Quinapril and Xerostomia: 8 Important Recommendations

Quinapril and Xerostomia

When your blood pressure rises sustainably or frequently, pharmacological treatment may be required, including antihypertensive drugs. Various therapeutic options manage this condition, which will depend upon age, pressure readings, the time elapsed, and the patient’s other diseases. Before opting for pharmacological treatment, it is advisable to try non-pharmacological measures such as reducing salt intake, exercising, hydrating properly, and avoiding tobacco and alcohol consumption.

In the world of modern medicine, antihypertensives represent an essential class of medications in the treatment and management of high blood pressure, a condition that affects millions globally. These drugs, designed to regulate blood pressure and prevent cardiovascular complications, have significantly improved patients’ quality of life. However, they are not free of side effects, one of the most common being xerostomia, popularly known as dry mouth. This side effect, although often underestimated, can have a considerable impact on quality of life, affecting aspects such as dental health, nutrition, and general well-being.

What is Blood Pressure?

Blood pressure is a measure of the force that blood exerts on the walls of the arteries as it is propelled by the heart to the rest of the body. This measurement is vital, since its alteration can negatively impact various organs, leading to heart disease, cerebrovascular disease, kidney disease, and visual problems, among other health problems.

Blood pressure is determined in two phases: systole and diastole, which are movements carried out by the heart muscle. The measurement is presented in two numbers: the systolic pressure (upper number) and the diastolic pressure (lower number). Normally, healthy values are around 120/80 mmHg. If these values rise above the standard, we speak of arterial hypertension; if they are below, it is considered hypotension.

Multiple risk factors contribute to the development of blood pressure problems, such as the water and salt balance in the body, kidney function, hormonal imbalances, and stress. Regular blood pressure checkups are crucial, especially during routine medical visits. It is advisable to be in a calm and restful state to obtain an accurate measurement.

How does Hypertension Affect Oral Health?

High blood pressure, a disorder that affects blood flow throughout the body, has a direct and significant impact on oral health. Changes in blood flow caused by hypertension alter electrolyte exchange and other essential metabolic processes that take place in the mouth. These alterations are reflected in the composition and function of saliva, a key element in the digestion of food and medications.

When hypertension affects kidney function, the concentration and electrolyte balance in the body become unbalanced, which can lead to changes in the pH of saliva, making it more acidic or basic. This alteration in salivary pH has the potential to damage tooth enamel, increasing the risk of cavities and periodontal disease.

In addition, various studies have revealed a relationship between severe periodontitis and uncontrolled high blood pressure, showing that inadequate management of high blood pressure can exacerbate existing dental problems or contribute to the development of new ones.

On the other hand, the anxiety associated with visits to the dentist can temporarily increase blood pressure, complicating the interpretation of blood pressure levels in patients diagnosed with hypertension. This phenomenon highlights the importance of rigorous and conscious control of hypertension, not only because of its impact on cardiovascular health but also its relevant effect on oral health.

What is Quinapril and what is it for?

Quinapril, a drug belonging to the family of angiotensin-converting enzyme (ACE) inhibitors, such as enalapril and captopril, plays a crucial role in the treatment of high blood pressure. These medications work by regulating blood pressure levels, whether administered alone or in combination with other treatments. Its mechanism of action focuses on the inhibition of a key enzyme involved in the renin-angiotensin system, a blood pressure regulatory system. By blocking this enzyme, quinapril facilitates the dilation of blood vessels, which helps reduce blood pressure and, therefore, minimizes the risk of cardiovascular complications associated with hypertension.

Generally, ACEIs such as quinapril are well tolerated by most patients and are considered first-line medications in the management of high blood pressure. However, it has been observed that these drugs may be less effective in African-American patients. One of the main adverse reactions associated with ACEIs is the generation of a dry cough and xerostomia (dry mouth). These side effects are a consequence of its mechanism of action and the body’s compensatory mechanisms when faced with changes in blood pressure. In some cases, xerostomia may be related to inadequate blood pressure control.

Saliva and Xerostomia

Saliva is crucial for oral health:

Production: Between 1 and 1.5 liters daily, essential for oral balance.

Principal functions:

● Lubricates the bolus to facilitate swallowing.

●Contains salivary amylase, important for digestion.

● Improves taste perception.

Xerostomia or dry mouth:

Definition: Decrease or absence of saliva production. While not a disease, it is a common symptom in various pathologies or side effects.

Common signs:

● Viscous or foamy saliva.

● Difficulty speaking and swallowing.

● Dry lips, tongue and mucous membranes.

● Bad breath and oral lesions.

Management and prevention of xerostomia:

General recommendations:

● Chew sugarless gum to avoid cavities.

● Limit caffeine consumption.

● Avoid mouthwashes with alcohol.

● Give up smoking.

● Drink water regularly.

● Consult the use of salivary substitutes.

● Avoid over-the-counter antihistamines and nasal decongestants.

● Breathe through your nose.

Maintain oral and dental health:

Healthy practices:

● Avoid sugary or acidic foods and drinks.

● Brush with fluoride toothpaste.

● Use mouthwash or gel with fluoride before going to sleep.

● Visit the dentist regularly.

Make a medical appointment:

●Important before the appearance of xerostomia.

●Avoid self-medication.

●Ensure adequate management of related antihypertensive therapies.

Conclusion

Awareness of the interaction between hypertension, the use of antihypertensives – such as quinapril – and oral health is crucial for both patients and health professionals. Hypertension can alter oral health through changes in blood flow and saliva, leading to conditions such as xerostomia. It is important that patients be informed about the side effects of their medications and that adequate follow-up is carried out to adapt treatments when necessary.

Management of xerostomia includes oral hygiene practices and lifestyle changes, as well as regular consultations with health professionals. A comprehensive approach that addresses both blood pressure and oral health is essential for the overall well-being of hypertensive patients.