Blood Pressure Medications

Blood pressure medications (antihypertensives) are medicines that lower your blood pressure. They treat high blood pressure (hypertension) to keep your heart strong and prevent heart failure, heart attack, kidney failure or stroke. Bringing your blood pressure down makes it easier for your heart to keep pumping blood to your body 24 hours a day.

These medicines lower your blood pressure in various ways, like widening your blood vessels or making your kidneys move extra fluids out of your blood.

Your healthcare provider will consider your health history, age, race and sex when discussing your high blood pressure medication options. They’ll also look at how high your blood pressure is.

Most people take high blood pressure medication in the form of a pill that you swallow every day. But your provider may give you some antihypertensive medications through an IV during a hospital stay.

Antihypertensive medications are very common. More than 1 billion people worldwide have high blood pressure.

Types of blood pressure medication

Types of blood pressure medicines include:

• Alpha-blockers: Relax artery wall muscles (examples: prazosin, doxazosin, terazosin)
• Angiotensin-converting enzyme (ACE) inhibitors: Help your body make less angiotensin, a blood vessel constrictor (examples: lisinopril, captopril, ramipril)
• Angiotensin II receptor blockers (ARBs): Keep angiotensin II from making your blood vessels tighten (examples: losartan, valsartan, olmesartan)
• Beta-blockers: Keep your heart rate low and may relax blood vessels (examples: metoprolol, atenolol, propranolol)
• Calcium channel blockers: Keep calcium out of your blood vessels, which lets the muscle in your blood vessels relax and loosen (examples: amlodipine, diltiazem, verapamil)
• Central alpha-2 receptor agonists: Prevent your nervous system from narrowing blood vessels (examples: clonidine, methyldopa, guanfacine)
• Diuretics: Help your blood vessels get wider and make your kidneys move extra fluid and salt into your pee (examples: hydrochlorothiazide, amiloride, furosemide)
• Renin inhibitors: Keep an enzyme called renin from working, leading to less angiotensin production (example: aliskiren)
• Vasodilators: Relax blood vessels, making them more open (examples: minoxidil, hydralazine)

What are the benefits and risks of antihypertensives?

Blood pressure medications help many people lower their high blood pressure and keep their hearts from becoming overworked. They also help people avoid having:

• Heart failure
• Kidney failure
• Heart attack
• Stroke

But there are some risks that can happen with high blood pressure medication, like:

• A sudden drop in blood pressure when you stand up (orthostatic hypotension)
• A change in electrolyte levels as you lose extra fluid in your pee, which can cause dangerous heart rhythms

Side effects of blood pressure medicine

Possible blood pressure medication side effects include:

• Fainting
• Dizziness
• Tiredness
• Constipation
• Cough
• Swelling
• Headache
• Fast or slow heart rate
• Dry mouth
• High or low levels of magnesium or potassium
• Upset stomach

Each type of medicine can have different side effects. Talk with your healthcare provider about what you can expect.

What happens during this treatment?

Each high blood pressure medication has a process for lowering blood pressure. It depends on which one you take. They may work by:

• Helping your blood vessels relax so blood flows through more easily
• Taking fluid out of your bloodstream so there’s less to pump
• Making your heart pump more slowly or with less force
• Helping your body make less of a substance that tightens blood vessels

How successful is this treatment?

Many people do well with managing their blood pressure. Hypertension is a long-term condition, so you’ll need to keep taking blood pressure medicine for the rest of your life. You may need to take more than one type of this medication to bring your blood pressure numbers down.

Your healthcare provider may try one antihypertensive drug and add a second or third little by little to get results. Your provider may also adjust or switch these medicines if they aren’t giving results or if you develop side effects or unsafe changes in your bloodwork.

People who keep their blood pressure in a normal range do the following:

• Take the medicine at the same time every day without missing doses.
• Check your blood pressure regularly at home.
• Go to regular checkups with their healthcare provider.
• Eat heart-healthy foods low in salt.
• Limit their alcohol use.
• Avoid drugs or supplements that may keep their medication from working.
• Get regular physical activity.
• Stay at a weight that’s healthy for them.

What happens if you miss a dose?

If you miss a dose, you can take it when you remember. But if it’s close to the time you’ll take your next dose, don’t take two doses at once. Just take the normally scheduled one.

How long will it take for me to feel better?

Hypertension often doesn’t cause any symptoms until you’ve had it for years or it becomes dangerously high. This is why it’s important to check your blood pressure regularly to know if you have it. Once you’re taking blood pressure medications, checking your blood pressure can tell you if what you’re taking is working. Blood pressure medicines can start working within one hour of taking them. Others can take longer.

When should I call my healthcare provider?

Tell your healthcare provider if you’re having problems with blood pressure medication side effects. They can order a different antihypertensive medication. They can also give you a different amount (dose) of what you’re taking. Tell your provider if your blood pressure readings get too high or too low on your home blood pressure monitor.

Can you take fish oil with blood pressure medication?

Yes, you can take fish oil. But you should check your blood pressure regularly because taking both may lower your blood pressure more.

What blood pressure medications are safe in pregnancy?

You can take methyldopa, labetalol or nifedipine during pregnancy. Check with your healthcare provider for their advice. Many other medicines aren’t safe for a fetus, so be sure to let your provider know when you plan to become pregnant.

What is the first drug of choice for hypertension?

First-line (first choice) options include thiazide diuretics and calcium channel blockers. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) are good first-line choices for people with kidney disease and heart failure.

Beta-blockers may also be first-line choices if you have a history of heart disease.

The best high blood pressure medication is the one that works best for you and your specific situation. Everyone has different health issues. What works well for one person may not work well for another.