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Blood pressure medications: A guide

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Healthcare professionals often prescribe angiotensin-converting enzyme (ACE) inhibitors, diuretics, beta-blockers, and calcium channel blockers as medications to help manage high blood pressure.
Medically reviewed by Alexandra Perez, PharmD, MBA, BCGP
Written by Rashida Ruwa, RN
Updated on November 27, 2023

Blood pressure is the force of blood against artery walls as your heart pumps blood through your body. It’s expressed as two values: systolic pressure (the higher number) over diastolic pressure (the lower number), measured in millimeters of mercury (mm Hg). 

Healthcare professionals classify blood pressure into three main groups:

  • High blood pressure (hypertension): It occurs when your blood pressure consistently exceeds 130/80 mm Hg. Unmanaged high blood pressure increases the risk of heart disease, stroke, and kidney problems.
  • Normal blood pressure: This refers to blood pressure that falls within the expected range, typically between 90/60 mm Hg and 120/80 mm Hg.
  • Low blood pressure (hypotension): Blood pressure below 90/60 mm Hg is considered low. Extremely low blood pressure may lead to symptoms like dizziness, fainting, and fatigue. In some cases, it may require treatment.

Healthcare professionals recommend blood pressure medications when lifestyle changes like a nutrient-dense diet and regular physical activity aren’t enough to manage blood pressure, and you have a higher risk of heart disease or other health complications.

Medications for high blood pressure

Nurse taking blood pressure to woman taking hypertension medications
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Managing chronic high blood pressure is essential and may involve medications. Depending on your symptoms, risk factors, and lifestyle options, medications for high blood pressure may include:

Angiotensin-converting enzyme (ACE) inhibitors

Healthcare professionals often prescribe ACE inhibitors as first-line treatment for people with high blood pressure, especially if they have heart failure, diabetes, or kidney disease.

ACE inhibitors help relax blood vessels, reducing blood pressure.

Examples may include:

People who are pregnant or have a history of angioedema (swelling of deeper layers of skin) related to previous ACE inhibitor use or severe kidney disease should not take ACE inhibitors. 

Calcium channel blockers

Healthcare professionals may opt for calcium channel blockers when other medications are ineffective or you cannot tolerate side effects. 

These medications work by preventing the entry of calcium ions into heart and blood vessel cells, which relaxes and widens blood vessels and reduces the heart’s workload.

Common examples include:

Calcium channel blockers may not be suitable for people with certain heart conditions, such as heart block and severe hypotension.

Beta-blockers

Doctors often prescribe beta-blockers for people with high blood pressure who have other heart-related conditions, such as angina or arrhythmias. They reduce the heart rate and the force of the heart’s contractions, thus decreasing blood pressure.

Commonly prescribed beta blockers include:

Side effects of beta-blockers may also make them unsuitable for people with some chronic conditions, like severe asthma or heart block.

Diuretics

Diuretics are often the initial choice to manage high blood pressure, as they help reduce blood volume in circulation and lower overall pressure. A healthcare professional may prefer diuretics for people with excess fluid retention.

Commonly prescribed diuretics include:

People with a history of severe electrolyte imbalances, gout, or kidney dysfunction should use diuretics cautiously.  

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Angiotensin II receptor blockers (ARBs)

ARBs are an alternative to ACE inhibitors, especially for people who cannot tolerate ACE inhibitors’ side effects like chronic cough. They work by relaxing blood vessels, reducing blood pressure, and protecting against the effects of angiotensin II. 

Common examples of ARBs include:

While ARBs are generally well-tolerated, you should not use them if you are pregnant or hypersensitive to ARBs.

Alpha-blockers

Healthcare professionals often prescribe alpha-blockers when other blood pressure medications are ineffective.

Alpha-blockers relax specific muscles and reduce resistance in the blood vessels, leading to lower blood pressure.

Alpha-blockers may include:

Individual responses to these medications can vary, and the choice of blood pressure medications depends on various factors, including your overall health, existing medical conditions, potential side effects, and any contraindications. 

If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Follow the links on drug names for savings on that medication, or search for a specific drug here.

Medications for low blood pressure

Healthcare professionals often treat low blood pressure through non-pharmacological methods, focusing on managing the underlying causes such as dehydration, heart conditions, or medication side effects.

Management strategies may include lifestyle modifications, such as increasing fluid and salt intake, wearing compression stockings, and addressing underlying causes like heart problems or endocrine disorders. 

In rare instances, if low blood pressure is severe and adversely affecting your quality of life, a healthcare professional may consider prescribing medications to raise blood pressure. These may include:

However, people use these medications cautiously and under close medical supervision to avoid potential side effects and complications. 

Common side effects of blood pressure medications

High blood pressure medications may lead to side effects, including:

  • chronic cough
  • frequent urination
  • fatigue
  • ankle swelling 
  • dizziness 
  • high blood potassium levels 

While medications for low blood pressure are infrequently prescribed, they can have side effects such as: 

  • sodium and fluid retention
  • goosebumps and urinary retention
  • increased blood viscosity and clotting risks 

Not all medications lead to the same side effects, and factors like your overall health and individual sensitivity to ingredients play a part.

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Summary

Blood pressure medications, like ACE inhibitors and beta-blockers, help manage high blood pressure. Reducing high blood pressure lowers your risk of stroke, kidney problems, and heart disease. 

Consider talking with a healthcare professional to find the correct blood pressure medication and dosage that suits your needs. Sticking to your treatment plan is crucial to maintaining healthy blood pressure and enhancing overall well-being.

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