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Side Effects of
Antihypertensive Agents


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Medications that are used to lower blood pressure are called “antihypertensive medications.” They are prescribed for hypertension and aim to prevent events like transient ischemic attacks (TIAs), strokes and myocardial infarction. There are various classes of medications which fall under the category “antihypertensive.” While the side effects vary according to the class, there are several side effects common to all classes which include:

  • Syncope (fainting)
  • Glaucoma
  • Dyspepsia (indigestion)
  • Hyperkalemia (high blood concentration of potassium)
  • Cognition difficulties
  • Dysarthria (trouble with speech)
  • Ataxia
  • Insomnia

(Journal of Cardiovascular Pharmacology “Antihypertensive drugs and the sympathetic nervous system,” Nov 2007); American Journal of Pharmacogenetics “Pharmacogenetics of antihypertensive drug responses,” Apr 2004)

Antihypertensive Medications Classes

There are many different classes and are used in slightly different clinical situations. Classes of antihypertensives include:

  • Diuretics
  • Calcium channel blockers,
  • ACE inhibitors,
  • Angiotensin II receptor antagonists,
  • Adrenergic antagonists,
  • Benzodiazepines,
  • Renin inhibitors
  • Aldosterone receptor antagonists.
  • Endothelin receptor blockers

(Journal of Cardiovascular Pharmacology “Antihypertensive drugs and the sympathetic nervous system,” Nov 2007).

Antihypertensive Agents Side Effects by Class

Thiazide diuretics are used to treat hypertension and high blood pressure. They work by inhibiting the sodium chloride symporter. The increase in fluid loss decreases blood volume and reduced blood pressure. Side effects include:

  • Hypotension (low blood pressure)
  • Gastric irritation
  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Abdominal pain
  • Rash

Calcium Channel Blockers include drugs like isradipine and verapamil. Side effects include:

  • Headache
  • Dizziness
  • Lethargy
  • Edema (swelling)
  • Pharyngitis (sore throat)
  • Fatigue
  • Malaise
  • Pain
  • Rash
  • Scalp irritation
  • Sleep disturbance
  • Myalgia (muscle pain)
  • Allergic reactions
  • Hypersensitivity

ACE inhibitors are also used to treat hypertension but act by inhibiting angiotensin converting enzyme. This reduces activity of the renin angiotensin aldosterone system and thus, decreases blood pressure. Side Effects include:

  • Hypotension
  • Angina pectoris (chest pain)
  • Postural hypotension
  • Nausea
  • Vomiting
  • Diarrhea
  • Abdominal discomfort
  • Fatigue
  • Asthenia
  • Vertigo
  • Bronchitis
  • Cough
  • Depression
  • Anxiety
  • Nervousness
  • Restlessness
  • Headache
  • Dizziness
  • Muscle spasm
  • Myalgia (muscle pain)

Angiotensin II receptor antagonists include drugs like losartan. Common side effects include:

  • Nasal congestion
  • Sinusitis
  • Abdominal pain
  • Nausea
  • Diarrhea
  • Back pain
  • Myalgia (muscle pain)
  • Dizziness
  • Headache
  • Vertigo
  • Chest pain
  • Anemia

Adrenergic receptor antagonists are also used as antihypertensive. Common side effects include (occur in more than 1% of patients):

  • Hypotension (low blood pressure)
  • Cold extremities
  • Fatigue
  • Sleep disturbances
  • Nightmares
  • Sleep disorder
  • Agitation
  • Somnolence (lack of energy)
  • Irritability

(Pharmacogenomics “Pharmacogenomics of antihypertensive drugs: past, present and future,” Apr 2010).

Understand Your Risks with the Rxight® Genetic Test

MD Labs provides pharmacogenetic testing through Rxight®, which is based on the sequencing of their genes to establish how patients will react to hundreds of medications across dozens of pharmacological classes (including many antiplatelet medications). All that is required is a simple, non-invasive cheek swab by a participating pharmacist, which is reviewed with you in detail after it is analyzed at our labs.

How Does Pharmacogenetic Testing Work?

With the test results, your prescriber can determine the dosing that is safe for you based on how well you metabolize it. Medications that are metabolized slowly based on your genetics will cause side effects. Medications that are metabolized quickly will not provide therapeutic benefit at standard doses. Thus Rxight® will guide your prescriber in tailoring your medication treatment, or in some cases finding an alternative medication that is safer or more effective for you – preferably before you begin treatment. That way, the dangers to you of the traditional trial-and-error approach can be avoided.

Contributors to this Article:
Michael Sapko, MD, PhD; Deborah Kallick, PhD, Medicinal Chemistry

Antihypertensive Agents Tested Include:

Read more about Rxight® DNA Drug Testing Swabbing Mouth