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
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:
- lisinopril (Qbrelis)
- enalapril (Vasotec)
- ramipril (Altace)
- captopril (Capoten)
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:
- amlodipine (Norvasc)
- diltiazem (Cardizem)
- nifedipine (Procardia)
- verapamil (Verelan)
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:
- atenolol (Tenormin)
- metoprolol (Lopressor)
- propranolol (Inderal)
- carvedilol (Coreg)
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:
- hydrochlorothiazide (Microzide)
- furosemide (Lasix)
- bumetanide (Bumex)
People with a history of severe electrolyte imbalances, gout, or kidney dysfunction should use diuretics cautiously.
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:
- losartan (Cozaar)
- valsartan (Diovan)
- irbesartan (Avapro)
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.