Vasodilator Drugs

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 8 min read
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Vasodilator drugs relax and widen blood vessels, increasing blood flow. A few examples include ACE inhibitors, ARBs, calcium channel blockers, and nitrates.   Vasodilators are medicines that dilate (open) your blood vessels. Vasodilators keep your arteries and veins from narrowing or contracting (squeezing) shut. You have two main...

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Article Summary

Vasodilator drugs relax and widen blood vessels, increasing blood flow. A few examples include ACE inhibitors, ARBs, calcium channel blockers, and nitrates.   Vasodilators are medicines that dilate (open) your blood vessels. Vasodilators keep your arteries and veins from narrowing or contracting (squeezing) shut. You have two main types of blood vessels. Veins carry blood to your heart, while arteries carry blood from your heart to the rest of...

Key Takeaways

  • This article explains Types in simple medical language.
  • This article explains Mechanism of Action in simple medical language.
  • This article explains Indications in simple medical language.
  • This article explains Contraindications in simple medical language.
Educational health guideWritten for patient understanding and clinical awareness.
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  • Any symptom that feels urgent, unusual, or unsafe for the patient.
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See a doctor

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Vasodilator drugs relax and widen blood vessels, increasing blood flow. A few examples include ACE inhibitors, ARBs, calcium channel blockers, and nitrates.  

Vasodilators are medicines that dilate (open) your blood vessels. Vasodilators keep your arteries and veins from narrowing or contracting (squeezing) shut. You have two main types of blood vessels. Veins carry blood to your heart, while arteries carry blood from your heart to the rest of your body.

Vasodilation is blood vessel widening (or getting bigger). It occurs when the muscles in your blood vessel walls relax. When you take a vasodilator, the blood vessel’s middle interior (lumen) is the part that widens. There are several types of vasodilator medications, and they all work slightly differently. Direct vasodilators directly affect the muscle cells that line your blood vessels. They make your muscle cells relax so that blood vessels open. Because they work quickly, they can cause more side effects. Healthcare providers use direct vasodilators when other treatments haven’t worked.

Types

Other vasodilators control the chemicals that make your blood vessels expand or contract. They are effective but work more slowly.

ACE Inhibitors: 

  • Benazepril (Lotensin)
  • Lisinopril (Prinivil, Zestril)
  • Enalapril (Vasotec, Epaned)

ARBs (Angiotensin II Receptor Blockers): 

  1. Losartan (Cozaar),
  2. Candesartan (Atacand), and
  3. Olmesartan (Benicar). 

Calcium Channel Blockers (CCBs): 

  • Amlodipine (Norvasc)
  • Diltiazem (Cardizem, Tiazac)
  • Verapamil (Calan)

Nitrates: 

  • Nitroglycerin (Nitrostat, Nitrobid)
  • Isosorbide mononitrate (Ismo)
  • Isosorbide dinitrate (Imdur)

Other Vasodilators: 

  • Hydralazine (Apresoline)
  • Minoxidil (Loniten)
  • Fenoldopam (Cilopam)
  • Sodium Nitroprusside (Nipride, Nitropress)

List of ACE inhibitors

  • benazepril (Lotensin)
  • captopril (Capoten)
  • enalapril (Vasotec, Epaned)
  • fosinopril (Monopril)
  • lisinopril (Prinivil, Zestril)
  • moexipril (Univasc)
  • perindopril (Aceon)
  • quinapril (Accupril)
  • ramipril (Altace)
  • trandolapril (Mavik)

List of ARBs

  • azilsartan (Edarbi)
  • candesartan (Atacand)
  • eprosartan (Teveten)
  • irbesartan (Avapro)
  • telmisartan (Micardis)
  • valsartan (Diovan)
  • losartan (Cozaar)
  • olmesartan (Benicar)

List of CCBs

  • amlodipine (Norvasc)
  • clevidipine (Cleviprex)
  • diltiazem (Cardizem)
  • felodipine (Cardene, Cardene SR)
  • isradipine
  • nicardipine
  • nimodipine
  • nisoldipine (Sular)
  • verapamil (Calan)

List of nitrates

  • nitroglycerin (Gonitro, Nitrobid, Nitromist, Nitrolingual, Nitrostat, Nitrobid)
  • isosorbide mononitrate (Ismo, Moneket)
  • isosorbide dinitrate (Imdur, Isordil))
  • Hydralazine (apresoline)
  • Minoxidil
  • Fenoldopam (carlopam)
  • Nitroprusside (Nipride, Nitropress)

Mechanism of Action

In general, Vasodilators dilate or prevent constriction of the blood vessels, which allow greater blood flow to various organs in the body. Many vasodilators bind to receptors on endothelial cells of the blood vessel, which stimulate calcium release. Calcium activates the enzyme nitric oxide synthase (NO synthase) and converts L-arginine into NO. It leaves the endothelial cell via diffusion and enters vascular smooth muscle cells. NO activates GTP and converts it into cGMP. cGMP then stimulates myosin-light chain phosphatase, which removes a single phosphate from myosin and actin filaments. The dephosphorylation of myosin and actin filaments allows vascular smooth muscle relaxation.

Below are the specific mechanisms of action for different classes of vasodilators:

  1. ACE Inhibitors: Prevent the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor.
  2. Angiotensin Receptor Blockers: Prevent angiotensin II from binding to its receptor.
  3. Nitrates: Increase the amount of NO in vascular smooth muscle cells, causing vasodilation. Nitrates dilate veins more than arteries and decrease preload.
  4. Calcium Channel Blockers: Block calcium channels in the cardiac and smooth muscles, causing decreased muscle contractility and vasodilation. There are two classes of CCBs: Dihydropyridines (act on the vascular smooth muscle), and non-dihydropyridines (act on the heart).
  5. Minoxidil: Directly relaxes arteriolar smooth muscle, with minimal effect on the vein. Cyclic AMP may mediate its effects.
  6. Hydralazine: the exact mechanism is still unknown.
  7. Beta-Blockers: Nebivolol and carvedilol are third-generation β-adrenoreceptor antagonists that have additional endothelium-dependent vasodilating properties.

Indications

Vasodilators are useful in treating a variety of medical conditions, most commonly systemic hypertension. Other diseases include myocardial infarction (both ST-segment elevation and non-ST-segment elevation), angina, heart failure, stroke, chronic kidney disease, preeclampsia, hypertensive emergency. There are different classes of vasodilators used today in the current clinical practice, and each has different actions on the coronary arteries and peripheral vasculature (arteries and veins). Vasodilators most commonly affect the arteries in the human body, but some vasodilators (such as nitroglycerin) can affect the venous system of the body predominantly.

Several different vasodilators have undergone development over the years, as mentioned below.

  1. Direct-acting vasodilators (hydralazine, minoxidil, nitrates, nitroprusside)
  2. Calcium channel blockers (verapamil, diltiazem, nifedipine, amlodipine)
  3. An antagonist of the renin-angiotensin-aldosterone system (angiotensin receptor blockers, angiotensin-converting-enzyme inhibitors)
  4. Beta-2 receptor agonist (salbutamol, terbutaline)
  5. Postsynaptic alpha-1 receptor antagonist (prazosin, phenoxybenzamine, phentolamine)
  6. Centrally acting alpha-2 receptor agonist (clonidine, α-methyldopa)
  7. Endothelin receptor antagonist (bosentan, ambrisentan)
  8. Phosphodiesterase inhibitors (sildenafil, tadalafil)

Renin-angiotensin-aldosterone system blockers such as ACE inhibitors and ARBs are first-line of the treatment in patients with heart failure, history of ST-elevation myocardial infarction, insulin is low or not working well. সহজ বাংলা: রক্তে চিনি বেশি থাকার রোগ।" data-rx-term="diabetes" data-rx-definition="Diabetes is a condition where blood sugar stays too high because insulin is low or not working well. সহজ বাংলা: রক্তে চিনি বেশি থাকার রোগ।">diabetes, or proteinuria. Both groups of medications have cardioprotective and renoprotective effects.

Clinicians can use many vasodilators in preeclampsia, which is a condition seen in the pregnancy characterized by severe hypertension and proteinuria. If not treated quickly, patients can develop seizures. ACE Inhibitors and ARBs are contraindicated in pregnancy due to teratogenicity. Hydralazine and calcium channel blockers (amlodipine, nifedipine) are safe to use in these circumstances.

Many vasodilators are used in hypertensive emergencies and urgencies. Hypertensive emergency is defined as an elevation of systolic blood pressure over 180 mmHg and/or diastolic blood pressure exceeding 120 mmHg with the presence of acute target organ damage (such as kidney insult, encephalopathy, retinal hemorrhage, aortic dissection, subarachnoid hemorrhage). Hypertensive urgencies are defined as an elevation of systolic blood pressure greater than 180 mmHg and/or diastolic blood pressure over 120 mmHg without any clinical or laboratory evidence of acute end-organ damage. In hypertensive emergency following drugs are the first choice depending on systemic involvement.

  • Aortic dissection: intravenous esmolol, intravenous nitroprusside, or nitroglycerine
  • Acute pulmonary edema: intravenous nitroglycerine, nitroprusside, or clevidipine
  • Acute myocardial infarction/unstable angina: intravenous esmolol or nitroglycerine
  • Acute renal failure: intravenous fenoldopam, clevidipine, or nicardipine
  • Eclampsia: intravenous hydralazine, nicardipine, or labetalol
  • Pheochromocytoma/hyperadrenergic state secondary to amphetamine or cocaine: intravenous clevidipine, phentolamine, or nicardipine

This review will focus more on direct-acting vasodilators, calcium channel blockers, and renin-angiotensin-aldosterone antagonists as these classes of medications are more commonly used in the current practice

Contraindications

  • ACE Inhibitors: pregnancy, previous history of angioedema, hereditary angioedema.
  • ARBs: ARBs are teratogens and should not be used in pregnant patients.
  • Nitrates: Nitrates decrease preload, so the administration of nitrates would be contraindicated in a person having an inferior MI (right ventricular infarction).
  • Calcium Channel Blocker: severe hypotension, hypersensitivity.
  • Hydralazine: CAD or angina (it can cause compensatory tachycardia), mitral valve rheumatic heart disease
  • Beta-blockers: Bradycardia, severe chronic obstructive pulmonary disease, hypotension, cardiogenic shock, and high degree of atrioventricular block.

What are the benefits of using vasodilators?

Vasodilators can be very effective for people with certain heart conditions. They are widely used treatments for high blood pressure.

Opening your blood vessels can:

  • Improve blood flow through your heart.
  • Reduce pressure in your blood vessels or on your heart.
  • Send more oxygen to your heart.

What are the risks of using vasodilators?

Direct vasodilators are strong medicines. Typically, healthcare providers only prescribe them when other treatments have failed to control symptoms.

Direct vasodilators may cause more severe side effects than other types of vasodilators. Sometimes, these side effects are severe enough that you need other medicines to treat the side effects. For example, a vasodilator may cause water retention, which can raise pressure and lead to congestive heart failure. You may need to take a diuretic to help your body release the additional fluid.

Some types of vasodilators cause more severe effects, and the effects can vary from person to person. You and your provider may need to try several medicines to find one that works well with the fewest side effects. When you take vasodilators, you may have:

  • Dizziness.
  • Dry cough (with ACE inhibitors).
  • Edema (fluid retention).
  • Fatigue.
  • Headaches.
  • Joint pain.
  • Heart palpitations or rapid heartbeat (tachycardia).
  • Nausea and vomiting.

Are there natural vasodilators?

Vasodilators are not the only way to open blood vessels. Some other factors that cause vasodilation include:

  • Exercise: When you exercise, your blood vessels open so that your muscles can get extra nutrients and oxygen.
  • infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">Inflammation: Inflammation is part of your body’s process of repairing the damage. When a part of your body is inflamed, your blood vessels dilate to send more oxygen and nutrients to that area.
  • Natural chemicals: Your body releases some chemicals naturally that can encourage vasodilation. Some examples of these chemicals include carbon dioxide, nitric oxide and the hormone prostaglandin.
  • Alcohol: Drinking alcohol causes blood vessel dilation. This is why some people get flushed, warm skin after drinking alcohol. It’s especially common with alcohol intolerance.

Some herbs or supplements can also help with vasodilation. Some supplements have adverse medication reactions, so speak with your provider before taking any herb or supplements. Vasodilator supplements may include:

  • Cocoa.
  • Coenzyme Q10 (CoQ10).
  • Garlic.
  • L-arginine.
  • Magnesium.
  • Niacin (vitamin B3).

What medication interactions should I watch for?

Ask your provider about possible food or drug interactions if you are taking vasodilators. It’s important to be honest and thorough when telling your provider what medications or supplements you take.

Some vasodilator interactions to watch for include:

  • ACE inhibitors and potassium supplements.
  • ACE inhibitors and medications with lithium.
  • ARBs and ACE inhibitors.
  • CCBs and grapefruit juice.
  • CCBs and verapamil (Calan®, Isoptin®) and diltiazem (Cardizem®).
  • Nitrates and sildenafil (Viagra®), tadalafil (Cialis®) and vardenafil (Levitra®).

How long should I take vasodilators?

How long you need to take vasodilators depends on what condition the medicine is treating. For example, if you take vasodilators to treat preeclampsia, you may stop taking the drug after you give birth. But if you have a chronic condition such as pulmonary hypertension, your provider may keep you on vasodilators long-term.

Sometimes, you can manage chronic conditions through lifestyle changes. For example, you may lower your blood pressure by losing weight and exercising regularly. Your provider will monitor any chronic conditions and guide your treatment options.

Who should not use vasodilators?

Vasodilators are not right for everyone. Ask your cardiologist (heart doctor) if you are a good candidate for vasodilator drugs. Generally, you may not be able to take certain types of vasodilators if you are pregnant or have:

  • History of angioedema.
  • Mitral valve rheumatic heart disease.
  • Right ventricular infarction.
  • Severe hypersensitivity or hypotension (low blood pressure).

Are vasodilators the only heart treatment I need?

For most people, vasodilators are one part of an overall heart treatment plan. You can keep your heart healthier by adopting healthy lifestyle habits. You may:

  • Achieve and maintain a healthy weight.
  • Avoid secondhand smoke or quit smoking.
  • Drink alcohol in moderation only.
  • Eat a nutrient-dense diet full of vegetables, fruits and whole grains.
  • Exercise aerobically for at least 150 minutes per week.
  • Manage stress with healthy strategies, such as meditation or talk therapy.
Doctor visit helper

Prepare before seeing a doctor

A simple rural-patient checklist to help you explain symptoms clearly, ask better questions, and avoid unsafe self-treatment.

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

  • Write when the problem started and how it changed.
  • Bring old prescriptions, investigation reports, and current medicines.
  • Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
  • Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

  • What is the most likely cause of my symptoms?
  • Which danger signs mean I should go to hospital quickly?
  • Which tests are necessary now, and which can wait?
  • How should I take medicines safely and what side effects should I watch for?
  • When should I come for follow-up?

Tests to discuss

  • Vital signs: temperature, pulse, blood pressure, oxygen saturation
  • Basic physical examination by a clinician
  • CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

  • Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
  • Do not hide pregnancy, kidney disease, ulcer, allergy, or blood thinner use.
  • Do not delay emergency care when danger signs are present.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

  • Stop activity and seek urgent medical evaluation.
  • Chest pain should not be managed only with home medicine.
  • Discuss ECG and cardiac blood tests with emergency care when appropriate.

OTC medicine safety

  • Do not take random painkillers to hide chest pain before medical evaluation.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Chest pressure, sweating, breathlessness, fainting, pain spreading to arm/jaw/back, or known heart disease needs emergency care.
Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Doctor / qualified healthcare provider
Tests to discuss with doctor
  • Basic vital signs: temperature, pulse, blood pressure, oxygen level if needed
  • Relevant blood, urine, imaging, or specialist tests only after clinical assessment
Questions to ask
  • What is the most likely cause of my symptoms?
  • Which warning signs mean I should go to emergency care?
  • Which tests are really needed now?
  • Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Safe pathway to proper treatment

Care roadmap for: Vasodilator Drugs

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

    A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.

  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

RX Patient Help

Ask a health question safely

Write your symptom story. A health professional or site editor can review it before any answer is prepared. This box is not for emergency care.

Emergency first: Severe chest pain, breathing trouble, unconsciousness, stroke signs, severe injury, heavy bleeding, or rapidly worsening symptoms need urgent local medical care now.

Frequently Asked Questions

Types Other vasodilators control the chemicals that make your blood vessels expand or contract. They are effective but work more slowly.ACE Inhibitors: Benazepril (Lotensin) Lisinopril (Prinivil, Zestril) Enalapril (Vasotec, Epaned)ARBs (Angiotensin II Receptor Blockers): Losartan (Cozaar), Candesartan (Atacand), and Olmesartan (Benicar). Calcium Channel Blockers (CCBs): Amlodipine (Norvasc)Diltiazem (Cardizem, Tiazac)Verapamil (Calan)Nitrates: Nitroglycerin (Nitrostat, Nitrobid)Isosorbide mononitrate (Ismo)Isosorbide dinitrate (Imdur)Other Vasodilators: Hydralazine (Apresoline)Minoxidil (Loniten)Fenoldopam (Cilopam)Sodium Nitroprusside (Nipride, Nitropress)List of ACE inhibitorsbenazepril (Lotensin) captopril (Capoten) enalapril (Vasotec, Epaned) fosinopril (Monopril) lisinopril (Prinivil, Zestril) moexipril (Univasc) perindopril (Aceon) quinapril (Accupril) ramipril (Altace) trandolapril (Mavik)List of ARBsazilsartan (Edarbi) candesartan (Atacand) eprosartan (Teveten) irbesartan (Avapro) telmisartan (Micardis) valsartan (Diovan) losartan (Cozaar) olmesartan (Benicar)List of CCBsamlodipine (Norvasc) clevidipine (Cleviprex) diltiazem (Cardizem) felodipine (Cardene, Cardene SR) isradipine nicardipine nimodipine nisoldipine (Sular) verapamil (Calan)List of nitratesnitroglycerin (Gonitro, Nitrobid, Nitromist, Nitrolingual, Nitrostat, Nitrobid) isosorbide mononitrate (Ismo, Moneket) isosorbide dinitrate (Imdur, Isordil)) Hydralazine (apresoline) Minoxidil Fenoldopam (carlopam) Nitroprusside (Nipride, Nitropress)Mechanism of Action In general, Vasodilators dilate or prevent constriction of the blood vessels, which allow greater blood flow to various organs in the body.[rx] Many vasodilators bind to receptors on endothelial cells of the blood vessel, which stimulate calcium release. Calcium activates the enzyme nitric oxide synthase (NO synthase) and converts L-arginine into NO. It leaves the endothelial cell via diffusion and enters vascular smooth muscle cells. NO activates GTP and converts it into cGMP. cGMP then stimulates myosin-light chain phosphatase, which removes a single phosphate from myosin and actin filaments. The dephosphorylation of myosin and actin filaments allows vascular smooth muscle relaxation.Below are the specific mechanisms of action for different classes of vasodilators:ACE Inhibitors: Prevent the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor.[rx] Angiotensin Receptor Blockers: Prevent angiotensin II from binding to its receptor. Nitrates: Increase the amount of NO in vascular smooth muscle cells, causing vasodilation. Nitrates dilate veins more than arteries and decrease preload. Calcium Channel Blockers: Block calcium channels in the cardiac and smooth muscles, causing decreased muscle contractility and vasodilation. There are two classes of CCBs: Dihydropyridines (act on the vascular smooth muscle), and non-dihydropyridines (act on the heart). Minoxidil: Directly relaxes arteriolar smooth muscle, with minimal effect on the vein. Cyclic AMP may mediate its effects. Hydralazine: the exact mechanism is still unknown. Beta-Blockers: Nebivolol and carvedilol are third-generation β-adrenoreceptor antagonists that have additional endothelium-dependent vasodilating properties.Indications Vasodilators are useful in treating a variety of medical conditions, most commonly systemic hypertension.[rx] Other diseases include myocardial infarction (both ST-segment elevation and non-ST-segment elevation), angina, heart failure, stroke, chronic kidney disease, preeclampsia, hypertensive emergency. There are different classes of vasodilators used today in the current clinical practice, and each has different actions on the coronary arteries and peripheral vasculature (arteries and veins). Vasodilators most commonly affect the arteries in the human body, but some vasodilators (such as nitroglycerin) can affect the venous system of the body predominantly.Several different vasodilators have undergone development over the years, as mentioned below.[rx] Direct-acting vasodilators (hydralazine, minoxidil, nitrates, nitroprusside) Calcium channel blockers (verapamil, diltiazem, nifedipine, amlodipine) An antagonist of the renin-angiotensin-aldosterone system (angiotensin receptor blockers, angiotensin-converting-enzyme inhibitors) Beta-2 receptor agonist (salbutamol, terbutaline) Postsynaptic alpha-1 receptor antagonist (prazosin, phenoxybenzamine, phentolamine) Centrally acting alpha-2 receptor agonist (clonidine, α-methyldopa) Endothelin receptor antagonist (bosentan, ambrisentan) Phosphodiesterase inhibitors (sildenafil, tadalafil)Renin-angiotensin-aldosterone system blockers such as ACE inhibitors and ARBs are first-line of the treatment in patients with heart failure, history of ST-elevation myocardial infarction, diabetes, or proteinuria. Both groups of medications have cardioprotective and renoprotective effects.Clinicians can use many vasodilators in preeclampsia, which is a condition seen in the pregnancy characterized by severe hypertension and proteinuria. If not treated quickly, patients can develop seizures. ACE Inhibitors and ARBs are contraindicated in pregnancy due to teratogenicity. Hydralazine and calcium channel blockers (amlodipine, nifedipine) are safe to use in these circumstances.Many vasodilators are used in hypertensive emergencies and urgencies. Hypertensive emergency is defined as an elevation of systolic blood pressure over 180 mmHg and/or diastolic blood pressure exceeding 120 mmHg with the presence of acute target organ damage (such as kidney insult, encephalopathy, retinal hemorrhage, aortic dissection, subarachnoid hemorrhage). Hypertensive urgencies are defined as an elevation of systolic blood pressure greater than 180 mmHg and/or diastolic blood pressure over 120 mmHg without any clinical or laboratory evidence of acute end-organ damage. In hypertensive emergency following drugs are the first choice depending on systemic involvement. Aortic dissection: intravenous esmolol, intravenous nitroprusside, or nitroglycerine Acute pulmonary edema: intravenous nitroglycerine, nitroprusside, or clevidipine Acute myocardial infarction/unstable angina: intravenous esmolol or nitroglycerine Acute renal failure: intravenous fenoldopam, clevidipine, or nicardipine Eclampsia: intravenous hydralazine, nicardipine, or labetalol Pheochromocytoma/hyperadrenergic state secondary to amphetamine or cocaine: intravenous clevidipine, phentolamine, or nicardipineThis review will focus more on direct-acting vasodilators, calcium channel blockers, and renin-angiotensin-aldosterone antagonists as these classes of medications are more commonly used in the current practiceContraindicationsACE Inhibitors: pregnancy, previous history of angioedema, hereditary angioedema. ARBs: ARBs are teratogens and should not be used in pregnant patients. Nitrates: Nitrates decrease preload, so the administration of nitrates would be contraindicated in a person having an inferior MI (right ventricular infarction). Calcium Channel Blocker: severe hypotension, hypersensitivity. Hydralazine: CAD or angina (it can cause compensatory tachycardia), mitral valve rheumatic heart disease Beta-blockers: Bradycardia, severe chronic obstructive pulmonary disease, hypotension, cardiogenic shock, and high degree of atrioventricular block.What are the benefits of using vasodilators?

Vasodilators can be very effective for people with certain heart conditions. They are widely used treatments for high blood pressure. Opening your blood vessels can: Improve blood flow through your heart. Reduce pressure in your blood vessels or on your heart. Send more oxygen to your heart.

What are the risks of using vasodilators?

Direct vasodilators are strong medicines. Typically, healthcare providers only prescribe them when other treatments have failed to control symptoms. Direct vasodilators may cause more severe side effects than other types of vasodilators. Sometimes, these side effects are severe enough that you need other medicines to treat the side effects. For example, a vasodilator may cause water retention, which can raise pressure and lead to congestive heart failure. You may need to take a diuretic to help your body release the…

Are there natural vasodilators?

Vasodilators are not the only way to open blood vessels. Some other factors that cause vasodilation include: Exercise: When you exercise, your blood vessels open so that your muscles can get extra nutrients and oxygen. Inflammation: Inflammation is part of your body’s process of repairing the damage. When a part of your body is inflamed, your blood vessels dilate to send more oxygen and nutrients to that area. Natural chemicals: Your body releases some chemicals naturally that can encourage vasodilation. Some examples of these…

What medication interactions should I watch for?

Ask your provider about possible food or drug interactions if you are taking vasodilators. It’s important to be honest and thorough when telling your provider what medications or supplements you take. Some vasodilator interactions to watch for include: ACE inhibitors and potassium supplements. ACE inhibitors and medications with lithium. ARBs and ACE inhibitors. CCBs and grapefruit juice. CCBs and verapamil (Calan®, Isoptin®) and diltiazem (Cardizem®). Nitrates and sildenafil (Viagra®), tadalafil (Cialis®) and vardenafil (Levitra®).

How long should I take vasodilators?

How long you need to take vasodilators depends on what condition the medicine is treating. For example, if you take vasodilators to treat preeclampsia, you may stop taking the drug after you give birth. But if you have a chronic condition such as pulmonary hypertension, your provider may keep you on vasodilators long-term. Sometimes, you can manage chronic conditions through lifestyle changes. For example, you may lower your blood pressure by losing weight and exercising regularly. Your provider will monitor…

Who should not use vasodilators?

Vasodilators are not right for everyone. Ask your cardiologist (heart doctor) if you are a good candidate for vasodilator drugs. Generally, you may not be able to take certain types of vasodilators if you are pregnant or have: History of angioedema. Mitral valve rheumatic heart disease. Right ventricular infarction. Severe hypersensitivity or hypotension (low blood pressure).

Are vasodilators the only heart treatment I need?

For most people, vasodilators are one part of an overall heart treatment plan. You can keep your heart healthier by adopting healthy lifestyle habits. You may: Achieve and maintain a healthy weight. Avoid secondhand smoke or quit smoking. Drink alcohol in moderation only. Eat a nutrient-dense diet full of vegetables, fruits and whole grains. Exercise aerobically for at least 150 minutes per week. Manage stress with healthy strategies, such as meditation or talk therapy.

References

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