Vasodilators
The word vasodilators in modern day might make the average person think of many different types of hypertension drugs that have vasodilation effects. However vasodilators are a separate class of drugs altogether. Although other hypertensive drugs like calcium channel blockers, alpha blockers, and central agonists have vasodilation effects, they are not solely vasodilators. They all have added effects to the body in addition to vasodilation. This article is going to be about specifically the vasodilator class of drugs. We will go over how they work, are they effective for hypertensive treatment, what can patients expect from taking them, are they safe, what the side effects are from them, and when they are used in the medical world.
The first vasodilator dates back to 1953, it was called Apresoline. Apresoline was invented by a company in Switzerland. The drug was originally developed in an attempt to treat malaria. Fast forward to 1981 and there were about three or four different brand vasodilators on the market.
These drugs work by loosening and relaxing the walls of the blood vessels and arteries in the body. This in turn can increase blood flow and oxygen supply to the heart. It can also increase blood flow to all other areas of the body. It is a fast acting medicine, if taken it can start to work in as little as 5 minutes.
Let me start by saying these are stronger than the average hypertension drugs. Many studies have showed mixed results with treating hypertension using vasodilators. The somewhat newer drug nitroglycerin has seen a lot more positive patient reviews than the older drug Apresoline (generic Hydralazine). Nitroglycerin been shown to lower blood pressure in most patients. Especially in acute angina or heart attack situations. Because of the fact that this is not a commonly prescribed hypertension maintenance drug, it is impossible to put together median blood pressure lowering numbers. There simply is not enough accurate data to support them. However under the circumstances that a patient has uncomplicated hypertension, long term treatment with the drug class vasodilators is generally not a good idea.
Vasodilators are used today mainly for a hypertensive crisis, heart attacks, high blood pressure, heart failure, angina, raynaud's syndrome, erectile dysfunction, and anal fissures. On rare occasions some doctors may prescribe them for patients to take on a daily basis for hypertension. This is usually for when a patient has just undergone surgery to have coronary stents installed, or after a heart attack. They are usually deemed not necessary for the average patient with uncomplicated hypertension.
Side effects of taking vasodilators on a regular basis can be extensive. Many patients are not able to tolerate them. As mentioned earlier, Hydralazine seems to have worse side effects than other vasodilators. Side effects can include dizziness, lightheadedness, the feeling of faintness, feeling as if the room is spinning around you, headache, blurred vision, a feeling of warmth (from the body not able to regulate temperature properly), chest pain or tightness, sweating, weight gain, constipation, diarrhea, stomach issues, stomach pain, hypotension, pins and needles feeling, itching, feeling of something crawling under the skin, fatigue and tiredness, easily bruising, high heart rate, palpitations, pain in the joints, pain in the jaw, pain in the back, pain or soreness in the arm, blurred vision, chills, swelling of different areas of the face, cough, confusion, clumsiness, fluid retention in the extremities, depression, anxiety, stuffy nose, rashes, tremors, kidney damage, night blindness, development of Lupus, and nausea.
Everyone responds to drugs in different ways. A few patients taking vasodilators have actually experienced a rise in their blood pressure. Although this is uncommon, it can happen. Medical professionals are not quite sure why this happens. But it is thought that either the body is objecting to the effects of the drug and making the heart pump harder and increase adrenaline in order to try and raise arterial pressure back to normal, or the drug gives the patient so much anxiety that the blood pressure spikes in response.
One of the worst long term side effects patients taking vasodilators can experience is kidney damage. A few patients taking vasodilators for over a year even experienced kidney failure. This can happen because the blood passage ways in the kidneys become too large, causing the kidneys to not be able to function properly. The kidneys are responsible for filtering blood, so this process can become hindered. Vasodilation in unwanted areas can be an issue with most hypertensive medications, but the drug class vasodilators themselves have shown more instances of severe kidney damage than any other medications. Even in comparison with beta blockers and ace inhibitors.
Many patients taking vasodilators have experienced a side effects one step worse than dizziness, and that is the feeling of the whole room spinning around them. The side effect makes the patient feel as if they are trapped in a spinning world, and laying down or standing up does not make a difference. In some patients this can come and go, and in some patients it is a constant feeling as long as the drug is in their system.
Patients can develop Lupus. Lupus is an autoimmune disease which can cause the immune system to attack healthy tissue. This seems to be isolated with the drug Hydralazine, as there has been limited research to confirm any other of the vasodilators causing this. It has been shown that some patients just develop Lupus like symptoms and not the disease itself, so after discontinuing the drug the Lupus symptoms subsided.