A detailed explanation of the adverse reactions of eight major categories of antihypertensive drugs to help you safely control your blood pressure.

Common Adverse Reactions of Antihypertensive Drugs

1. Dry cough, without sputum, and without fever: This adverse reaction is common after taking ACE inhibitors, such as captopril and perindopril. The dry cough is caused by increased bradykinin levels due to ACE inhibitors. While bradykinin can cause a dry cough, it also has multiple functions, such as dilating blood vessels and inhibiting platelet aggregation. If the patient tolerates it, they can continue taking the medication; if they cannot tolerate it, the dosage can be adjusted under the guidance of a doctor.

2. Ankle edema: This is usually symmetrical edema and is common after taking dihydropyridine calcium channel blockers, such as nifedipine and felodipine.

3. Facial flushing, headache, and gingival hyperplasia: These are common after taking dihydropyridine calcium channel blockers. Facial flushing and headache often appear in the first week of medication and are tolerated by most patients, with symptoms gradually lessening or disappearing after one week. Gingival hyperplasia is relatively rare; clinically, patients may observe swollen and easily bleeding gums.

4. Hypokalemia and hyponatremia: Commonly seen after taking diuretic antihypertensive drugs, such as hydrochlorothiazide. Mild hypokalemia is usually asymptomatic and can only be detected through blood electrolyte tests; severe hypokalemia can cause symptoms such as fatigue, loss of appetite, and weakness in both lower limbs, and in severe cases, can lead to malignant arrhythmias.

5. Hyperkalemia: Commonly seen in patients with hypertension and renal insufficiency after taking angiotensin II receptor blockers (ARBs) and ACE inhibitors, such as valsartan and losartan. Patients may experience bradycardia and fatigue, and in severe cases, it can also lead to malignant arrhythmias.

6. Bradycardia: Commonly seen after taking beta-blockers (β-blockers), such as metoprolol and bisoprolol. Not recommended for asthmatic patients.

7. Gynecomastia in men: Manifests as breast tenderness, swelling, and enlargement, commonly seen after taking aldosterone receptor antagonists, such as spironolactone.

8. Nasal congestion and depression: Commonly seen after taking centrally acting antihypertensive drugs, such as reserpine.