Blood Pressure Medications: Labtal vs. Diovan for Seniors

Medication inquiries

Dear Dr.
Wu,
My mother is nearly 70 years old.
Over the past two months, she has experienced several episodes of sudden high blood pressure, reaching 200/100 mmHg.
We have two types of antihypertensive medications at home: "Labetalol 200 mg" and "Valsartan 160 mg." When her blood pressure suddenly rises and she feels significantly unwell, taking "Labetalol 200 mg" can quickly lower her blood pressure and alleviate her discomfort.
However, taking "Valsartan 160 mg" seems to have little effect.
I would like to ask Dr.
Wu the following questions:
Q1.
Based on the above, when my mother's blood pressure suddenly rises and she feels unwell, taking "Labetalol 200 mg" provides noticeable relief, while "Valsartan 160 mg" has almost no effect.
Could you explain why there is such a difference in the results between these two medications? Additionally, what are the differences between these two antihypertensive drugs?
Q2.
Can my mother take "Labetalol 200 mg" regularly and long-term? The medication packaging states "take as needed." Therefore, I would like to ask whether "Labetalol 200 mg" is intended for "emergency and short-term" use only, or if it can be taken "regularly and long-term" without significant side effects and harm to her health.
Thank you, Dr.
Wu.

A-Xiang, 40~49 year old female. Ask Date: 2023/05/06

Dr. Wu Xueming reply Cardiology

1.
"Labtal (Labetalol) 200mg" has a rapid onset of action but a shorter duration of effect; "Diovan (Valsartan) 160mg" is a long-acting medication.
2.
Long-acting antihypertensive medications are still the first choice for blood pressure control, and it is recommended to discuss with your outpatient physician whether to change medications.

Reply Date: 2023/05/06

More Info

When considering the use of blood pressure medications, especially for seniors, it's essential to understand the differences between various drugs and their effects on blood pressure management. In your case, you are comparing Labtal (Labetalol) and Diovan (Valsartan), both of which are used to treat hypertension but have different mechanisms of action and indications.

Q1: Why does Labtal provide immediate relief while Diovan seems ineffective?
Labtal is a non-selective beta-blocker that also has alpha-blocking properties. This means it can quickly lower blood pressure by reducing heart rate and causing vasodilation (widening of blood vessels). This rapid action is particularly beneficial in acute situations where blood pressure spikes suddenly, as you described with your mother's episodes of hypertension reaching 200/100 mmHg. The immediate effect of Labtal can provide quick relief from symptoms associated with high blood pressure, such as headaches, dizziness, or palpitations.

On the other hand, Diovan is an angiotensin II receptor blocker (ARB) that works by preventing the action of a hormone that causes blood vessels to constrict. While Diovan is effective for long-term blood pressure control, it may take several hours to days to achieve its full effect. This difference in pharmacodynamics explains why your mother experiences immediate relief with Labtal but not with Diovan during acute episodes.

Q2: Can Labtal be used regularly for long-term management?
Labtal is generally prescribed for both acute and chronic management of hypertension. However, it is often recommended for use in specific situations, such as during pregnancy or in cases of hypertensive emergencies. The label stating "use as needed" suggests that it may not be the first-line treatment for long-term management in all patients. Long-term use of Labtal can lead to side effects such as fatigue, dizziness, and potential heart rate issues, particularly in older adults.

For chronic management, it is often advisable to use medications like Diovan, which are designed for long-term control of blood pressure without the immediate side effects associated with beta-blockers. However, if your mother finds that Labtal effectively manages her symptoms during episodes of high blood pressure, it may be appropriate to discuss with her healthcare provider the possibility of using it as part of her long-term treatment plan, potentially in conjunction with Diovan for better overall blood pressure control.

Additional Considerations:
1. Monitoring: Regular monitoring of blood pressure is crucial, especially when using multiple medications. This helps ensure that blood pressure remains within a safe range and allows for timely adjustments to medication dosages.

2. Side Effects: Both medications can have side effects, and it’s essential to monitor for any adverse reactions. For instance, Labtal can cause fatigue and dizziness, while Diovan may lead to low blood pressure or kidney function changes.

3. Consultation with Healthcare Providers: It is vital to maintain open communication with healthcare providers about any changes in symptoms or side effects experienced with these medications. Adjustments may be necessary based on individual responses to treatment.

4. Lifestyle Modifications: Alongside medication, lifestyle changes such as diet, exercise, and stress management can significantly impact blood pressure control and overall cardiovascular health.

In conclusion, while Labtal may provide immediate relief during acute hypertension episodes, Diovan is more suited for long-term management. A tailored approach that considers your mother's specific health needs, response to medications, and potential side effects is essential for effective hypertension management. Always consult with her healthcare provider before making any changes to her medication regimen.

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