All about ARB medications (Angiotensin II Receptor Blockers) for your blood pressure

High blood pressure, or as we all know it, "pressure," is a condition that many people in our country are currently experiencing. Maybe you are also taking medication for this, or someone in your family may have this condition. When a doctor prescribes you medication for your blood pressure, there are many types of those medications. So today we are going to talk about one of the most commonly used and important classes of medications. That is the ARBs, or Angiotensin II Receptor Blockers.

Simply put, what is this ARB?

ARBs (Angiotensin II Receptor Blockers) are a class of drugs that are used to treat not only high blood pressure, but also several other conditions, such as heart failure and kidney disease. They come in the form of pills, which means they are taken by mouth. While the name may sound a bit complicated, its meaning is quite simple. Let's break it down.

• Angiotensin II is a hormone produced in our bodies. Its main function is to constrict (tighten) our blood vessels .
• A receptor is a specific spot on the walls of blood vessels where this hormone can bind. It's like the blade of a key.
• A blocker is something that blocks.

What this medicine does is to block the hormone (key) from binding to the receptor (plate) in the blood vessels. Then the blood vessels do not become clogged, they are well open, so blood can move easily, and the pressure is also reduced. Let's look at some of the situations in which doctors usually prescribe this type of ARB medicine below.

What are the commonly prescribed ARB medications?

There are several types of drugs that belong to the ARB class. There is a very easy way to identify them. The names of these drugs usually end in “-sartan.” Check the medicine box your doctor gave you, it may also have a name like this. The table below shows some of the most commonly used ARBs.

Okay, now let's see how this medicine works inside the body.

To understand this, let's take a small example. Imagine there is a water pipe, what happens if you squeeze the middle of the pipe and hold it? The water pressure inside the pipe increases, right? Our blood vessels are like that. The hormone `Angiotensin II` in our body constricts our blood vessels as if squeezing the water pipe. When the blood vessels contract, the space for blood to flow through them decreases. Then the heart has to pump blood with more force . This is what we call high blood pressure, or pressure. In order for this `Angiotensin II` hormone to do its job, it needs to attach to a specific place on the blood vessels, which is a ``receptor``. ARB drugs do a very simple thing. They go and sit on that receptor. Then the `Angiotensin II` hormone has nowhere to attach. It's like when you go to sit on a chair and someone else is sitting on it, you can't sit down.

Are there any side effects to this medicine?

Like any medicine, ARBs can cause some minor side effects. However, most people do not experience any side effects. The most common ones that can occur are:

• Dizziness
• Feeling tired ( Fatigue )
• Headache​
• Swelling of the face and tongue - This is very rare.

The main reason for dizziness is that it takes your body time to adjust to the low blood pressure. This condition usually goes away within a few days. Special attention for the kidneys:Very rarely, ARBs can affect the blood flow to the kidneys. This risk is especially high if you already have renal artery disease. But don't worry. After you start taking this medicine, your doctor will order a blood test (Serum Creatinine test) to check your kidney function from time to time. Therefore, it is important to get these tests done as your doctor recommends.

How long do I need to take this medicine?

This is a question that many people ask. High blood pressure is often a lifelong condition. If you stop taking your medication, your blood pressure may return to its previous level. Therefore, never stop taking your medication without your doctor's advice. You may need to take an ARB or other blood pressure medication for the rest of your life.

What is the difference between ACE inhibitors and ARBs?

You may have also heard of a class of medications called ACE inhibitors. Both of these classes of medications work by reducing the effects of angiotensin. But they work in two different ways.

• ACE inhibitors : These work by reducing the production of the hormone `Angiotensin II` that causes the problem. It's like reducing the production of a factory that makes people who cause the problem.
• ARBs: These do not stop the production of the hormone `Angiotensin II`, but block the ability of the hormone to bind to the blood vessels.

One of the main and most common side effects of ACE inhibitors is a persistent, painful dry cough. If you develop this type of cough while taking an ACE inhibitor (e.g., Enalapril, Lisinopril), your doctor will likely stop the medication and start you on an ARB instead.

Do I need to be careful about other medications and foods when taking ARBs?

Yes, absolutely. It's very important to tell your doctor if you're taking any other medications, vitamins, or supplements while taking your blood pressure medication.

Other medications

Some over-the-counter medicines for colds, coughs, and allergies can increase your blood pressure. Also, taking painkillers, especially NSAIDs (such as ibuprofen, diclofenac, naproxen), can reduce the effectiveness of ARBs and damage your kidneys. So ask your doctor before using any painkillers.

Be especially careful about potassium.

ARB medications can increase potassium levels in the blood. Therefore,

• Do not take potassium supplements without your doctor's advice.
• Some "salt substitutes" used by people on a salt control diet contain potassium chloride. Read the label carefully before using these.

If potassium levels in the blood increase, it can cause dangerous conditions such as irregular heartbeat.

What about alcohol?

If you drink alcohol regularly and in excess, it can increase your blood pressure even more. Also, if you drink too much alcohol at once, your blood pressure can suddenly drop and you can faint. So if you drink alcohol, do it in moderation.

Is it safe to take ARB medications during pregnancy?

No. It is not safe at all. Both ARB and ACE inhibitor medications can cause serious harm to the unborn baby if taken during pregnancy.

• Birth defects
• Kidney failure
• High potassium levels
• Low blood pressure
• Stillbirth

These serious complications can occur. If you have high blood pressure and are pregnant or planning to have a baby, tell your doctor right away. Your doctor will prescribe a different medication that is safe for you and your baby.

Are ARBs a type of 'water pill' (Diuretics)?

No. ARBs are not diuretics, or "water pills" as we commonly call them. Water pills help the body get rid of extra water and salt in the urine. However, sometimes doctors will prescribe a combination of an ARB and a diuretic (often a thiazide diuretic) in one pill . If your medication is labeled "Losartan H" or "Valsartan HCT," that means it contains both an ARB and a diuretic. There are many types of blood pressure medications, so it can be difficult to figure out which one is right for you. ARBs are the first class of medications that doctors prescribe, and they work well for most people. If you have any questions or concerns about these medications, don't hesitate to ask your doctor. ARB in sinhala, Angiotensin II Receptor Blockers, High Blood Pressure, Pressure Medication, Losartan, Valsartan, Heart Attack