Choosing blood pressure medications

Choosing the right high blood pressure medication can be tricky. Find out which of the various drug options is appropriate for you.

By Mayo Clinic Staff

Dozens of high blood pressure medications (anti-hypertensives) are available, each with pros and cons. Your doctor might prescribe more than one high blood pressure medication to treat your condition.

If you have high blood pressure or are at risk of developing it, lifestyle changes can help keep your numbers under control. But you might need medication, as well. Having an effective medication regimen, taking drugs as prescribed, monitoring your blood pressure and making lifestyle changes can help you keep your blood pressure under control.

Lifestyle changes

Whether you're beginning to develop high blood pressure (prehypertension) or you already have it (hypertension), you can benefit from lifestyle changes that can lower your blood pressure.

Lifestyle changes can reduce or eliminate your need for medications to control your blood pressure.

  • Eat a healthy diet, focusing on fruits and vegetables and, especially, reduce the sodium in your diet.
  • Maintain a healthy weight.
  • Exercise. Get 30 minutes of moderate activity on most days of the week. It's OK to break up your activity into three 10-minute sessions a day.
  • Limit the amount of alcohol you drink. For healthy adults, that means up to one drink a day for women of all ages and men older than 65, and up to two drinks a day for men 65 and younger.
  • Don't smoke.
  • Manage stress.

Medication options

If a trial of making lifestyle changes isn't enough to control your blood pressure, you'll likely receive a prescription for one or more of these medications in addition to maintaining your lifestyle measures.

  • Diuretics (water pills). Your doctor might first suggest diuretics, which remove excess water and sodium from your body. That decreases the amount of fluid flowing through your blood vessels, which reduces pressure on your vessel walls.

    There are three types of diuretics: thiazide, loop and potassium-sparing. The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends that most people try thiazide diuretics first to treat high blood pressure and heart problems related to high blood pressure.

    If diuretics aren't enough to lower your blood pressure, your doctor might recommend adding other blood pressure medications to your treatment.

  • Angiotensin-converting enzyme (ACE) inhibitors. These help relax blood vessels by preventing the formation of a hormone called angiotensin, a substance in your body that narrows blood vessels. Frequently prescribed ACE inhibitors include enalapril (Vasotec), lisinopril (Prinivil, Zestril) and ramipril (Altace).
  • Angiotensin II receptor blockers (ARBs). These help relax blood vessels by blocking the action, not the formation, of angiotensin, a chemical in your body that narrows blood vessels. ARBs include valsartan (Diovan), losartan (Cozaar) and others.
  • Calcium channel blockers. These medications prevent calcium from entering heart and blood vessel muscle cells, thus causing the cells to relax. Frequently prescribed calcium channel blockers include amlodipine (Norvasc), diltiazem (Cardizem, Tiazac, others) and nifedipine (Adalat CC, Afeditab CR, Procardia).
  • Beta blockers. Also known as beta-adrenergic blocking agents, these work by blocking the effects of the hormone epinephrine, also known as adrenaline. They cause your heart to beat slower and with less force.

    Frequently prescribed beta blockers include metoprolol (Lopressor, Toprol-XL), nadolol (Corgard) and atenolol (Tenormin).

  • Renin inhibitors. Renin is an enzyme produced by your kidneys that starts a chain of chemical steps that increases blood pressure. Aliskiren (Tekturna) slows the production of renin, reducing its ability to begin this process.
July 06, 2016 See more In-depth