It is quite common that patients suffering from high blood pressure suffer from asthma too. Although the combination of these two isn’t dangerous, still it can present some difficult treatment challenges even for highly qualified health providers.
Common blood pressure medications, the most effective and proven to work, still can cause negative effects in people with asthma. Developing effective treatment plan should be taken seriously and done though careful approach.
Problematic Hypertension Drugs
Today high blood pressure is treated with various drugs and among them beta blockers and ACE inhibitors have the most potential to cause problems in patients suffering from asthma.
The beta blockers used to treat high blood pressure are not very selective, so they don’t do a good job distinguishing between the different types of receptors on the blood vessels and respiratory passages. They are blocking the beta receptors in the blood vessels (causing blood vessel dilatation) similar blockade of beta receptors on respiratory passages causes constriction, and can lead to dangerous consequences.
On the other hand beta stimulating drugs used to treat asthma generally target only the receptors on respiratory passages.
The fact that beta blockers are so effective at treating high blood pressure lead to developing a new versions of the drug, called selective beta-1-blockers, that do a better job and are more selective between blood vessels and respiratory passages.
Beta-1-blockers have been subject of a variety of clinical tests and studies in order to determine how safe they are for asthmatic patients. These clinical tests showed that new beta-1-blockers were safer for asthmatic patients. However, still a tendency to constrict the respiratory passages in some people was reported.
Therefore, even these, new beta-1-blockers that are more selective drugs, still are rarely prescribed to people suffering from asthma. It turns out that these kinds of blockers are only suitable for specific types of asthma patients.
ACE inhibitors, another category of drugs to treat high blood pressure, may cause to some serious problems for patients with asthma. Among many side effects that occur when taking ACE inhibitors up to 20% of people reported one of the most common side effects — persistent, dry cough. This cough is a result of a type of respiratory activity called an “asthma equivalent.”
Why is it called “asthma equivalent”? The activity inside the respiratory passages mimics the effects of asthma.
In general, it’s rare to see serious reactions to ACE inhibitors in asthmatic people, however they have been reported. For these reason, ACE inhibitors are not considered as a “first line” drug of choice to treat high blood pressure. In some cases they may still be prescribed by doctor through careful monitoring of their effects.
Safe Hypertension Drugs
There is a long list of drugs to treat hypertension and are safe to use in asthmatic patients:
• Angiotensin Receptor Blockers (ARBs)
• Diuretics
• Calcium Channel Blockers
The main drawback and one side effect of diuretic treatment — in all patients, not just those with asthma –- is lowering of potassium level in the body (Hypokalemia).
Medications to treat asthma have a tendency to force potassium out of the blood. When this tendency is combined with the potassium sapping nature of diuretics, regular monitoring of potassium levels is required.
Calcium channel blockers and ARBs have not been shown to cause any increased or unusual risk in asthmatic patients. These types of drugs are excellent treatment choices for safe treatment. Calcium channel blockers because of their longer track record and lower cost tend to be used at first.
Other Hypertension Drugs
Some hypertension drugs have an undefined status: neither “safe” nor “unsafe” for use in people with asthma. They have this undefined status because these drugs yet haven’t been specifically studied in people who suffer from both high blood pressure and asthma at the same time.
It’s of interest that, most of these drugs – including Clonidine and Hydralazine – are rarely used in treatment anyway. That way the specific investigation to use them in patients suffering from asthma is not that appealing option.