Medicines for High Blood Pressure
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Medicines for High Blood Pressure

The Basics

Written by the doctors and editors at UpToDate

Why do I need medicines to treat high blood pressure? — Having high blood pressure puts you at risk for heart attack, stroke,kidney damage, and other serious problems. The medicines your doctor or nurse prescribes to treat high blood pressure can help reduce the risk of these problems and even help you live longer.
It’s very important that you take your blood pressure medicines every day as directed. High blood pressure doesn’t usually cause symptoms, so people sometimes don’t take it seriously. Plus, blood pressure medicines can cause side effects and be expensive, so it’s easy to understand why people don’t like to take them. But if you are tempted to skip your medicines, remember, they can save your life!
If your medicines cause unpleasant side effects, or if you can’t afford your medicines, talk to your doctor or nurse. There are often ways to deal with these problems. The first step is to let your doctor or nurse know.
Which medicines might I need? — There are lots of different medicines to treat high blood pressure. But some of the medicines have other health benefits besides lowering blood pressure
Your doctor or nurse will decide which medicine is best for you depending on:

  • How high your blood pressure is
  • Your other health problems, if you have any
  • How well you do on the medicines you try

Your doctor or nurse might need to change your medicine or its dose a couple of times to find the medicine and dose that work best and cause the fewest side effects. Plus, you might need to take more than 1 medicine to get your blood pressure under control. Whatever your doctor or nurse prescribes, it’s important to take your medicines exactly as prescribed (table 1). But always let your doctor or nurse know if you have any problems with the medicines. That way he or she can make changes so that you are as comfortable as possible and also get the most benefit. Never stop or make changes to the way you take your medicines without talking to your doctor or nurse
first.
Below is a list of the most common types of medicine given to people with high blood pressure:

  • Medicines called “diuretics”
  • Medicines called “angiotensin-converting enzyme inhibitors” (“ACE inhibitors”) or “angiotensin receptor blockers” (“ARBs”)
  • Medicines called “calcium channel blockers”
  • Medicines called “beta blockers”

This article has only some basic information on these medicines. For more detailed information about your medicines, ask your doctor or nurse for the patient hand-out from Lexicomp, available through UpToDate. It explains how to use each medicine, describes its possible side effects, and lists other medicines or foods that can affect how it works.
Diuretics — Diuretics are sometimes called “water pills,” because they make you urinate more than usual. Some examples of diuretics include chlorthalidone, indapamide, hydrochlorothiazide (also known as HCTZ), and furosemide (brand name: Lasix).

ACE inhibitors and ARBs — ACE inhibitors and ARBs are often grouped together, because they work in similar ways. These medicines can help prevent kidney disease. Doctors often prescribe them for people with diabetes, because people with diabetes have a higher-than-average risk of kidney disease.
Some examples of ACE inhibitors include enalapril, captopril, and lisinopril. Some examples of ARBs include candesartan (brand name: Atacand) and valsartan (brand name: Diovan).
Calcium channel blockers — Some examples of calcium channel blockers include amlodipine (brand name: Norvasc), felodipine(brand name: Plendil), and diltiazem (brand name: Cardizem). These medicines also help prevent chest pain caused by heart disease.

Beta blockers — Besides lowering blood pressure, beta blockers help reduce the amount of work the heart has to do. Studies show that people who take a beta blocker after a heart attack are less likely to have another heart attack or die than people who don’t take a beta blocker. Studies also show that people with heart failure who take beta blockers live longer than people with heart failure who don’t.
When people first start taking beta-blockers, they sometimes feel tired. That is just while the body gets used to the medicine. But once the body gets used to beta blockers, the medicines can really help. If your doctor prescribes a beta blocker, give it a little time to start working.
Some examples of beta blockers include atenolol (brand name: Tenormin), metoprolol (brand names: Lopressor, Toprol-XL), and propranolol (brand name: Inderal LA).

All topics are updated as new evidence becomes available and our peer review process is complete.

Tips on taking oral medicines

Take your medicines exactly as your doctor, nurse, or pharmacist tells you to.
Use a daily or weekly pill box to organize your medicines
Keep your medicine containers in a place you will see them every day
Create reminders for yourself to take your medicines. Try using a calendar, a smart phone app, a digital watch, or whatever works to help you remember.
Read the prescription label and printed patient information that comes with each medicine.
Do not skip pills, change doses, or take extra pills unless your doctor tells you to. The dose your doctor prescribes is based on your age,weight, health problems, and other medicines you take. It can be dangerous to take different amounts.
Learn the names of each of your medicines, how it works, and why you take it.
Learn what each of your medicines looks like (shape, size, color). When you get a refill, you might get a new generic version that looks different from the last time. That is OK as long as the new medicine has the same ingredient as the one it is replacing. If you are worried about a refill looking different, talk to your pharmacist.
Tell your doctor or nurse about any side effects you have. He or she might have ways to reduce or get rid of the side effects.
Tell your doctor, nurse, or pharmacist if you can’t afford your medicines. There are often ways to lower costs
Make a list of all the medicines you take, plus any medicines you are allergic to or have had problems with in the past. Keep one copy at home and one in your wallet
Bring a bag containing all your medicines with you to your doctor’s office, every time you go. If you can’t do this, bring the list of your medicines. Have your doctor or nurse go over your medicines or list with you.
Talk to your doctor, nurse, or pharmacist before you take any cough, cold, allergy, pain, or other extra medicines. The same goes for supplements and herbal medicines. Over-the-counter and herbal medicines can affect the way prescription medicines work.
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