High blood pressure, also known as hypertension, is a common condition affecting nearly half of all American adults.
High blood pressure happens when blood pushes too hard against your blood vessels. This makes your heart work extra hard and can damage your body over time. High blood pressure forces the heart to work harder to circulate blood to the rest of the body. If not treated, it can lead to serious problems like heart disease, stroke, kidney problems, some types of dementia and more.
Let’s discuss suggested treatment options and what medications are available.
Treatment options for managing high blood pressure
Lifestyle changes can help lower your blood pressure and help you make daily choices focused on better health and wellness, including:
- Choose healthy foods, especially those high in potassium, which lowers blood pressure, such as fruit and vegetables.
- Follow a diet low in salt (sodium), as sodium can make your body retain water, increasing blood pressure.
- Exercise regularly
- Keep a healthy weight
- Drink less alcohol
- Not smoking
- Get enough sleep. The recommended range is 7-9 hours.
Lifestyle changes alone can lower blood pressure for some people. Many others require prescription medications to achieve normal levels. Nearly 48% of adults rely on blood pressure medication as part of their treatment plan under the guidance of their healthcare providers.
Types of medications for blood pressure
If you and your healthcare provider discuss adding medications to your treatment plan, there are many factors your provider will consider when recommending a specific medication.
- Your overall health
- Your blood pressure level and what stage of blood pressure you have. See here for the different blood pressure stages
- Your age
- Your risk for developing cardiovascular disease
- Family history
- If you have a chronic condition, such as diabetes, kidney disease or heart disease
Your provider may recommend taking more than one pressure or combination medication. Let’s look at some of the more common medications for hypertension.
This list is meant to help you understand the medicines available. It’s important that you consult with your provider and read patient information materials to learn the full details about any medication.
| Medication Type | How it works | Generic name (Brand) | Potential side effects, precautions* |
| Diuretics (Water pills) | These are usually the first medications your provider may recommend because they help remove water and sodium from the body. Why does removing water help? High sodium levels make your body retain water. The excess water contributes to high blood pressure. | Chlorthalidone Hydrochlorothiazide (Microzide) | Frequent urination Dehydration Muscle cramps Low electrolytes (sodium) Low potassium levels |
| Angiotensin-converting enzyme (ACE) inhibitors | ACE inhibitors help relax the blood vessels in your arteries by blocking a natural chemical that narrows blood vessels from forming | Lisinopril (Prinivil, Zestril) Benazepril (Lotensin) Captopril | Dry cough Dizziness Hypotension (low blood pressure) |
| Angiotensin II receptor blockers (ARBs) | Similar to ACE inhibitors, ARBs also relax blood vessels. The difference is that they block the natural chemical that narrows blood vessels rather than stopping their formation. | Candisartan (Atacand) Losartan (Cozaar, Hyzaar) | Frequent urination Headache Fainting Dizziness Fatigue Respiratory symptoms Vomiting Diarrhea Back pain Leg swellingHigh potassium levels |
Calcium channel blockers | These drugs also help relax the blood vessels. Some of the medicines in this group may slow down your heart rate. | Amlodipine (Norvasc) Diltiazem (Cardizem, Tiazac, others) | Avoid eating or drinking grapefruit products, as they can increase the level of certain calcium blockers, which can be dangerous. |
| Beta-blockers | Beta-blockers reduce the workload on the heart and widen the blood vessels, which in turn helps the heart beat slower and with less force. | Atenolol (Tenormin) Metoprolol (Lopressor, Toprol-XL, Kapspargo sprinkle) and others. | It prevents aldosterone, a hormone in your body, from causing excess salt and water retention. Aldosterone helps reduce resistant hypertension that hasn’t responded well to other treatments. |
| If your the medicines you are taking aren’t getting your blood pressure low enough, your doctor may recommend adding one of these other medications to help: | |||
Alpha-blockers | Alpha-blockers reduce the nerve signals to the blood vessels and help lower the narrowing of blood vessels. | Doxazosin (Cardura), prazosin (Minipress) and others. | Dizziness Headache Low blood pressure (hypotension) Headache Fast or pounding heartbeat Weakness |
| Alpha-beta blockers | Like alpha-blockers, Alpha-beta blockers reduce the nerve signals and slow the heartbeat and the amount of blood pumped through blood vessels. | Carvedilol (Coreg) and labetalol (Trandate) | Dizziness Low blood pressure (hypotension) Fatigue Nausea Dry mouth or eyes |
| Aldosterone antagonists | Prevents aldosterone, a hormone in your body, from causing excess salt and water retention. Aldosterone helps reduce resistant hypertension that hasn’t responded well to other treatments. | Spironolactone (Aldactone) and eplerenone (Inspra). | Cough Dizziness Headache Diarrhea High potassium levels Vaginal bleeding after menopause |
| Renin-inhibitors | Lowers renin levels in the kidneys to reduce blood pressure. | Aliskiren (Tekturna) | It’s important to note that due to the risk of serious complications, including stroke, renin inhibitors should not be combined with ACE inhibitors or ARBs. |
| Vasodilators | It prevents the muscles in artery walls from tightening, thereby keeping the arteries from narrowing. This type of medication is often prescribed to those with high blood pressure during pregnancy or childbirth. | Hydralazine and minoxidil | Fast heartbeat Fluttering, pounding or rapid heartbeat, called palpitations. Swelling due to fluid buildup Nausea Vomiting Headache Excessive hair growth Joint paint Chest pain |
| Central-acting agents | These drugs stop the brain from signaling the body to reduce the heart rate and narrow blood vessels. | Clonidine (Kapvay, Nexiclon XR) Guanfacine (Intuniv) Methyldopa | Slow heart rate Constipation Extreme sleepiness FeverHeadache Dry mouth Erectile dysfunction |
Things to consider if you have high blood pressure
- Stay proactive and informed about your health by regularly monitoring your blood pressure. Many healthcare providers recommend home monitoring to understand your daily patterns. This is helpful for people who get nervous at the doctor’s office, as it can temporarily increase their blood pressure. This is called “white coat syndrome.”
- Stay on top of it: Taking your medication as prescribed is important. Try to avoid skipping doses or stopping suddenly, as this can cause a dangerous spike in blood pressure called rebound hypertension. By staying dedicated to your medication plan, you can maintain stable blood pressure and reduce your risk of complications. It’s always important to consult your provider before changing your treatment plan.
- Pregnancy: If you already have high blood pressure before becoming pregnant, there is a potential risk of developing certain pregnancy complications, such as preeclampsia. You may want to consider seeing a provider who has experience in managing hypertensive disorders during pregnancy. Let your team of providers know so they can monitor your blood pressure closely and adjust any medication you can take as needed.
- Know where you stand: Some groups face higher risks of blood pressure complications.
- Black adults tend to develop it earlier and may respond differently to some medications. Black women also have a higher risk of preeclampsia during pregnancy.
- Your family history can also increase your risk.
- Knowing your risk group can help you better understand what you can do to manage your health.
Reviewed by the Ovia Health Clinical Team
Sources
- “ACE Inhibitors – StatPearls – NCBI Bookshelf.” National Center for Biotechnology Information, 26 June 2023, www.ncbi.nlm.nih.gov/books/NBK430896/.
- “Cache://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure-medication/art-20048154 – Google Search.” www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure-medication/art-20048154.
- “High Blood Pressure (hypertension).” Mayo Clinic, 15 Sept. 2022, www.mayoclinic.org/diseases-conditions/high-blood-pressure/diagnosis-treatment/drc-20373417.
- “High Blood Pressure Facts.” High Blood Pressure, 18 July 2024, www.cdc.gov/high-blood-pressure/data-research/facts-stats/index.html#:~:text=In%202022%2C%20high%20blood%20pressure,3.
- “How Do Central-acting Agents Lower Blood Pressure?” Mayo Clinic, 16 Aug. 2023, www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure-medication/art-20044451#:~:text=These%20medicines%20lower%20heart%20rate,This%20lowers%20blood%20pressure.
- “Hypertension Prevalence in the U.S. | Million Hearts®.” Centers for Disease Control and Prevention, 12 May 2023, millionhearts.hhs.gov/data-reports/hypertension-prevalence.html.
- “Products – Data Briefs – Number 511 -October 2024.” Centers for Disease Control and Prevention | CDC, 24 Oct. 2024, www.cdc.gov/nchs/products/databriefs/db511.htm.
