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Managing your high blood pressure with medications can seem daunting.  So many medicines, complicated names, long lists of side effects, etc can leave your head spinning and wondering if it’s even worth it.  So is it? Should you even bother?

YES!  High blood pressure is sneaky.  Many people have few or no symptoms when they are diagnosed with high blood pressure. When you add the seemingly complex task of managing one or several medications it can seem like an unnecessary addition to an already busy life.  But keeping your high blood pressure under control is extremely important. Poorly controlled blood pressure can lead to many problems down the road.  These problems can include heart failure, heart attacks, strokes, kidney disease (possibly requiring dialysis), blockages in blood vessels of the legs, and erectile dysfunction.  

The good news is that control of high blood pressure (also called hypertension), along with control of other medical conditions can go a long way toward preventing these other problems.  

Lifestyle Modifications as a First Step

The first step in getting control of hypertension involves making lifestyle changes.  Watching what you eat, controlling your weight, increasing your physical activity, and getting quality sleep can also make your blood pressure easier to control. If you’ve already tried those things, or if your doctor feels additional treatments are needed, medications are usually the next step.  

High Blood Pressure Medications

Doctors have known for many years that uncontrolled hypertension leads to unwanted health consequences.  Hypertension is well studied and many of the medications used to treat hypertension have been available for a longtime.  This is really good news because it means that the safety profile of these medicines is well known and it often means that generic versions of blood pressure medications are available.  If finances are an issue, make sure to let your doctor know this because there may be cheaper options available.

When your doctor chooses to prescribe medications for your high blood pressure it can help to have an understanding of some of the commonly used medicines and their possible side effects.  Keep in mind that treatment of any disease is highly individualized and that you should ask your doctor any questions you have about your treatment plan and of course, any medication can cause undesired side effects so make sure your doctor knows if you are having trouble tolerating your medications.

In general, getting great control of your hypertension is more important than the specifics of which medication is being used.  There are also other uses for most of the commonly used medications so it may be the case that your doctor has chosen a medication for you based on not just your blood pressure but also any other condition that you might have or might be at risk of developing.  

Sometimes, when blood pressure has been high for some time and a new medication is started you will notice symptoms related to newly lowered blood pressure.  These symptoms will often improve or resolve over a few weeks as your body gets used to a new, lower blood pressure.  These symptoms include things like fatigue or light headedness.  Other side effects can be related to the medications themselves.

Medications for high blood pressure can be prescribed alone or in combination with other blood pressure medications.  Many commonly available medications are actually combinations of more than one medicine.  You can determine this by looking at the generic medication names listed on the label. Ask your doctor or pharmacist for help if you are uncertain about this.

Women who are pregnant or who might become pregnant need to make sure to discuss this with their doctor.  Some of the above medications are not safe in pregnancy and your doctor may choose to change your medications.

Ace Inhibitors (ACE-I) and Angiotensin Receptor Blockers (ARB)

One category of medications is called ace inhibitors (ACE-I) and angiotensin receptor blockers (ARB). These medication names often end with the letters …pril or …sartan.  These medications work to lower blood pressure by their effect on the kidney and on the receptors in the heart and blood vessels. They can be used alone or in combination with other medications.  Use of this type of medication will often require periodic lab monitoring to check your kidney function and blood electrolyte levels (like potassium).  This type of medications also has some specific uses in addition to control of hypertension including diabetes, kidney disease, coronary disease (blockage of the arteries of the heart), and heart failure. A common side effect of these medications is development of a cough.  This is not an emergency but it is important to let you doctor know if you develop a cough which taking this type of medicine.  A rare but serious side effect is face and throat swelling (called angioedema).  This can be dangerous.  If you develop this side effect you should stop taking your medication and seek medical attention.  

Calcium Channel Blockers (CCB)

The next category of medications used for hypertension is calcium channel blockers (CCB).  These medication names often endin …ipine, …izem, or …amil.  These medications have an effect of the blood vessels.  Some (but not all) of these types of medicines will also lower your heart rate (or pulse).  They are sometimes also used for treatment of an irregular heart rhythm called atrial fibrillation.  Sometimes calcium channel blockers can cause leg swelling or constipation.  Make sure to mention this to your doctor if you develop either of these side effects while taking this medication.  

Diuretics

The third category of medications is called diuretics. These medications sometimes end in …adone, …azone, …azide, …amide.  Diuretics work in the kidney.  They often cause an increase in urination and can also be used for control of excess fluid in people with congestive heart failure. Periodic lab monitoring is often required to follow kidney function and blood electrolyte levels.  

Beta blockers (B-blocker)

The next category of hypertension medications is called beta blockers (B-blocker).  These medication names often end in…olol.  Beta blockers work on the muscle in the blood vessel and on the heart itself. They can also be used to treat other conditions like congestive heart failure or atrial fibrillation. Beta blockers will cause a decrease in the pulse rate. Beta blockers can sometimes worsen control of asthma so make sure your doctor is aware if you have this condition.

The above categories are the most common types of blood pressure medications but certainly not the only ones.  There are several other types of medications used to treat hypertension.  In general, these other categories of medicines are used for people with specific medical conditions, who have difficult to treat hypertension, or have intolerances to the more common medications. Knowing about your medications can help you and your doctor make the choices that are best for your health.  If you have questions, make sure to ask your doctor so that you can be the healthiest version of you.