The Health Corner Vol. 60 – Blood Pressure IV

This is the fourth article in my series on blood pressure. So far, we have given a general overview of blood pressure and have discussed diuretics and beta blockers. In this article, we will continue looking at the medications used in controlling hypertension–specifically the ACE inhibitors.

ACE (Angiotensin Converting Enzyme) Inhibitors were introduced in 1981. These agents prevent the kidneys from retaining sodium and water by deactivating angiotensin-converting enzyme (ACE). ACE is a compound that converts inactive angiotensin I to the active angiotensin II. Angiotensin II raises blood pressure by triggering sodium and water retention and constricting the arteries. Ace Inhibitors prevent Angiotensin Converting Enzyme from activating Angiotensin I into Angiotensin II. Therefore, sodium and water are not retained and arterial constriction is not stimulated. This keeps the blood pressure down.

The most common side effects of these medications are a reduced sense of taste and a dry cough. Rarely, a patient can have difficulty breathing because of swelling of the lips, tongue, and throat. ACE inhibitors can also cause potassium retention; therefore people with poor kidney function must use them cautiously. Because these drugs can cause fetal abnormalities, women who are pregnant or trying to get pregnant should not take them.

The function of ACE inhibitors can be thought of as waging a sort of chemical warfare attack. They force the blood pressure lower by blocking the release of angiotensin in the body which is meant to raise the blood pressure. I have found in my many years practical experience that it is rarely expedient to force the body into an unnatural state.

The body’s chemical regulatory mechanisms do things for a reason as mentioned in my first article. Most of the time high blood pressure is a protective mechanism designed to maintain ‘homeostasis’, or the body’s biological balance despite internal and external happenings. One might think that keeping the blood pressure ‘low’ is a good thing. However, when the body needs to raise blood pressure to maintain homeostasis and is prevented from doing so it only results in a greater strain being placed on the entire homeostatic mechanism. As a result, the adverse reactions and side effects of ACE Inhibitors include dizziness, drowsiness, fatigue, fainting, headache, insomnia, vertigo, weakness, cough, dyspnea (difficulty breathing), hypotension, chest pain, edema, tachycardia, hypuricemia (excess uric acid in the urine), taste disturbances, abdominal pain, anorexia, constipation, diarrhea, nausea, vomiting, erectile dysfunction, proteinemia, fetal abnormalities, renal dysfunction, renal failure, flushing, pruritis, rashes, hyerkalemia (high blood potassium), back pain, muscle cramps, and fever.
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The medical establishment has determined that high blood pressure is a pathological condition. While there are times when this may be the case, the majority of the time it is the body’s response to a particular need, and higher blood pressure is necessary for the body to maintain its homeostatic balance. In these cases, circumventing that process with drugs to bring the blood pressure down only forces the body into a greater homeostatic challenge. The human body is adaptive and over time adjusts to this challenge and continues to increase blood pressure despite the drugs, which results in more or stronger medications being given to once again gain ‘control’. Although this may sound strange it is exactly what happens. In fact, anyone that is placed on blood pressure control is never taken off of it. With time they are periodically given more and stronger medication to control their blood pressure. If you could listen to someone’s heart who has been on blood pressure meds for ten or fifteen years the heartbeat would be much more abnormal than when they were initially placed on the medication. The irregularities in rhythm, rate, sound, etc., all become distorted over time as the heart is beaten to death by these cardiac killers. The quality of the persons’ life on these drugs becomes more tenuous over time, as well, but they are convinced that they are doing what they have to in order to live.

Does that mean that someone on heart medication should immediately stop the medication? Certainly not, for that is setting him up for severe and often fatal consequences. Rather, a gradual reduction of the medications should ensue under the doctor’s direction, as requested by the patient who understands his or her body’s true needs.

After all, ultimately we are all responsible for our own health and should be free to make our own informed decisions.

In my next article I will be talking about the deadliest of all of the blood pressure medications, the calcium channel blockers. Following that, I will discuss the alternative therapies and treatments for working with hypertension.

Until then, here’s to your good health.

Dr. Jon R. Link