Your High Blood Pressure Prescription, Decoded

Your High Blood Pressure Prescription, Decoded

Understanding your medication options can help you stick to your treatment plan.

If your doctor tells you that you have high blood pressure (hypertension) you are certainly not alone. The Centers for Disease Control and Prevention estimates that about one in three American adults has high blood pressure—a whopping 75 million people—and that only about half of those with the condition have it under control.

That’s a problem because high blood pressure can lead to a host of other serious heart problems, like heart attack, stroke, aneurysm and heart failure—all of which can be fatal. In addition to these cardiac problems, high blood pressure is also a cause of or contributor to kidney problems, vision loss, metabolic syndrome, cognitive problems and dementia.

The good news is that doctors know a lot about what works to get high blood pressure under control. Sometimes making lifestyle changes for hypertension—like changing your diet, getting more active and keeping weight under control—is enough. For others, medications can help.

Whichever strategies your doctor prescribes, most important is sticking to the plan to ensure that it works. If medications are part of that plan, here’s what’s important to know about them.

Drugs for treating high blood pressure
There are a few different types of medications used to treat high blood pressure. Your prescription will depend on things like your blood pressure measurements, other medical problems and your health history.

Diuretics: Sometimes called “water pills,” diuretics help lower the amount of sodium and water in the body, which lowers the amount of fluid in the blood. Lowering the volume of blood in your vessels, in turn, lowers blood pressure.  Doctors may prescribe a diuretic alone or in combination with another blood pressure medication. In some cases your doctor may prescribe a potassium supplement if your blood potassium level drops too low on a diuretic.

Thiazide diuretics (including chlorothiazide, hydrochlorothiazide and chlorthalidone) are the main type used. Sometimes loop diuretics (such as bumetanide and ethacrynic acid) and potassium-sparing diuretics (such as spironolactone) are used, as well.

Angiotensin-converting enzyme (ACE) inhibitors: ACE inhibitors work by blocking the formation of a natural chemical the body makes to narrow the blood vessels (angiotensin II hormone), which in turn relaxes blood vessels. Some ACE inhibitors include lisinopril, benazepril and captopril.

Angiotensin II receptor blocks (ARBs): ARBs employ a mechanism similar to ACE inhibitors. Instead of blocking the production of angiotensin II hormone, however, they stop the chemical from binding with receptors in the blood vessels. Like ACE inhibitors, ARBs prevent blood vessels from narrowing, thereby decreasing blood pressure overall. Specific ARBs include candesartan and losartan.

Calcium channel blockers: These drugs—which include amlodipine and diltiazem—block calcium from entering the muscle cells of the heart and blood vessels, thus allowing blood vessels to relax and blood pressure to lower.

Other drugs that may help control high blood pressure
Sometimes additional drugs are used to help control hypertension, including:

  • Alpha blockers, to reduce nerve impulses to blood vessels to lessen the natural narrowing process
  • Alpha-beta blockers, which have the same function as alpha blockers, while also slowing the heartbeat to reduce how much blood gets pumped through vessels
  • Beta blockers, to reduce the workload on the heart and open up blood vessels, which makes the heart beat slower and with less force
  • Aldosterone antagonists, which block the action of a chemical that causes the body to retain salt and fluid
  • Renin inhibitors, which slow down the production of renin, an enzyme produced by the kidneys that increases blood pressure
  • Vasodilators, which stop the muscles in the walls of your arteries from tightening
  • Central-acting agents, which turn down signals from the brain to your nervous system that increase heart rate and narrow blood vessels

Side effects to consider
Like most any types of medications, those used to treat hypertension can cause side effects. It’s important to remember, though, that you shouldn’t stop taking your medications for high blood pressure without checking with your doctor. A consideration of side effects might lead your provider to adjust the dose or type of drug you take.

Some of the more common side effects include:

  • Weakness, fatigue or drowsiness
  • Erectile dysfunction
  • Trouble sleeping
  • Slow or fast heartbeat
  • Skin rash
  • Feeling thirsty
  • Cough
  • Muscle cramps
  • Headache, dizziness or light-headedness
  • Constipation or diarrhea
  • Frequent urination (for diuretics)

Staying with your treatment plan
Your health care provider will come up with a treatment plan to help you manage your high blood pressure based on your health, lifestyle and personal preferences. That plan may include lifestyle changes, medications, a combination of medications or a combination of lifestyle changes and medications. What’s most important is that you follow your treatment plan—and let your doctor know about any problems that come up so you and your provider can work together to find the best solution for you.

Medically reviewed in November 2018.

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