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Medication for hypertension

Last updated: Monday, February 08, 2010

Although lifestyle changes will help, they may not be enough for you. If you can't bring your blood pressure under control by making these changes, you may also need to take medication. Lifestyle changes may still reduce the number and doses of medications needed to control hypertension.

The different classes of drugs used in the treatment of high blood pressure include:

Diuretics – Also known as water tablets, diuretics (hydrochlorthiazide is most commonly used) are often the first line of drug treatment. Diuretics act on your kidneys to help your body eliminate sodium and water.
Beta and alpha-beta adrenergic blockers – These drugs (Tenormin, Lopresor, Minipress and others) work by blocking the effects of certain chemicals in your body. With some of these drugs, your heart may beat more slowly and less forcefully. With others, your blood vessels may dilate and you may feel faint when you stand up. These actions on your heart and blood vessels lower your blood pressure.

NOTE: Diuretics and beta-blockers have been proven to reduce the risks associated with hypertension, including heart attacks and strokes. They have been used for many years, their side effects are well-known, and they are generally less expensive than some other blood pressure medications. All antihypertensive classes reduce CVS events with perhaps the exception of alpha blockers.

ACE inhibitors and angiotensin receptor blockers – Angiotensin converting enzyme (ACE) inhibitors dilate your blood vessels by blocking the formation of the natural body chemical angiotensin II, which constricts blood vessels. However, up to 20% of people who take ACE inhibitors (Capoten, Tritace, Renitec and others) develop a dry, hacking cough. This annoying side effect typically occurs in the 10 to 24 weeks after starting the drug. The cause is unknown. Switching to another type of ACE inhibitor may decrease or stop your cough. There are also similar anti-hypertensive medications that may not produce a cough. Don't stop taking a medication without first seeing your doctor. These drugs may be particularly effective in patients with diabetes and renal disease.
Calcium channel blockers – Long acting calcium channel blockers such as AdalatXL and Norvasc help dilate blood vessels and effectively reduce blood pressure for a short or long period. The short-acting drugs aren't recommended for hypertension because control is erratic and some reports have linked them to adverse health effects.

(Reviewed by Dr B. Rayner, nephrologist)

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