High blood pressure medications: MedlinePlus Medical Encyclopedia (2024)

Treating high blood pressure will help prevent problems such as heart disease, stroke, loss of eyesight, chronic kidney disease, and other blood vessel diseases.

You may need to take medicines to lower your blood pressure if lifestyle changes are not enough to bring your blood pressure to the target level.

WHEN ARE MEDICINES FOR HIGH BLOOD PRESSURE USED

Most of the time, your health care provider will try lifestyle changes first and check your BP two or more times.

If your blood pressure is 120/80 to 129/80 mm Hg, you have elevated blood pressure.

  • Your provider will recommend lifestyle changes to bring your blood pressure down to a normal range.
  • Medicines are rarely used at this stage.

If your blood pressure is equal to or higher than 130/80 but lower than 140/90 mm Hg, you have Stage 1 high blood pressure. When thinking about the best treatment, you and your provider must consider:

  • If you have no other diseases or risk factors, your provider may recommend lifestyle changes and repeat the measurements after a few months.
  • If your blood pressure remains equal to or higher than 130/80 but lower than 140/90 mm Hg, your provider may recommend medicines to treat high blood pressure.
  • If you have other diseases or risk factors, your provider may be more likely to recommend medicines at the same time as lifestyle changes.

If your blood pressure is equal to or higher than 140/90 mm Hg, you have Stage 2 high blood pressure. Your provider will most likely recommend that you take medicines and recommend lifestyle changes.

Before making a final diagnosis of either elevated blood pressure or high blood pressure, your provider should ask you to have your blood pressure measured at home, at your pharmacy, or somewhere else besides their office or a hospital.

If you have a higher risk for heart disease, diabetes, or a history of a stroke, medicines may be started at lower blood pressure readings. The most commonly used blood pressure targets for people with these medical problems are below 130/80.

MEDICINES FOR HIGH BLOOD PRESSURE

Most of the time, only a single drug will be used at first. Two drugs may be started if you have stage 2 high blood pressure.

Several types of medicine are used to treat high blood pressure. Your provider will decide, with you, which type of medicine is right for you. You may need to take more than one type.

Each type of blood pressure medicine listed below comes in different brand and generic names.

One or more of these blood pressure medicines are often used to treat high blood pressure:

  • Diuretics are also called water pills. They help your kidneys remove some salt (sodium) from your body. As a result, your blood vessels don't have to hold as much fluid and your blood pressure goes down.
  • Angiotensin-converting enzyme inhibitors (also called ACE inhibitors) reduce the production of angiotensin II in your body. This helps relax your blood vessels, which lowers your blood pressure.
  • Angiotensin II receptor blockers (also called ARBs) reduce the action of angiotensin II in your body. This helps relax your blood vessels, which lowers your blood pressure.
  • Calcium channel blockers relax blood vessels by reducing calcium entering cells in the wall of the blood vessels.

One category of blood pressure medicines that has been commonly used but is now usually only used if the drugs above are not adequate or cannot be used is beta-blockers. These medicines make the heart beat at a slower rate and with less force.

Blood pressure medicines that are not used as often include:

  • Alpha-blockers help relax your blood vessels, which lowers your blood pressure.
  • Centrally acting drugs signal your brain and nervous system to relax your blood vessels.
  • Vasodilators signal the muscles in the walls of blood vessels to relax.
  • Renin inhibitors act by reducing the amount of angiotensin precursors thereby relaxing your blood vessels.

SIDE EFFECTS OF BLOOD PRESSURE MEDICINES

Most blood pressure medicines are easy to take, but all medicines have side effects. Most of these are mild and may go away over time.

Some common side effects of high blood pressure medicines include:

  • Cough
  • Diarrhea or constipation
  • Dizziness or lightheadedness
  • Erection problems
  • Feeling nervous
  • Feeling tired, weak, drowsy, or a lack of energy
  • Headache
  • Nausea or vomiting
  • Skin rash
  • Weight loss or gain without trying

Tell your provider as soon as possible if you have side effects or the side effects are causing you problems. Most of the time, making changes to the dose of medicine or when you take it can help reduce side effects.

Never change the dose or stop taking a medicine on your own. Always talk to your provider first.

OTHER TIPS

Taking more than one medicine may change how your body absorbs or uses a drug. Vitamins or supplements, different foods, or alcohol may also change how a drug acts in your body.

Always ask your provider whether you need to avoid any foods, drinks, vitamins or supplements, or any other medicines while you are taking blood pressure medicine.

Alternative Names

Hypertension - medicines

References

Bakris GL, Sorrentino MJ. Systemic hypertension: mechanisms, diagnosis, and treatment. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 26.

Centers for Disease Control and Prevention website. Blood pressure medicines. www.cdc.gov/bloodpressure/medicines.htm. Updated January 23, 2020. Accessed September 11, 2023.

Flack JM. Arterial hypertension. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 64.

Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71(19):e127-e248. PMID: 29146535 pubmed.ncbi.nlm.nih.gov/29146535/.

Williams B. Pharmacologic treatment of hypertension. In: Johnson RJ, Floege J, Tonelli M, eds. Comprehensive Clinical Nephrology. 7th ed. Philadelphia, PA: Elsevier; 2024:chap 37.

Review Date 8/20/2023

Updated by: Jacob Berman, MD, MPH, Clinical Assistant Professor of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Related MedlinePlus Health Topics

  • Blood Pressure Medicines
  • High Blood Pressure
High blood pressure medications: MedlinePlus Medical Encyclopedia (2024)

FAQs

What are the top 10 high blood pressure medications? ›

ACE inhibitors
  • Benazepril hydrochloride (Lotensin)
  • Captopril (Capoten)
  • Enalapril Maleate (Vasotec)
  • Fosinopril sodium (Monopril)
  • Lisinopril (Prinivil, Zestril)
  • Moexipril (Univasc)
  • Perindopril (Aceon)
  • Quinapril hydrochloride (Accupril)

What is the most commonly prescribed medication for high blood pressure? ›

The ACE inhibitor, lisinopril (Prinivil and Zestril is the most prescribed high blood pressure medication in the United States.

What are four worst blood pressure drugs? ›

5 of the worst blood pressure medications
  1. Beta blockers. Usually, beta blockers aren't used as first-choice therapies to lower blood pressure. ...
  2. Loop diuretics. Furosemide (Lasix) is a type of diuretic (water pill) known as a loop diuretic. ...
  3. Alpha blockers. ...
  4. Vasodilators. ...
  5. Alpha-2 agonists.
Feb 14, 2024

What is the first drug of choice for high blood pressure? ›

There are three main classes of medication that are usually in the first line of treatment for hypertension: 1. Calcium Channel Blockers (CCB) 2. Angiotensin Converting Enzyme inhibitors (ACE inhibitors or ACE-I) and Angiotensin Receptor Blockers (ARBs) 3. Diuretics.

What is the best blood pressure pill with the least side effects? ›

If you live with high blood pressure, other approved medications are considered safer and more effective than alpha-blockers and alpha-2 agonists. These include: ACE inhibitors (benazepril, zofenopril, lisinopril, and others) angiotensin II receptor blockers (losartan and valsartan)

What is the safest high blood pressure medication to take? ›

Hypertension drug, amlodipine, is not associated with increased heart failure or other cardiovascular disorders, according to researchers.

Why is amlodipine a bad blood pressure medication? ›

This medicine may cause worsening of angina (chest pain) or a heart attack in certain patients with severe heart or blood vessel disease.

Which is safer, amlodipine or lisinopril? ›

For individuals with asthma or a history of angioedema (severe swelling), lisinopril may not be the ideal choice due to the risk of adverse reactions. Amlodipine may be preferred in such cases.

What is the new treatment for hypertension? ›

Findings from a clinical trial led by a Cleveland Clinic cardiologist showed that lorundrostat – a new type of blood pressure medication — safely decreased blood pressure in patients with uncontrolled hypertension.

What are two blood pressure medications to avoid? ›

The study revealed two classes of blood pressure medication that were linked to higher blood pressure variability in subjects: alpha blockers and alpha-2 agonists.

Why did they take lisinopril off the market? ›

A fragment of metal found embedded in a tablet has prompted Lupin Pharmaceuticals Inc and RemedyRepack, Inc to recall several lots of lisinopril, according to the September 21, 2022, US Food and Drug Administration (FDA) Enforcement Report.

Which is worse lisinopril or metoprolol? ›

Lisinopril has an average rating of 5.0 out of 10 from a total of 625 ratings on Drugs.com. 34% of reviewers reported a positive effect, while 43% reported a negative effect. Metoprolol has an average rating of 5.7 out of 10 from a total of 644 ratings on Drugs.com.

What brings blood pressure down in minutes? ›

Methods such as breathing exercises, lying down flat, cold showers, and drinking water can sometimes help to quickly reduce your blood pressure at home. But when your blood pressure of 180/120 or above causes symptoms, it's not safe to wait at home. This is a medical emergency that needs attention.

How do doctors decide which blood pressure medication to prescribe? ›

In addition to considering the effectiveness and potential side effects, they will consider your general health, sex, and age; the severity of your high blood pressure; any additional, underlying medical conditions; and whether there is a reason to avoid any particular drugs.

What are the four best blood pressure drugs? ›

What Are the 4 Best Blood Pressure Drugs?
  • 1) Thiazide diuretics.
  • 2) ACE (angiotensin-converting enzyme) inhibitors.
  • 3) Angiotensin receptor blockers (ARBs)
  • 4) Calcium channel blockers.
Jun 10, 2022

What are the two worst blood pressure medications? ›

The study revealed two classes of blood pressure medication that were linked to higher blood pressure variability in subjects: alpha blockers and alpha-2 agonists. Alpha blockers — which include doxazosin mesylate and prazosin hydrochloride — work by dilating the blood vessels.

Which blood pressure meds are bad for the kidneys? ›

ACE inhibitors are go-to medications for managing high blood pressure and heart failure. And in these conditions, they can protect the kidneys. But ACE inhibitors are cleared out of the body through the kidneys, so they also carry a risk of causing kidney injury.

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