How to Choose the Right High Blood Pressure Medication
Category: Healthy Living
Posted on February 12, 2021
Vanessa is a health writer and blogging expert. Her specialities are medicine, health and wellness. She is proud to call Vancouver, BC her home where she enjoys the ocean and mountains with her dog Mr. ChowChow.
An estimated 45% of US adults, or about 108 million, have high blood pressure. Of these individuals, about three-quarters (82 million) don't have their hypertension under control. What's more, at least one in four US adults has untreated high blood pressure.
The thing is, having hypertension magnifies your risk for heart disease and stroke. What's more, almost three in four diabetes patients report having hypertension, too.
There's still some good news, though. Hypertension is manageable with the right high blood pressure medication. Many of its risk factors, such as smoking and alcohol intake, are also modifiable.
Still, there are dozens of blood pressure drugs approved for use in the US, though. All come with contraindications and possible side effects. That's why it's vital to choose and use these medications wisely and with care.
To that end, we came up with this guide covering the chief facts about hypertension. Read on to discover the best and most common prescription medications to help manage it.
Determining if You Have Hypertension
Hypertension has earned the title of being a "silent killer" as it can be asymptomatic. This means that a person can have it without having any symptoms at all. So, it's no wonder many people have undiagnosed and untreated high blood pressure.
For this reason, a doctor's check-up is one of the best health strategies you shouldn't overlook. For starters, nurses and doctors always take their visiting patients' blood pressure. To do this, they use sphygmomanometers or digital blood pressure monitors.
Note that in 2017, US health experts revised hypertension definition and guidelines. These changes defined stage 1 hypertension as blood pressure at or more than 130/80 mm Hg. Stage 2 hypertension is blood pressure that sits at or goes beyond 140/90 mm Hg.
If you do get diagnosed with hypertension, ask your doctor to teach you how to use a blood pressure monitor. This way, you can also check it on your own with a home blood pressure monitor.
The First Big Step to Treating Hypertension: Lifestyle Changes
Studies found alcohol intake to be a risk factor in 43% of people with high blood pressure. Obesity is another risk factor with a prevalence of 18.8%, while it's 15.8% for smoking. Other risk factors are salty diets, high-stress levels, and physical inactivity.
As you've likely guessed, all of the above are "modifiable" hypertension risk factors. This means that taking them out of the picture can help you put your blood pressure under control.
You may not have to take blood pressure medication yet, but you need to commit to lifestyle changes. It's best to quit smoking, eat healthier, and reduce your alcohol and salt intake. You should also fit mental relaxation techniques into your daily anti-stress regimen.
Your age will be a huge deciding factor in your need to take blood pressure drugs, though. If you're still young, your blood pressure readings must not reach stage 2 thresholds. Otherwise, you most likely will receive a prescription from your doctor.
People in their 60s may already need medication, regardless of risk factors. The same goes for if you have other chronic health conditions, such as diabetes or heart disease. You most likely would need meds, too, if you still get high readings even after lifestyle changes.
Blood Pressure Medication Considerations
All FDA-approved medications for high blood pressure are prescription drugs. This means that you need a valid prescription to buy them.
Before writing a prescription, your doctor will also ask you for your family's history. After all, hypertension has a genetic tendency, so it may run in your family.
Your doctor will also consider other health woes you have. This is vital as some blood pressure medications can interact with other medicines. Your age, gender, and hypertension stage would also influence which meds you can take.
Your High Blood Pressure Medication Options
ACE inhibitors and calcium channel blockers are the most widely-prescribed hypertension medicines. Diuretics, beta-blockers, and ARBs are also top-selling high blood pressure medications. All of these help lower blood pressure, but they work in different ways.
Angiotensin-Converting Enzyme (ACE) Inhibitors
ACE inhibitors are the most popular first-line treatment for hypertension. So much so that they account for almost half of prescriptions for high blood pressure.
These drugs work by preventing the body from making angiotensin II. It's a hormone that constricts the blood vessels. If there's too much of it in your system, your blood vessels will become too narrow.
So, ACE inhibitors help lower blood pressure by helping the vessels expand. This means that more blood can pass through, reducing the force your blood puts on the vessels.
Examples of ACE Inhibitors
Prinivil and Zestril are two of the most common branded ACE inhibitors. Their generic version is Lisinopril.
Benazepril, sold under the brand name "Lotensin," is another ACE inhibitor. Captopril (Capoten), enalapril (Vasotec), and perindopril (Aceon) are a few other examples.
Side Effects of ACE Inhibitors
Between 1% and 10% of people who take ACE inhibitors will develop a type of dry cough. It may also cause angioedema, which is an inflammation of the skin's deeper layers. Pregnant women shouldn't take it, either, as it may cause fetal abnormalities.
Diuretics also go by the name "water pills." That's because they help the body get rid of excess water and sodium (salt). In this way, they help lower the volume of blood that passes through the blood vessels.
As a result, the vessels receive much less force from the passing blood. So, your blood pressure drops, and you also get to expel more unwanted salt from your system.
A large study found that some diuretics are often much safer than ACE inhibitors. These include thiazide or thiazide-like diuretics. They do a better job in preventing heart attack and stroke than ACE inhibitors.
Diuretics can also take the form of "potassium-sparing" or "loop diuretics." They're similar to thiazide diuretics, but thiazides still have the fewest side effects.
Examples of Diuretics
Hydrochlorothiazide, sold under the brand name Hydrodiuril, is a popular thiazide diuretic. Others include chlorthalidone (brand name, Hygroton) and metolazone (Zaroxolyn).
Potassium-sparing diuretics include amiloride (brand name, Midamor) and triamterene (Dyrenium). Some loop diuretics include bumetanide (Bumex) and torsemide (Demadex).
There are also combination diuretics, which use a mix of diuretic components. For example, there's Aldactazide, a combination of spironolactone and hydrochlorothiazide. Another is Moduretic, a mix of amiloride hydrochloride and hydrochlorothiazide.
Side Effects of Diuretics
So long as you take them as directed, you're more than likely to tolerate diuretics well. However, they may still cause side effects like low or high potassium and sodium levels. You may also feel increased thirst or experience dizziness and headaches.
Diuretics may also interact with other drugs, such as the antidepressant fluoxetine. The same may happen if taken with other certain high blood pressure drugs.
So, be sure to tell your doctor if you're taking any other medication. This way, your physician can determine which blood pressure drugs you can safely take.
These are drugs that block certain chemical actions in your body. These include chemicals that stimulate your heart. By blocking these, beta-blockers help ease the speed and force at which your heart beats.
In this way, each beat pumps less blood through the blood vessels. As a result, your blood pressure drops.
The use of beta-blockers is more common among US adults aged 60 to 79. They were the third most commonly used prescription drug in this age group from 2015 to 2016. Younger patients may still use them, though, usually as a second-line treatment.
Examples of Beta-Blockers
Lopressor (metoprolol tartrate) and Toprol XL (metoprolol succinate) are two common beta-blockers. Coreg (carvedilol), Tenormin (atenolol), and Inderal (propranolol) are also popular options.
As you might have noticed, the generic names of these drugs usually end with "olol." That's because they belong in the "-olol" stem of drugs. Aside from hypertension, they also help treat a few other heart conditions.
Side Effects of Beta-Blockers
As beta-blockers help keep your heart rate down, they can also cause fatigue and dizziness. It's also in this way that you may experience muscle cramps, swelling, or foot pain. These arise from the reduced circulation that these drugs can cause.
Some other side effects include nausea, diarrhea, and weight gain. They may also give rise to sexual health issues, such as erectile dysfunction in men. Weight gain may also occur as a side effect.
Angiotensin-II Receptor Antagonists/Blockers (ARBs)
ARBs, like ACE inhibitors, also help keep excessive narrowing of the blood vessels at bay. They work by relaxing tight and taut blood vessels. This helps them open up, which then lowers blood pressure.
Examples of ARBs
Drugs that classify as ARBs are those with names usually ending in "sartan." There's losartan, for instance, sold under the brand name Cozaar. Another example is valsartan, sold under the brand name Diovan.
Side Effects of ARBs
ARBs may be a better, safer choice than ACE inhibitors as they have a lower risk of causing coughs. This is also why doctors usually switch their patients to ARBs from ACE inhibitors. So, be sure to tell your doctor if you're experiencing signs of dry cough after taking ACE inhibitors.
Like other blood pressure drugs, though, ARBs can still make you feel dizzy or nauseous. You may also experience headaches, drowsiness, or diarrhea. Other common side effects are muscle aches, bone pain, and rashes.
Calcium Channel Blockers
All your muscles (and their cells) rely on calcium (Ca) to move. If you have hypertension, though, Ca can make your heart beat faster and with more force.
As such, your doctor may want you to take Calcium channel blockers to limit Ca passage to your heart muscles. These drugs also shield your blood vessels from too much calcium.
With less Ca entering your heart, it would pump at a reduced force. This then helps relax your blood vessels, leading to a drop in your blood pressure.
Examples of Calcium Channel Blockers
Most of these belong to the "-dipine" stem of drugs. These include amlodipine, such as Norvasc and Amlogard. Others include felodipine (brand name, Plendil) and nifedipine (like Adalat and Procardia).
Side Effects of Calcium Channel Blockers
Calcium channel blockers may be more effective than ARBs in older people. They may also be a safer alternative to ACE inhibitors, as they have fewer side effects.
However, these "-dipine" drugs may still make you feel dizzy, fatigued, or constipated. You may also get hit by headaches, rashes, or swelling in your legs and feet.
Your doctor will also likely tell you to avoid grapefruit products. That's because this fruit (especially its juice) can interact with your medicines. They don't mix well and can make your heart beat faster, raising your blood pressure.
Can You Take More Than One High Blood Pressure Drug?
If caught early, you may be able to manage with just one type of blood pressure medication. In this case, your doctor is most likely to have you go on a thiazide diuretic. If it's not enough, though, you may have to take a second (or even a third) one.
Additional medication can help boost the effects of a thiazide diuretic. The two can work together to lower your blood pressure faster than if you took a diuretic alone.
In any case, your doctor may add any of the other common blood pressure drugs to your treatment plan. Be sure to let your physician know if you've had any side effects with your initial prescription. This way, your doctor can prescribe other drugs that may have fewer side effects.
Don't Let Your Blood Pressure and Heart Beat You Up
As you can see, there are dozens of high blood pressure medication options for you to choose from. That's why you need to see a doctor, and not only because you need a written prescription. A more crucial reason is that these drugs work in different ways, so they don't come with a "one-size-fits-all."
Do you already have a valid prescription? If so, then our team here at PricePro Pharmacy can help you save on your meds! Get in touch with us now so we can help you access more affordable yet quality prescription drugs.