I read in the newspaper and saw a report on TV that calcium antagonists can be dangerous - is this true?

Unfortunately for reasons that are not clear, there were scare stories about calcium antagonists. The evidence has been refuted by other researchers who looked at the claims in depth. Very high doses of nifedipine capsules can cause angina because of the speed of action of this preparation, but the capsules are not used routinely and very rarely in high doses. Claims made of an increased risk of heart attack or cancer do not stand up to careful scientific scrutiny -the claims are so devoid of scientific fact that the stories should not have been put out publicly. Much of what has been written about the dangers of calcium antagonists is nonsense and this has upset many patients and doctors. There is no danger if you take long-acting calcium antagonists, e.g. amlodipine, nifedipine LA (long-acting), and diltiazem LA, but you should avoid short-acting formulations, e.g. nifedipine capsules. The calcium antagonist scares are a classical example of media hype with commercial undertones.

Someone told me that one particular medication for blood pressure makes your hair grow - is this true?

Yes. Minoxidil is a very potent treatment used only in severe resistant blood pressure cases. It can make people put on weight because of water retention and is not used routinely for this reason. It also makes your hair grow - this can be an advantage in bald men but is not usually liked by women!

You have not mentioned Aldomet. I am pregnant and my doctor prescribed this medication for my blood pressure. Why did she choose this rather than the others that you have talked about?

Methyldopa (Aldomet) is an old and effective drug for lowering blood pressure but it does have a large number of side effects. It can cause drowsiness, sluggishness, a dry mouth, depression and impotence (see Chapter 8). Because of these effects, it is not used so much these days and has been replaced by more user-friendly medications. However, it is effective and its main use today is for raised blood pressure in pregnancy, as the medication does not cause harm to your baby. It is usually stopped on delivery to reduce the chances of depression following the birth.

I've read about a new medication called Physiotens which was called a breakthrough for blood pressure treatment in my newspaper. Should I get my doctor to put me on it?

Physiotens is the trade name for moxonidine. It acts via the brain and is advised for mild to moderate hypertension if other drugs are not appropriate or are not fully effective. Side effects include dry mouth, headache, fatigue, dizziness and sleep disturbance. It has an effective but limited place in treatment.

When I went to see my doctor, he measured my blood pressure and put me on tablets straight away. Why was this?

If your blood pressure was very high when it was first measured, it would be unlikely that changing your lifestyle alone would help. However, it is worth trying the measures discussed in the section Self-help earlier because these may help to reduce the amount of tablets you need.

I have been feeling tired and lethargic lately. Do you think my tablets are causing the problem?

All medications can cause side effects. We try hard as doctors to prescribe the safest and most convenient medications. If you are concerned that a particular medication is causing a problem, let your doctor know. It may have occurred by chance but it may also be associated with your treatment and a change in your medicine could relieve the symptoms. For instance, if you feel that your sex life has been affected, it may be due to your medications.

 
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