High blood pressure (HBP) is when the force that your blood travels through your arteries is constantly high. Prescription medications are often used as a treatment for HBP when lifestyle changes aren’t helping. There are many different classifications of medications, including beta-blockers, diuretics, and ACE inhibitors.
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Best Types of High Blood Pressure (HBP) Medications
If you are struggling with HBP, your doctor may prescribe an antihypertensive to control your condition. There are several classifications of medications that you could potentially be told to take, and each has its own list of possible pills you can be prescribed. It’s important to disclose any current medications you are taking or other conditions with your doctor to ensure you are taking the best thing to reduce your blood pressure.
HBP medications are often prescribed together, so you may need to take more than one to see changes in your health. The most commonly prescribed medications are diuretics, beta-blockers, and ACE inhibitors. Other potential medications include:
- Calcium Channel Blockers
- Central Agonists
- Angiotensin II Receptor Blockers
- Alpha-2 Receptor Agonists
- Renin Inhibitors
- Peripheral Adrenergic Inhibitors
Commonly known as a ‘water pill,’ diuretics are a typical medication used to treat HBP.’ They function by removing salt and water from your body. The majority of them release salt from the kidneys into the urine. Salt takes the water with it, reducing the amount of fluid flowing through the bloodstream, reducing the pressure. Doctors often prescribe diuretics in combination with other HBP medications.
There are three different types of diuretics: thiazide, loop, and potassium-sparing. Thiazide diuretics are usually one of the first treatments recommended to help reduce blood pressure. They can be used to treat a wide variety of other conditions, such as liver and heart failure. Diuretics are generally safe medications. One of the most common side effects is excess urination.
Beta-blockers help to block the effects of the hormone epinephrine, which is commonly known as adrenaline. This hormone increases one’s heart rate, so beta-blockers will cause the heart to beat slower and reduce blood pressure. They can also help to make arteries and veins wider to improve blood flow. Your doctor will determine which is right for you based on your health condition.
Doctors don’t prescribe beta-blockers as the first solution for HBP. They are most often used after other medications, like diuretics, have been unsuccessful. Sometimes they are even used in combination with one or more separate medications. Beta-blockers may not work as effectively for black people or older people. Typically, they are not prescribed to those with asthma because they can trigger a severe attack. It's important not to abruptly stop taking your beta-blocker medication, as it can have negative effects on your heart.
Angiotensin-converting enzyme (ACE) inhibitors prevent enzymes in the body from producing angiotensin II, which narrows the blood vessels. The narrowing of the blood vessels increases blood pressure, so ACE inhibitors work to relax them instead. Angiotensin II also releases hormones into the bloodstream that raise blood pressure. This medication is used for a wide variety of other conditions as well, including diabetes and migraines.
A doctor may prescribe ACE inhibitors in combination with another antihypertensive, like a diuretic. They should never be taken with renin inhibitors or angiotensin II receptor blockers. In general, ACE inhibitors are more effective for younger people than older people. Doctors commonly recommend these as a treatment for HBP because there is not a great risk of harmful side effects. There are, however, very detrimental side effects to those who are pregnant, so make sure to speak with a doctor about switching medications.
Calcium Channel Blockers
Calcium channel blockers are another class of high blood pressure medications. They block calcium from entering the heart and arteries, where it causes them to contract strongly. Preventing its entrance into the heart aids the blood vessels in relaxing, therefore reducing blood pressure. They can sometimes even slow one’s heart rate.
Calcium channel blockers come in two different forms: short-acting and long-acting. Short-acting will take effect more quickly but only continue to do so for a few hours. Long-acting typically provides a more lasting effect on the patient. Doctors normally prescribe calcium blockers in combination with another antihypertensive. This is an HBP medication that is found to be more successful in black people and older people. Many people experience typical side effects, but the Mayo Clinic advises not to take calcium channel blockers with any grapefruit product. The two can interact negatively and affect your heart rate.
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Alpha-blockers function similarly to beta-blockers and calcium channel blockers. They prevent the hormone norepinephrine from causing the muscles in the walls of veins and arteries from tightening, which restricts blood flow. Because of their ability to relax muscles, alpha-blockers can also be used for men with urine problems. They come in short-acting and long-acting forms.
If you have difficult-to-control blood pressure, you may be prescribed alpha-blockers with other medications when other treatments aren’t effective. You may experience a ‘first-dose effect’ when you start your prescription, which involves developing low blood pressure and dizziness. Therefore, the first dose should be taken before going to bed. In addition, they can decrease the effect of other medications you are taking.
Central agonists are another common type of medication used to treat HBP. They block signals from your brain that causes your heart rate to speed up and narrow your veins. Sometimes, they are also referred to as central-acting agents or central alpha agonists. In addition to high blood pressure, central agonists can be used to treat ADHD and Tourette’s.
Unfortunately, central agonists tend to have powerful side effects. Some people may experience effects like anemia and constipation. If you stop taking them without consulting a doctor, your blood pressure could increase dramatically and pose a dangerous threat to your health.
Angiotensin II Receptor Blockers
Angiotensin II receptor blockers also help to relax veins and arteries to reduce one’s blood pressure. They block the chemical angiotensin II from narrowing the blood vessels and forcing blood to be pumped harder throughout the body. Doctors typically prescribe these to people who cannot handle ACE inhibitors for their HBP.
There are a few harmful side effects that angiotensin II receptor blockers can have on the body, including; swelling of the skin, severe vomiting and diarrhea, and fainting when standing up. Some people have reported losing a significant amount of weight while taking this medication. It is not recommended to take angiotensin II receptor blockers while pregnant.
Vasodilators work to open up the blood vessels to allow for better blood flow. They keep the muscles in blood vessel walls from tightening. They are prescribed to a wide variety of people, including pregnant women and children. Typically, vasodilators are combined with other medications as well. There are 3 different types of dilating medications: venous dilators (affect the veins), arterial dilators (affect the arteries), and mixed dilators (affects both).
There are several side effects associated with vasodilators. You may have to take other medications to counteract the effects of the blood pressure medicine. You may experience flushing, heart palpitations, and chest pain. Some doctors will recommend going on a special diet when taking vasodilators.
Alpha-2 Receptor Agonists
Alpha-2 receptor agonists stimulate alpha-2 receptors to drop one’s blood pressure. They help to decrease the amount of adrenaline produced by the body. Besides high blood pressure, they can also treat ADHD, fibromyalgia, and even menopause. Doctors often prescribe alpha-2 agonists to pregnant women experiencing high blood pressure because there are rarely any associated side effects.
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Renin-inhibitors block the work of the enzyme renin. Renin helps to regulate blood pressure, so preventing it from working helps to relax the blood vessels. They work similarly to ACE inhibitors and angiotensin II receptor blockers. This HBP medication is slightly newer than others, so doctors do not know the long-term effects or continue to work well over time.
Pregnant or breastfeeding women should not take renin inhibitors and should look for an alternative to treating their HBP. There are not many associated side effects. You may experience minor effects like a cough or congestion, but you may not even associate it with the medication.
Peripheral Adrenergic Inhibitors
Peripheral adrenergic inhibitors (PAIs) are the final group of high blood pressure medications. They block neurotransmitters in the brain that cause blood vessels to constrict. Therefore, veins and arteries remain open to allow good blood flow and reduce blood pressure. They are not a doctor’s first line of defense and are rarely prescribed by doctors.
There are a lot of different PAIs, and all have varying side effects. Overall, none of them are severe and match up to previously discussed medications. Possible effects include diarrhea, heartburn, dizziness, and congestion. This medication may not work well for people with asthma or diseases of the vascular system.
Other HBP Treatments
Before you begin taking medications, your doctor may encourage you to make lifestyle changes to see if it helps with your high blood pressure. The development of HBP happens over a long period of time and is usually caused by lack of exercise, poor diet, and other unhealthy habits. Conditions like diabetes and obesity also are typical causes of hypertension.
Some healthy lifestyle habits to reduce one’s blood pressure include:
- Getting at least 30 minutes of exercise each day
- Eating a balanced diet of fruits and vegetables
- Reducing the amount of alcohol consumed
- Not smoking
If you continue to experience problems with blood pressure, a doctor will then prescribe an HBP medication. It's a good habit to continue these practices even if taking medication to prevent further heart problems.
High blood pressure (HBP) is typically caused by an unhealthy lifestyle like not exercising and eating unhealthy foods. Medication is just one way to treat the condition. There are several different classifications for HBP, the most common being diuretics, beta-blockers, and ACE inhibitors. Consult your doctor to determine which medication is best for you.
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Talor graduated from Penn State University with a B.S. in Biobehavioral Health, and minors in Spanish and Diversity & Inclusion in May of 2022. She has a passion for health equity and diversity in health. In the future, Talor hopes to work in public health policy reform to help eliminate health disparities. She enjoys reading, cooking, and listening to podcasts in her free time.