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There were hardly any drugs for the treatment of this condition. It was only in the latter half of the last century, that medical science made rapid advancements, and today drugs allow a hypertensive patient to live a near normal life are available.

The first real drug to treat hypertension was given to the rest of the world by India’s indigenous system of medicine, Ayurveda. The roots of the plant ’sarpgandha’ (rauwolfia serpentina) formed a part of the repitoire used for treating various ailments. Indian researchers of the system discovered the blood pressure lowering properties of these roots. Subsequently in 1953, Swiss scientists isolated the pure chemical substance, and named it reserpine (SERPASIL), which remained in the forefront for the treatment of high blood pressure for almost two decades. Now, it has been replaced by more modern drugs and is rarely used.

In spite of these recent advances, it is a pity that the treatment of hypertension remains palliative rather than curative. There is a difference between anti-hypertensives and other drugs like antibiotics. The latter drugs destroy micro-organisms and remove the cause of the infective state, enabling a complete cure; while the former, hardly ever cure the disease. They only lower the blood pressure without removing the cause. Nevertheless, these drugs are important, as they are all at we have. They increase the lifespan and quality of life of patients of high blood pressure.

Since all of us fear high blood pressure, let us first examine what blood pressure (BP)actually is and why blood should need a pressure at all.

Nimodipine (Nimodip 30 mg)

It increases brain blood flow, therefore, it is commonly used in the treatment of stroke. Nicardipine, nitrendipine, lercanidipine and lecidipine are some other drugs.

Advantages: All CCBs are useful in angina, IHD and hypertension. Except diltiazem and verapamil all can be combined with beta-blockers (Atenolol commonly). They are also usefull in migraine and peripheral vascular disease. Kidney blood flow is well maintained and nifedipine may increase urine output. The antihypertensive effect is not blunted by anti-intlamatory pain relievers which is its unique feature.

Adverse effects and Precautions: As a group CCBs can cause sensation of vomiting, constipation, swelling over feet and hypotension. Verapamil and diltiazem precipitate congestive heart failure and heart blocks. Verapamil and diltiazem are never used with betablockers. They are not safe in pregnancy. These should be used with caution in angina to avoid alarming rise in pulse rate. These drugs do not significantly alter blood lipids and may have some bronchodilatory effects, thus are very useful in asthmatic hypertensives. In this aspect they are better than nonselective beta-blockers.

Alien
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