Definition
Reducing blood pressure by pharmacological means reduces cardiovascular morbidity and mortality rates. Benefits include protection from stroke, coronary events, heart failure, progression of renal disease, progression to more severe hypertension, and, most importantly, mortality from all causes. Owing to the complexity of the pathogenesis of hypertension, antihypertensive drugs are directed against a variety of pharmacological targets in various cell types in different organs involved in blood pressure control.
Mechanism of Action
The fundamental mechanisms involved in blood pressure control have been outlined in chapter “Blood Pressure Control.” In addition to direct neuronal modulation of arterial pressure, two neurohumoral systems, i.e., the sympathetic nervous system and the renin–angiotensin–aldosterone system (RAS), play a pivotal role in blood pressure control. Both systems are always either directly or...
References
Algharably E, Kreutz R (2019) In: Mancia G, Grassi G, Tsioufis K, Dominiczak A, Rosei EA (eds) Manual of hypertension of the European Society of hypertension, 3rd edn. CRC Press, London
Arendse LB, Danser AHJ, Poglitsch M, Touyz RM, Burnett JC Jr, Llorens-Cortes C, Ehlers MR, Sturrock ED (2019) Novel therapeutic approaches targeting the renin-angiotensin system and associated peptides in hypertension and heart failure. Pharmacol Rev 71(4):539–570. https://doi.org/10.1124/pr.118.017129
Ayers K, Byrne LM, DeMatteo A, Brown NJ (2012) Differential effects of nebivolol and metoprolol on insulin sensitivity and plasminogen activator inhibitor in the metabolic syndrome. Hypertension 59(4):893–898. https://doi.org/10.1161/hypertensionaha.111.189589
Baker JG (2005) The selectivity of beta-adrenoceptor antagonists at the human beta1, beta2 and beta3 adrenoceptors. Br J Pharmacol 144(3):317–322. https://doi.org/10.1038/sj.bjp.0706048
Benowitz N (2015) Antihypertensive agents. In: Katzung BG, Trevor AJ (eds) Basic & clinical pharmacology, 13th edn. McGraw-Hill education, New York, pp 169–190
Ignarro LJ (2008) Different pharmacological properties of two enantiomers in a unique beta-blocker, nebivolol. Cardiovasc Ther 26(2):115–134. https://doi.org/10.1111/j.1527-3466.2008.00044.x
Knowles HJ, Tian Y-M, Mole DR, Harris AL (2004) Novel mechanism of action for hydralazine. Circ Res 95(2):162–169. https://doi.org/10.1161/01.RES.0000134924.89412.70
Kreutz R, Algharably E (2016) Novel drugs in the treatment of hypertension. In: Tsioufis C, Schmieder R, Mancia G (eds) Updates in hypertension and cardiovascular protection. Springer, Switzerland, pp 157–178
Laurent S (2017) Antihypertensive drugs. Pharmacol Res 124:116–125. https://doi.org/10.1016/j.phrs.2017.07.026
McMurray JJV, Packer M, Desai AS, Gong J, Lefkowitz MP, Rizkala AR, Rouleau JL, Shi VC, Solomon SD, Swedberg K, Zile MR (2014) Angiotensin–Neprilysin inhibition versus Enalapril in heart failure. N Engl J Med 371(11):993–1004. https://doi.org/10.1056/NEJMoa1409077
Paul M, Poyan Mehr A, Kreutz R (2006) Physiology of local renin-angiotensin systems. Physiol Rev 86(3):747–803. https://doi.org/10.1152/physrev.00036.2005
Prichard BNC, Graham BR (2000) Il Imidazoline agonists. General clinical pharmacology of Imidazoline receptors. Drugs Aging 17(2):133–159. https://doi.org/10.2165/00002512-200017020-00005
Ruilope LM, Dukat A, Bohm M, Lacourciere Y, Gong J, Lefkowitz MP (2010) Blood-pressure reduction with LCZ696, a novel dual-acting inhibitor of the angiotensin II receptor and neprilysin: a randomised, double-blind, placebo-controlled, active comparator study. Lancet 375(9722):1255–1266. https://doi.org/10.1016/s0140-6736(09)61966-8
Sarafidis PA, Georgianos PI, Lasaridis AN (2010) Diuretics in clinical practice. Part I: mechanisms of action, pharmacological effects and clinical indications of diuretic compounds. Expert Opin Drug Saf 9(2):243–257. https://doi.org/10.1517/14740330903499240
Schmieder RE, Mahfoud F, Azizi M, Pathak A, Dimitriadis K, Kroon AA, Ott C, Scalise F, Mancia G, Tsioufis C (2018) European Society of hypertension position paper on renal denervation 2018. J Hypertens 36(10):2042–2048. https://doi.org/10.1097/hjh.0000000000001858
Tamargo J, Segura J, Ruilope LM (2014) Diuretics in the treatment of hypertension. Part 1: thiazide and thiazide-like diuretics. Expert Opin Pharmacother 15(4):527–547. https://doi.org/10.1517/14656566.2014.879118
Volpe M (2014) Natriuretic peptides and cardio-renal disease. Int J Cardiol 176(3):630–639. https://doi.org/10.1016/j.ijcard.2014.08.032
Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC Jr, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA Sr, Williamson JD, Wright JT Jr (2018) 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. J Am Coll Cardiol 71(19):e127–e248. https://doi.org/10.1016/j.jacc.2017.11.006
Williams B, MacDonald TM, Morant S, Webb DJ, Sever P, McInnes G, Ford I, Cruickshank JK, Caulfield MJ, Salsbury J, Mackenzie I, Padmanabhan S, Brown MJ (2015) Spironolactone versus placebo, bisoprolol, and doxazosin to determine the optimal treatment for drug-resistant hypertension (PATHWAY-2): a randomised, double-blind, crossover trial. Lancet 386(10008):2059–2068. https://doi.org/10.1016/s0140-6736(15)00257-3
Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, Clement DL, Coca A, de Simone G, Dominiczak A, Kahan T, Mahfoud F, Redon J, Ruilope L, Zanchetti A, Kerins M, Kjeldsen SE, Kreutz R, Laurent S, Lip GYH, McManus R, Narkiewicz K, Ruschitzka F, Schmieder RE, Shlyakhto E, Tsioufis C, Aboyans V, Desormais I (2018) 2018 ESC/ESH guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: the task force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens 36(10):1953–2041. https://doi.org/10.1097/hjh.0000000000001940
Wright JM, Musini VM, Gill R (2018) First-line drugs for hypertension. Cochrane Database Syst Rev 4:Cd001841. https://doi.org/10.1002/14651858.CD001841.pub3
Xu B, Bobek G, Makris A, Hennessy A (2017) Antihypertensive methyldopa, labetalol, hydralazine, and clonidine reversed tumour necrosis factor-alpha inhibited endothelial nitric oxide synthase expression in endothelial-trophoblast cellular networks. Clin Exp Pharmacol Physiol 44(3):421–427. https://doi.org/10.1111/1440-1681.12712
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer-Verlag Berlin Heidelberg New York
About this entry
Cite this entry
Kreutz, R., Algharably, E.A.EH. (2020). Antihypertensive Drugs. In: Offermanns, S., Rosenthal, W. (eds) Encyclopedia of Molecular Pharmacology. Springer, Cham. https://doi.org/10.1007/978-3-030-21573-6_11-1
Download citation
DOI: https://doi.org/10.1007/978-3-030-21573-6_11-1
Received:
Accepted:
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-21573-6
Online ISBN: 978-3-030-21573-6
eBook Packages: Springer Reference Biomedicine and Life SciencesReference Module Biomedical and Life Sciences