Hypertension treatments & medications

Hypertension, or high blood pressure, is a very common condition. According to the Centers for Disease Control and Prevention, it affects almost half of adults in the United States. Understanding high blood pressure and how to treat it are great first steps in managing your condition. Continue reading to learn more about high blood pressure and how to manage it.

What is hypertension?

High blood pressure is when the force of blood pushing against the walls of your blood vessels is consistently high. Blood pressure levels are reported as two numbers: systolic pressure (the pressure in blood vessels when the heart beats) and diastolic pressure (the pressure in the blood vessels when the heart rests in between beats) and are as follows:

• Normal blood pressure: Systolic blood pressure is less than 120 mm Hg, and diastolic blood pressure is less than 80 mmHg

• Elevated blood pressure: Systolic is 120 to 129 mmHg, and diastolic is less than 80 mmHg

• Stage 1 high blood pressure: Systolic is 130 to 139 mmHg, OR diastolic is 80 to 89 mmHg

• Stage 2 high blood pressure: Systolic is 140 mmHg or higher, OR diastolic is 90 mmHg or higher

Many people with high blood pressure have no symptoms, although people with very high blood pressure may have symptoms like headache, dizziness, shortness of breath, and vision changes. High blood pressure can lead to serious complications, like heart and kidney problems and stroke. That’s why it is important to check your blood pressure regularly.

Although there is no single identifiable cause of hypertension, risk factors for high blood pressure include being overweight or obese, not being physically active, excessive salt consumption, and excessive alcohol consumption. Older adults and those with family members who have high blood pressure are also at higher risk.

Treating high blood pressure usually involves a combination of methods, such as dietary changes, increased exercise, and medication, if needed.

Complications of high blood pressure

Chronic hypertension can lead to several health conditions, according to the American Heart Association. These include:

• Heart attack

• Stroke

• Heart failure

• Chronic kidney disease or kidney failure

• Vision loss

• Sexual dysfunction

• Cardiovascular disease and angina (chest pain)

• Peripheral artery disease

How is hypertension diagnosed?

Many people discover blood pressure issues during a doctor's visit when a blood pressure reading is taken using a blood pressure cuff. However, your doctor might also order laboratory tests to determine if there is organ or tissue damage and to look for other health conditions. These tests may check your cholesterol, blood sugar, potassium, sodium, and other labs your doctor may think are necessary. Your doctor might also request an ECG – electrocardiogram – to detect heart problems.

Preparing for your doctor’s appointment

Blood pressure issues, especially hypertension, are frequently noticed during a routine office visit or while being treated for a different condition. When a doctor sees elevated blood pressure, they might ask questions such as:

• What were you doing right before you came to the office?

• Are you on medications? Which ones?

• How much exercise do you get regularly?

• What is your typical diet?

Your doctor might also ask about your family, medical history, and other health conditions, especially diabetes mellitus and high cholesterol. The doctor might order laboratory tests to determine if hypertension has caused any other health issues. Based on these results, your healthcare provider might refer you to a specialist such as a cardiologist, nephrologist (a medical doctor specializing in kidney conditions), or neurologist.

When diagnosed with hypertension, you will probably have numerous questions and concerns. Some questions to ask your doctor include:

• What do the blood pressure numbers mean?

• What is healthy blood pressure?

• What lifestyle changes can I make to improve my blood pressure?

• How often should I check my blood pressure?

• Should I use a home blood pressure monitor? What type?

• Will I need to take blood pressure medication? How long will I need to take it?

• What are the types of medications? What are the side effects?

• What happens if I forget to take a dose?

Hypertension treatment options

There is no cure for hypertension. However, it can be managed through healthy lifestyle changes and antihypertensive medication (drug therapy). For some people, simple lifestyle changes alone are enough. Some tips for lifestyle changes for high blood pressure include:

• Quitting smoking or vaping

• Weight loss if needed

• Eating a healthy diet (limiting alcohol as well as salty food)

• Exercising (ask your healthcare provider before beginning any new exercise plan, but walking is the best way to begin to increase physical activity)

• Getting enough quality sleep

• Minimizing stress

In addition to general lifestyle changes, there are specific steps you can take to improve your blood pressure.

Hypertension medications

Types of blood pressure prescription medication include (note that brand names are for reference; not all medications are available in the brand name form):

Angiotensin-converting enzyme (ACE) inhibitors: ACE inhibitors are a type of vasodilator that blocks the production of angiotensin II, a hormone that causes blood vessels to narrow. Common adverse effects of ACE inhibitors include cough, elevated potassium levels, dizziness, headache, weakness, increased uric acid, and sun sensitivity. Some common ACE inhibitors include:

• Lotensin (benazepril)

• Vasotec, Epaned (enalapril)

• Prinivil, Zestril, Qbrelis (lisinopril)

• Accupril (quinapril)

• Altace (ramipril)

• Mavik (trandolapril)

• Capoten (captopril)

• Monopril (fosinopril)

• Univasc (moexipril)

• Aceon (perindopril)

Angiotensin receptor blockers (ARBs): Also known as angiotensin II receptor blockers, ARBs also target the angiotensin II hormone, stopping it from binding with receptors in the blood vessels. This medication helps relax your veins and arteries to lower blood pressure and make it easier for your heart to pump blood. Some people experience side effects, such as dizziness, increased potassium levels, and swelling under the skin. Some of the common ARBs include:

• Edarbi (azilsartan)

• Atacand (candesartan)

• Avapro (irbesartan)

• Cozaar (losartan)

• Diovan (valsartan)

• Benicar (olmesartan)

• Micardis (telmisartan)

Calcium channel blockers: These medicines keep calcium from entering the muscle cells of your heart and blood vessels, allowing blood vessels to relax, making it easier for your heart to pump blood. Side effects can include constipation, dizziness, palpitations, fatigue, flushing, headache, nausea, rash, and swelling in feet and lower legs. Common calcium channel blockers include:

• Norvasc (amlodipine)

• Cardizem, Tiazac (diltiazem)

• Plendil (felodipine)

• Dynacirc (isradipine)

• Cardene SR (nicardipine)

• Adalat CC, Procardia (nifedipine)

• Sular (nisoldipine)

• Calan, Verelan (verapamil)

Diuretics (water pills): These work by flushing excess sodium from your body through the urine and reducing the amount of fluid in your body. Diuretics are often combined with other high-blood-pressure medicines. Combining medication often allows lower doses and less potential for side effects. Side effects of diuretics can include electrolyte imbalance, dizziness, headaches, dehydration, muscle cramps, sun sensitivity, and sexual problems. Common diuretics used for hypertension include:

• Diuril (chlorothiazide)

• Hygroton (chlorthalidone)

• Microzide (hydrochlorothiazide)

• Lozol (indapamide)

• Zaroxolyn (metolazone)

• Lasix (furosemide)

• Demadex (torsemide)

• Bumex (bumetanide)

Beta-blockers – These reduce the heart rate, which reduces the heart’s workload, which lowers blood pressure. Common side effects include dizziness, cold hands and feet, tiredness, shortness of breath, and impotence. Some of the beta-blockers commonly used to treat high blood pressure include:

• Sectral (acebutolol)

• Tenormin (atenolol)

• Kerlone (betaxolol)

• Zebeta (bisoprolol)

• Lopressor (metoprolol tartrate)

• Toprol XL (metoprolol succinate extended-release)

• Corgard (nadolol)

• Visken (pindolol)

• Inderal (propranolol)

• Coreg (carvedilol)

• Trandate, Normodyne (labetalol)

• Bystolic (nebivolol)

• Betapace (sotalol)

Alpha-blockers: Alpha-blockers relax the muscle tone of the vascular walls, lowering blood pressure. Side effects include palpitations, dizziness, and a drop in blood pressure when standing up. Some of these medications include:

• Cardura (doxazosin)

• Minipress (prazosin)

• Hytrin (terazosin)

Central alpha agonists: These medications decrease the ability of blood vessels to contract, which leads to lower blood pressure. Side effects can include sleepiness, headache, low blood pressure, stomach pain, irritability, and constipation. Some common central agonists used for hypertension include:

• Catapres (clonidine)

• Tenex (guanfacine)

Combination medications: There are many combination medications that combine two or three blood pressure medications into one pill. A few examples include:

• Hyzaar (losartan/hydrochlorothiazide)

• Diovan HCT (valsartan/hydrochlorothiazide)

• Exforge (valsartan/amlodipine)

• Benicar HCT (olmesartan/hydrochlorothiazide)

• Tribenzor (amlodipine/olmesartan/hydrochlorothiazide)

What is the best medication for hypertension?

There are many different choices for the treatment of hypertension, and there is no "best" medication. What works for one person might not work for another. Everyone reacts differently to medicines, and it sometimes takes time to find the right drug or combination of drugs and the right dosage for you. Your healthcare provider will take your medical conditions, medical history, and other medication you are taking into consideration when suggesting a treatment for you. An ACE inhibitor, ARB, calcium channel blocker, or diuretic will be the first treatment choice for many people. The chart below provides examples of blood pressure medications from different drug classes. You can always use a free SingleCare card to save up to 80% off the cost of your hypertension medications and other medications.

*many of these medications require an initial lose dose and gradual increase in dosage until maintenance level is achieved.

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Common hypertension medications