies.
Body Blood Sugar LevelsHigh blood sugar can be a sign of diabetes or prediabetes. The drugs that treat it sometimes cause low blood sugar too. WebMD helps guide you through the effects of both.
Diabetes Foot ProblemsLearn more about diabetes related foot problems. For people with diabetes, too much glucose in the blood can cause serious foot complications such as nerve damage, infection, and ulcers. Find tips for proper foot care to help prevent serious complications.
Diabetes MellitusDiabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
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Diabetes Symptoms in Men
Diabetes mellitus is a disease in which a person's blood sugar (blood glucose) is either too high (hyperglycemia) or too low (hypoglycemia) due to problems with insulin regulation in the body. There are two main types of diabetes mellitus, type 1 and type 2. Type 1 diabetes usually occurs during childhood, while type 2 diabetes usually occurs during adulthood, however, rates of both types of diabetes in children, adolescents, and teens is increasing.
More men than women have diabetes in the US, and the disease can affect men differently than women.
Warning symptoms of diabetes that men have and women do not include:
- Low testosterone (low-T)
- Sexual problems
- Impotence (erectile dysfunction)
- Decreased interest in sex
- Retrograde ejaculation
Type 1 and type 2 diabetes symptoms and signs that are the same in men and women include:
- Skin infections
- Numbness or tingling in the feet or hands
- Excessive thirst or hunger
- Blurred vision
- Weight gain
- Weight loss
- Urinary tract infections (URI)
- Kidney problems
Treatment for type 1 diabetes is insulin, and treatment for type 2 diabetes are lifestyle changes like eating a healthy diet, getting exercise daily, and if necessary, diabetes medications.
NIH; National Institute of Diabetes and Digestive and Kidney Diseases. "Preventing Type 2 Diabetes. Updated: Nov 2017.
NIH; National Institute of Diabetes and Digestive and Kidney Diseases. "Symptoms and Causes of Diabetes." Updated: Nov 2017.
Diabetes Symptoms in Women
Diabetes is a disease where your body does not make enough insulin or does not use insulin correctly, and you blood sugar (glucose) levels become too high (hyperglycemia or high blood sugar). There are two main types of diabetes, type 1 and type 2. Prediabetes (pre-diabetes) often precedes type 2 diabetes. In prediabetes your blood sugar levels are high, but not high enough to be diagnosed with diabetes. Most people with prediabetes have no symptoms or warning signs until type 2 diabetes develops. Prediabetes can be reversed with exercise, diet, and stress management.
In type 1 and type diabetes, there are symptoms particularly unique to women.
- More than half of women with polycystic ovary syndrome, or PCOS, develop type 2 diabetes by the age of 40.
- Women have a higher risk for heart disease, heart attack, and stroke. Women also have lower survival rates and a poorer quality of life after a heart attack than men.
- Women have a higher risk for blindness and depression.
- In women with diabetes, the "good" or HDL cholesterol drops, which puts them at greater risk of heart disease.
- Vaginal itching and pain due to vaginal and oral yeast infections.
- Vaginal pain, dryness, reduced libido (sex drive), or decreased vaginal sensation during sex due to blood flow problems to the genitals.
- Increased urinary tract infections, or UTIs.
There are signs and symptoms of both types of diabetes that are common in men and women.
- Sores or wounds that do not heal
- Numbness and/or tingling in the hands or feet
- Increased hunger
- Increase thirst
- Increased urination
- Blurred vision
- Unexplained weight loss
If you are planning to become pregnant, talk with your doctor about managing your diabetes during pregnancy to avoid complications. Gestational diabetes occurs during pregnancy and causes blood sugar levels too become to high. Gestational diabetes can be managed with diet, and if necessary medication. It usually goes away once the baby is born. However, if you have gestational diabetes during pregnancy it increases your risk of developing type 2 diabetes later.
CDC. "PCOS and Diabetes, Heart Disease, Stroke..." Updated: Oct 11, 2016.
CDC. "Prediabetes." Updated: Jul 25, 2017.
NIH; National Institute of Diabetes and Digestive and Kidney Diseases. "Symptoms and Causes of Diabetes." Updated: Nov 2016.
NIH; National Institute of Diabetes and Digestive and Kidney Diseases. "What is Diabetes?" Updated: Nov 2016.
NIH; National Institute of Diabetes and Digestive and Kidney Diseases. "Risk Factors for Type 2 Diabetes." Nov 2016.
Womenshealth.gov. "Diabetes." Updated: Jun 12, 2017.
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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.
High Blood Pressure TreatmentHigh 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.
Kidney Disease QuizKidney disease is common. Take this kidney disease quiz to test your knowledge and learn the symptoms, causes and types of kidney disease and what foods to eat and avoid!
Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss, dehydration, or medication. Some of the renal causes of kidney failure include sepsis, medications, rhabdomyolysis, multiple myeloma, and acute glomerulonephritis.
Post renal causes of kidney failure include bladder obstruction, prostate problems, tumors, or kidney stones.Treatment options included diet, medications, or dialysis.
ParathyroidectomyParathyroidectomy is the removal of one or more of the parathyroid glands to treat hyperparathyroidism. Risks of parathyroidectomy include:
- paralysis of the vocal cords,
- difficulty swallowing thin liquids,
- difficulty breathing,
- and drug reactions.
- damage to the recurrent laryngeal nerve,
- bleeding or hematoma,
- problems maintaining calcium levels in the blood,
- need for further and more aggressive surgery,
- need for a limited or total thyroidectomy,
- prolonged pain,
- impaired healing,
- and recurrence of the tumor.
Stroke Symptoms and Treatment
A stroke is an interruption of the blood supply to part of the brain caused by either a blood clot (ischemic) or bleeding (hemorrhagic). Symptoms of a stroke may include
- double vision or vision loss,
- vertigo, and
- difficulty speaking or understanding speech.
A physical exam, imaging tests, neurological exam, and blood tests may be used to diagnose a stroke. Treatment may include administration of clot-busting drugs, supportive care, and in some instances, neurosurgery. The risk of stroke can be reduced by controlling high blood pressure, high cholesterol, diabetes, and stopping smoking.
Superfoods QuizTake our Superfoods Quiz! Get to know how unprocessed, raw, organic foods and healthy drinks are rich in nutrients and dietary benefits.
Type 2 Diabetes
Type 2 diabetes is a condition in which a person's pancreas does not produce enough insulin to meet the needs of the body. Causes of type 2 diabetes are a sedentary lifestyle, eating excess sugar and carbohydrates, lack of exercise, being overweight, and genetics. Symptoms of type 2 diabetes are often subtle, but may include fatigue, urine odor, unintentional
Type 2 Diabetes SlideshowLearn about type 2 diabetes warning signs, symptoms, diagnosis, and treatment options. Read how diet and exercise can help manage type 2 diabetes.