A Review: Drugs on Hypertension

Abstract

Hypertension it is linked to renal problems, stroke, and cardiovascular illnesses, hypertension—also referred to as high blood pressure—is a serious worldwide health concern. It is typified by consistently high arterial pressure, which is frequently brought on by lifestyle, environmental, and hereditary factors. Pharmacological and non-pharmacological methods are the mainstays of hypertension treatment. Depending on the demands of each patient, a variety of antihypertensive medication classes are frequently administered, such as diuretics, beta-blockers, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, and angiotensin II receptor blockers (ARBs). Novel therapeutic drugs including vasodilators and direct renin inhibitors have been investigated recently to enhance blood pressure management and lessen side effects. Combination treatments are also frequently used in order to maximize effectiveness and reduce medication resistance. Poor drug adherence is still a significant problem, even with the abundance of treatment alternatives available. This can result in uncontrolled hypertension and increased morbidity. Additionally, developments in personalized therapy and precision medicine have the potential to improve the management of hypertension. The pharmacological treatments for hypertension are thoroughly examined in this review, with a focus on their mechanisms of action, clinical effectiveness, and possible adverse effects. Healthcare providers may choose the best treatment plans for better patient outcomes and efficient blood pressure control by having a thorough understanding of the therapeutic landscape of antihypertensive medications.

Introduction

1. Historical Perspective

In the past, elevated blood pressure (BP) was misunderstood as necessary for adequate organ perfusion. However, studies like those from the Veterans Administration later confirmed that reducing BP lowers cardiovascular risks—even in high-risk, normotensive individuals. The current focus is on understanding emerging therapeutic strategies.

2. Etiology of Hypertension

• Primary (Essential) Hypertension:

  • Accounts for 90–95% of cases.

  • Caused by genetic factors, aging, obesity, stress, high salt intake, and hormonal imbalance.

• Secondary Hypertension:

  • Comprises 5–10% of cases.

  • Caused by underlying medical conditions such as kidney disease, endocrine disorders, drug use (e.g., NSAIDs, steroids), and sleep apnea.

3. Pathophysiology

Hypertension involves chronic elevation of BP due to multiple mechanisms:

• RAAS Activation: Increases vasoconstriction and water retention.

• SNS Overactivity: Raises heart rate and vascular resistance.

• Endothelial Dysfunction: Reduces nitric oxide and increases oxidative stress.

• Water & Sodium Retention: Leads to fluid overload.

• Vascular Remodeling: Thickens artery walls, increasing resistance.

4. Herbal Drugs for Hypertension

Natural remedies manage BP through vasodilation, diuresis, and reducing oxidative stress. Examples:

• Garlic, Hibiscus, Ginger – Promote vasodilation and reduce BP.

• Ashwagandha, Brahmi – Help manage stress-induced hypertension.

• Olive Leaf, Turmeric – Improve vascular health.

• Gokhru, Fenugreek – Act as mild diuretics and antioxidants.

5. Allopathic Drugs for Hypertension

Medications classified by mechanism of action:

• Calcium Channel Blockers (e.g., Amlodipine) – Relax blood vessels.

• ACE Inhibitors (e.g., Lisinopril) – Prevent vasoconstriction.

• ARBs (e.g., Losartan, Valsartan) – Block angiotensin II effects.

• Diuretics (e.g., Hydrochlorothiazide, Furosemide) – Remove excess fluid.

• Beta-Blockers (e.g., Metoprolol) – Slow heart rate.

• Central Alpha Agonists (e.g., Clonidine) – Reduce nerve signals.

• Aldosterone Antagonists (e.g., Spironolactone) – Prevent sodium retention.

6. Herbal vs. Allopathic Drugs

7. Future Perspective

Combining herbal and allopathic treatments could offer better hypertension control with fewer side effects. Future directions include:

• Standardized herbal formulations

• Clinical trials and molecular studies

• Personalized treatments using genetics and AI

• Research on herb-drug interactions and long-term outcomes

Conclusion

In summary, while allopathic medications remain the cornerstone of hypertension management due to their rapid and clinically validated effectiveness, herbal remedies offer promising complementary benefits with fewer side effects and added cardio protective properties. A personalized and integrative treatment approach—considering patient-specific factors, lifestyle choices, and potential herb-drug interactions—may lead to safer, more effective, and sustainable blood pressure control. Future research should prioritize the standardization of herbal formulations and thorough clinical evaluations to ensure long-term safety and efficacy. A synergistic blend of modern medicine and traditional herbal therapies holds the potential to enhance the overall quality of hypertension care.

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Copyright

Copyright © 2025 Mr. Vivek Anil Patil, Ms. Ketakee More , Ms. Arti Gadade, Mr. Nitin Gawai. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.