Examples
Angiotensin-converting enzyme (ACE) inhibitors:
|
| Lotensin | benazepril |
| Capoten | captopril |
| Vasotec | enalapril |
| Monopril | fosinopril |
| Prinivil, Zestril | lisinopril |
| Accupril | quinapril |
| Altace | ramipril |
| Mavik | trandolapril |
Angiotensin II receptor blockers (ARBs):
|
| Atacand | candesartan |
| Avapro | irbesartan |
| Cozaar, Hyzaar | losartan |
Nitrates:
|
| Dilatrate, Isordil | isosorbide dinitrate |
| Nitropress | nitroprusside (used in acute MR) |
How It Works
Vasodilators work on different substances
in the body to help widen (dilate) blood vessels.
Why It Is Used
Vasodilators are used for
(MR) because the wider
blood vessel will reduce resistance in blood flow and make it easier for blood
to move forward from the left atrium to the left ventricle to the aorta. This
helps reduce the amount of blood that leaks backward through the valve into the
left atrium.
How Well It Works
Data support the use of vasodilators
for those with acute and chronic MR when the left ventricle is enlarged. But
there are no data to support using vasodilators in mitral valve regurgitation
with no symptoms or with normal ventricular function.
Side Effects
Hydralazine may lower blood pressure,
which may cause symptoms of dizziness, weakness, fainting, or fluid retention.
People whose blood pressure is low when they start therapy will generally be
started with a low dose and may need close monitoring to avoid reducing blood
pressure too much. Hydralazine may also result in an allergic reaction
(difficulty breathing; closing of the throat; swelling of the lips, tongue, or
face; or hives); numbness, tingling, pain, or weakness of arms or legs;
irregular or very fast heartbeat; new or chest pain or chest pain getting
worse; or fainting.
ACE inhibitor side
effects may include:
- Dry cough.
- Rash or itching.
- Symptoms that
are like allergy symptoms.
- Allergic reaction with generalized
swelling (angioedema) or, in rare cases, swelling of the upper
airway.
- Excess potassium in the body (hyperkalemia), especially in
people with kidney failure.
ACE inhibitors may interact with anti-inflammatory
medicines, antacids, potassium supplements, certain diuretics, and
lithium.
ARB side effects may
include:
- Diarrhea.
- Stomach
problems.
- Muscle cramps.
- Back and leg
pain.
- Dizziness.
- Insomnia.
- Nasal
congestion.
- Sinus problems.
- Upper respiratory
infection.
Nitrate side effects may
include:
- Feeling of pulsating fullness in the head (most
common side effect), which can also cause headache.
- Drop in blood
pressure, which can cause dizziness.
- Burning sensation under the
tongue (with sublingual nitroglycerin).