Medically Approved

Blood pressure medications: The Optum Perks Guide

Woman having blood pressure taken

High blood pressure often has no symptoms. And that’s worrisome because it’s a leading cause of heart disease and stroke. Learn about this condition and how it’s treated.

Jessica Migala

By Jessica Migala

Table of contents

  1. What causes high blood pressure?
  2. How do I know if I have high blood pressure?
  3. How is high blood pressure treated?
  4. Will I be on blood pressure medication forever?
  5. What are the top blood pressure medications I should know about?
  6. What are the most common blood pressure medication side effects?
  7. What lifestyle changes can I make to lower my blood pressure?

There’s a silent killer in our midst. It’s a condition that develops slowly over time and can have no symptoms at all. And it’s a key risk factor for heart disease and stroke, which are among the leading causes of death in the U.S., according to the Centers for Disease Control and Prevention (CDC).

We’re talking about high blood pressure, of course, also known as hypertension. Almost half of adults in the U.S. have it, and about 1 in 3 don’t even know it.

The good news: High blood pressure can be prevented — and controlled.

That means that if you’ve been diagnosed with hypertension, you can do something about it. That includes lifestyle changes and medication, when necessary, to bring your numbers into a safe zone. This will help protect your heart and health. (If you’re on medications for high blood pressure or another condition, get your free prescription discount card today. You could save up to 80% at the pharmacy.)

Here’s what you need to know about this potentially serious condition and how to protect your health for the long term.

What causes high blood pressure?

Blood pressure is the amount of force that your blood exerts against your blood vessels. Like a gushing stream that erodes its banks, high blood pressure can damage delicate blood vessels in organs such as your eyes and kidneys over time. And this can cause a range of problems, including vision loss and chronic kidney disease. In fact, high blood pressure is one of the top causes of kidney failure in the U.S.

According to the National Heart, Lung, and Blood Institute, you’re at greater risk of developing hypertension if:

  • You have a family history of the condition.
  • You have diabetes or metabolic syndrome.
  • Your weight is in the overweight or obese range.
  • You aren’t following healthy lifestyle recommendations. (This includes eating a healthy diet and exercising.)
  • You smoke, use drugs or drink too much alcohol.
  • You don’t get enough sleep. (When you sleep, your blood pressure goes down. Trouble getting your z’s can mean your blood pressure stays higher for longer.)
  • You’re older. (Changes to blood vessels over time increase the risk of high blood pressure.)
  • You’re taking certain medications that affect your blood pressure. Here are the prescription and over-the-counter medications that can raise your blood pressure.
  • You’re male.
  • You’re African American or Hispanic.

You’ve experienced certain social and economic factors, such as childhood trauma or working night shifts.

How do I know if I have high blood pressure?

This condition may not have any symptoms. So the best way to know whether you have high blood pressure is to get it checked, says Cait E. Kulig, PharmD. She’s a cardiology clinical pharmacist at St. Joseph’s University Medical Center and clinical assistant professor at the Ernest Mario School of Pharmacy at Rutgers University in New Jersey.

You can check it at a blood pressure station at your local pharmacy or grocery store, says Kulig. Your health care team will also check it at your yearly well visit. They’ll wrap an inflatable cuff around your arm. As they inflate the cuff, it will tighten, and they’ll be able to measure your blood pressure.

When you get a blood pressure reading, you’ll be given 2 numbers. The first (or upper) number is called systolic blood pressure. That is the pressure in your arteries as your heart beats. The second (or bottom) number is called diastolic blood pressure. It’s the pressure in your arteries between heartbeats, when your heart is relaxed.

Here’s what the numbers indicate, according to the American Heart Association (AHA):

  • Normal blood pressure: Less than 120/80 mm Hg
  • Elevated blood pressure: 120–129/less than 80 mm Hg
  • High blood pressure: Greater than or equal to 130 mm Hg systolic, or greater than or equal to 80 mm Hg diastolic

How is high blood pressure treated?

Your doctor will likely recommend that you make lifestyle changes to lower your numbers. They may also pair those healthy behaviors with medication.

If your health care provider recommends medication to lower your blood pressure, there are several different classes that can be prescribed. To get you on the right one, your doctor will consider any other conditions you may have (such as kidney disease or diabetes). They’ll also consider your race and ethnicity and other medications you’re currently taking.

This diagnosis is a perfect time to ask your health care team for a comprehensive medication review. A review in JAMA Internal Medicine found that nearly 1 in 5 people with hypertension are on medications that raise their blood pressure. Here’s what you need to know.

Remember: Just because you’re taking a high blood pressure medication does not mean that you can forgo healthy lifestyle changes. Those measures are just as important during treatment. And they help support healthy blood pressure levels for a lifetime.

Will I be on blood pressure medication forever?

Possibly. When you’re first diagnosed, a medication may be used to get your blood pressure under control as quickly as possible. This will happen at the same time you’re working on lifestyle changes to help naturally keep your numbers in check, says Eduardo Sanchez, MD. He’s the chief medical officer for prevention at the American Heart Association and the principal investigator for the National Hypertension Control Initiative.

Medication can work quickly. And this almost immediately reduces the risk of a bad event such as a heart attack or stroke. Lifestyle changes take more time to be effective. Some people will be able to go off their blood pressure medication once the benefits from their healthy habits take effect, says Dr. Sanchez.

However, many folks with high blood pressure will need to stay on medication for the long term. Therefore, both medication and lifestyle changes play an important role in controlling high blood pressure. Whether you have to stay on medication for good varies from person to person.

What are the top blood pressure medications I should know about?

There are a lot of blood pressure medications out there. In fact, the AHA lists 11 classes of them, with many options in each class.

When it comes to controlling blood pressure, it’s good to have options. The blood pressure medication you’re on can be tailored to your health history and other conditions you may have. Some people don’t respond well to a particular medication. Or they may have resistant hypertension. That’s when blood pressure doesn’t respond well to treatment. Those people may have to be on several different blood pressure medications to bring their numbers down.

In general, there are 4 main classes of blood pressure medication that your doctor may try, explains Kulig. They include:

  • Angiotensin-converting enzyme inhibitors (ACE inhibitors)
  • Angiotensin II receptor blockers (ARBs)
  • Calcium channel blockers
  • Diuretics

Learning a bit more about each medication will help you understand how they work and their role in blood pressure reduction.

First, it’s important to know that blood pressure can be influenced by 2 main factors. One is blood volume, or the amount of blood in your blood vessels. The other is the squeezing of those vessels, which can contract or dilate. The above classes of medications either act on the amount of blood flowing through the vessels or on the size of those vessels, explains Kulig. And some do both.

Some people will be prescribed more than 1 blood pressure medication. A 2021 study suggests that combining medication classes, rather than maximizing the dose of just 1, may offer even better results in older adults.

Here’s how each major class of medication works in your body:

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ACE Inhibitors and ARBs

What do they do: These 2 medications are grouped together because they both work on the body’s renin-angiotensin-aldosterone system (also called RAAS). This system controls blood volume and the size of your blood vessels. Think of it as a regulator: When your blood pressure is too low, RAAS activates and causes your blood vessels to squeeze. It also causes you to retain more water to boost your blood volume.

ACE inhibitors and ARBs both block this system. They do it through slightly different means, but the result is less squeezing of blood vessels and lower blood volume. That ultimately decreases blood pressure.

Who they’re for: Anyone with high blood pressure. People who do not have normal kidney function may be prescribed one of these medications as a first option. These medications can help prevent further damage to kidney function while lowering blood pressure. In addition, if you have heart failure or Type 2 diabetes, you’re also more likely to be prescribed one of these medications.

Examples:

Not seeing the name of your medication? Use the Optum Perks search tool to find prescription coupons.

Recommended reading: What to eat (and avoid) while taking an ACE inhibitor.

Calcium channel blockers

What they do: Blood vessels have muscles within them that squeeze (contract) and relax (dilate). The more they squeeze, the higher your blood pressure will be. For that contraction to happen, it needs calcium. Calcium channel blockers block those calcium receptors. And this encourages blood vessels to relax and dilate.

Who they’re for: Anyone with high blood pressure. Calcium channel blockers are often given to patients with chest pain due to poor cardiac blood flow (a condition called angina). They can be used on their own or paired with an ACE inhibitor or an ARB.

If you’re a Black American, you may be prescribed either a calcium channel blocker or a diuretic rather than an ACE inhibitor or an ARB. That’s because Black adults usually respond differently to an ACE inhibitor or ARB compared with non-Black patients. But there are always exceptions. If you’re a Black adult with diabetes or kidney disease, an ACE inhibitor or an ARB may be a better option for you.

Examples:

Diuretics

What they do: You may be most familiar with this type of medication. Also called water pills, diuretics target your blood volume. They get your kidneys to release more sodium (and with it, water from your blood) into your urine. This lowers the amount of fluid moving through your veins and arteries. Your blood pressure will go down along with it.

Who they’re for: Anyone with high blood pressure. If you have mildly elevated blood pressure, your doctor may prescribe a diuretic first. It’s common for doctors to use diuretics when combining medications, too.

Examples:

What are the most common side effects of blood pressure medication?

Whenever you take a medication, there’s a risk of side effects. Blood pressure medications are no different, says Kulig. In general, though, blood pressure medications have minimal side effects.

If you’ve started a new medication and are experiencing side effects, talk to your doctor. They may want to change your dose or consider switching your medication to something you may tolerate better.

Reminder: It’s important to actually have this conversation, rather than assuming the medication won’t work for you and stopping it on your own. The doctor can prescribe other options that may have fewer side effects (or none).

The most common side effects people experience are:

  • Low blood pressure. You might feel it as dizziness, light-headedness, brain fog, problems concentrating or low energy.
  • A change in kidney function. ACE inhibitors or ARBs can cause high levels of potassium in the blood and a change in kidney function. After starting you on one of these medications, your doctor should monitor these changes with bloodwork.
  • A dry cough. This is a common side effect of ACE inhibitors. Talk to your doctor to rule out other causes of a cough.
  • Leg swelling. Calcium channel blockers may cause small blood vessels to leak fluid into nearby tissues. It appears as swelling in the extremities, particularly the legs.
  • Feeling dehydrated. Diuretics make your body expel more water. For some people, they work too well, causing headaches and dry mouth. If you think you’re experiencing dehydration, your doctor may want to lower your dose or switch your medication.
  • Urinating more than usual. This is another side effect of diuretics. Some people may need to go to the bathroom during the night if they take the medication too close to bedtime. To avoid this side effect, take the diuretic first thing in the morning.

What lifestyle changes can I make to lower my blood pressure?

Generic advice to just eat healthier and exercise can fall flat — and leave you without a plan. The good news is that you don’t need to overhaul your life to see improvements in your blood pressure, says Dr. Sanchez. It’s the little everyday habits that count.

Here are 3 lifestyle changes that can make a world of difference:

Try the DASH diet

The DASH diet is the go-to recommendation from the AHA when it comes to lowering blood pressure. It stands for Dietary Approaches to Stop Hypertension.

This diet promotes eating more fruits and vegetables, quality carbohydrates (such as whole grains) and lean proteins, and less sugar, salt and saturated fat. Eating less processed food and restaurant fare is generally a good way to reduce sodium, says Dr. Sanchez.

Follow our comprehensive DASH diet guide to get started today.

Move more

The AHA recommends 30 minutes of moderate-intensity physical activity on most days of the week. Moderate intensity is walking a mile in 15 to 20 minutes. But when it comes down to it, all you have to do is move your body more than you do now, says Dr. Sanchez.

If you’re just starting out, aim for 10 minutes of movement every day. That could be dancing to 2 of your favorite songs, walking up and down the stairs, or trekking down your driveway to get the mail.

Gradually work your way up to 30 minutes (and beyond). And know that it doesn’t need to be a solid block of exercise if you don’t have the time. You can still get benefits from spurts of activity throughout the day. So take the extra minute to climb the stairs or power walk across the grocery store parking lot.

Curb your vices

Smoking cigarettes and drinking alcohol both contribute to high blood pressure. If you smoke, now is the time to find supportive resources to help you quit for good.

As for alcohol, it’s “no or low.” If you don’t currently drink, don’t start — there’s no reason to do so for your heart health, says Dr. Sanchez. Otherwise, drink alcohol in moderation. For men, the recommendation is no more than 2 drinks per day, while for women it’s no more than 1.

For some fun, simple ways to lower blood pressure, check out these 16 little ways to lower your blood pressure. And don’t forget to download the Optum Perks prescription discount app. Use it to find, save and share medication coupons.

 

Additional sources
Heart disease facts: Centers for Disease Control and Prevention
Risk factors for hypertension: National Heart, Lung, and Blood Institute
Medications that raise blood pressure: JAMA Internal Medicine (2021). “Prevalence of medications that may raise blood pressure among adults with hypertension in the United States”
Types of blood pressure medication: American Heart Association
Benefits of combining blood pressure medications: Annals of Internal Medicine (2021). “Adding a new medication versus maximizing dose to intensify hypertension treatment in older adults”
Physical activity recommendations: American Heart Association