While diet and exercise play a large role in managing high blood pressure, don’t underestimate the power of medications in reducing blood pressure. Many types of high blood pressure medications are available and they all work in different ways to lower blood pressure. Here are the details of each of the eight types to know in order to have an educated discussion with your doctor about which treatment might work best for you.
Diuretics can often be referred to as “water pills.” This is because they help eliminate sodium and excess water by promoting urination. This decreases blood vessel fluid volume, which reduces pressure against artery walls, thereby lowering blood pressure. The three classes of diuretic drugs include thiazide, loop, and potassium-sparing. Examples of diuretics include:
- Chlorothiazide (Diuril)
- Hydrochlorothiazide (Microzide)
- Furosemide (Lasix)
- Eplerenone (Inspra)
This drug category may also be called beta-adrenergic blocking agents. Beta-blockers inhibit the effects of the hormone epinephrine (aka adrenaline), resulting in a slower, less forceful heartbeat. Beta-blockers can also promote vasodilation (i.e. widening of the blood vessels). These two actions results in reduced blood pressure. Examples of beta-blockers include:
- Acebutol (Sectral)
- Atenolol (Tenormin)
- Metoprolol (Lopressor, Toprol-XL)
ACE stands for Angiotensin Converting Enzyme. Angiotensin II is a substance that promotes blood vessel narrowing and increased blood pressure. ACE inhibitors reduce enzyme production of angiotensin II; therefore, resulting in lower blood pressure. Examples of ACE inhibitors include:
- Quinapril (Accupril)
- Benazepril (Lotensin)
- Ramipril (Altace)
Angiotensin II receptor blockers
As well as narrowing blood vessels and increasing blood pressure, angiotensin II also releases a hormone to increase sodium and water in your body. More fluid/blood volume leads to higher blood pressure. Angiotensin II also promotes arteriosclerosis, which is the thickening and stiffening of blood vessels. Angiotensin II receptor blockers inhibit the actions of angiotensin II to promote vasodilation and lower blood pressure. Examples of angiotensin II receptor blockers include:
- Losartan (Cozaar)
- Olmesartan (Benicar)
- Valsartan (Diovan)
Please note, both ACE inhibitors and angiotensin II receptor blockers promote lower blood pressure by impacting angiotensin II, but they do so in slightly different ways. Therefore, one type of medication may provide different results than the other.
Calcium channel blockers
This drug category may also be called calcium antagonists. Calcium channel blockers lower blood pressure by decreasing the excitability of muscle cells in arterial walls. This is done by preventing calcium from entering muscle cells of the arterial walls, thus allowing blood vessels to widen and blood pressure to decrease. There are short-acting and long-acting forms of calcium channel blockers. Short-acting, which take effect quickly, only have impact for a few hours. While long-acting are released slowly for longer impact. Examples of calcium channel blockers include:
- Amlodipine (Norvasc)
- Nifedipine (Procardia)
This drug category may also be called alpha-adrenergic antagonists. Alpha blockers inhibit the actions of norepinephrine. The hormone norepinephrine causes blood vessel muscles to tighten. Alpha blockers relax muscles to allow for wider blood vessels and lower blood pressure. Like calcium channel blockers, there are short-acting and long-acting forms of alpha blockers. Examples of alpha blockers include:
- Doxazosin (Cardura)
- Prazosin (Minipress)
This drug category may also be called central-acting agents, central alpha agonists, or central adrenergic inhibitors. Central agonists prevent increased heart rate and the narrowing of blood vessels by reducing signals to the nervous system, resulting in lower blood pressure. Examples of central agonists include:
- Clonidine (Catapres)
- Guanfacine (Tenex)
Renin is an enzyme that promotes the production of angiotensin II. As explained earlier, angiotensin II leads to vasoconstriction and increased blood pressure. Renin inhibitors prevent renin actions, promoting vasodilation and lower blood pressure. Examples of renin inhibitors include:
- Aliskiren (Tekturna)
Depending on the severity of your high blood pressure, your doctor may prescribe more than one blood pressure medication. All medications come with varying side effects, which may include headaches, dizziness, fatigue, nausea, and constipation.
Reduce your dependence on medication by making dietary and lifestyle changes to lower blood pressure levels. Here is a free e-course: 7 Natural Ways to Lower Blood Pressure.
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Lisa Nelson RD, a registered dietitian since 1999, provides clients step-by-step guidance to lower cholesterol and lower blood pressure, so they can live life and enjoy their family for years to come. Because her own health is the foundation of her expertise, you can trust that Lisa will make it truly possible for you to see dramatic changes in your health, without unrealistic fads or impossibly difficult techniques. She can be found on Twitter @lisanelsonrd and Facebook at hearthealthmadeeasy.