Choosing blood pressure medicines

Updated: 2023-08-17

There are many different types of blood pressure medicines. Medicines to treat high blood pressure are sometimes called antihypertensives. Choosing the right blood pressure medicine can be challenging. Your health care team may recommend more than one type of medicine to treat high blood pressure.

Always take blood pressure medicines as directed and get regular blood pressure checkups.

Lifestyle changes

Healthy lifestyle habits are suggested to control and manage high blood pressure. If your blood pressure is high or slightly above what is considered ideal, a healthy lifestyle might prevent or reduce your need for medicine.

Try these tips.

• Eat a healthy diet rich in whole grains, fruits and vegetables, lean meats, and low-fat dairy products.
• Use less salt.
• Manage stress.
• Maintain a healthy weight.
• Develop healthy sleeping habits so you get a good night's rest.
• Get regular exercise. Aim for 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.
• Avoid or limit alcohol. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men.

Medicine options

Sometimes lifestyle changes are not enough to treat high blood pressure. If not, your health care team may recommend blood pressure medicine.

The type of medicine used to treat high blood pressure depends on your overall health and how high your blood pressure is. Two or more blood pressure medicines often work better than one. It can take some time to find the best medicine or combination of medicines.

Medicines to treat high blood pressure include:

• Water pills, also called diuretics. These medicines remove extra water and sodium from the body. So, there's less fluid flowing through the veins and arteries. This reduces pressure on the walls of the blood vessels. Types of diuretics include thiazide, loop and potassium-sparing.
• Angiotensin-converting enzyme (ACE) inhibitors. These medicines help relax blood vessels. They block the formation of a natural chemical that narrows blood vessels.
• Angiotensin 2 receptor blockers (ARBs). These medicines block the action of angiotensin. Angiotensin is a chemical the body makes that narrows blood vessels.
• Calcium channel blockers. These medicines stop calcium from entering the cells of the heart and arteries. This allows the arteries to relax and open.
• Beta blockers. These medicines help the heart beat slower and with less force.
• Renin inhibitors. Renin is a substance made by the kidneys. It triggers a series of steps that increases blood pressure. Renin inhibitors slow how much of this substance is made.

Other medicines for high blood pressure

If you cannot reach your blood pressure goal with one or more of the above medicines, your doctor may prescribe:

• Aldosterone antagonists. These medicines often are used with other blood pressure treatments, such as a diuretic. They block a hormone called aldosterone. That hormone sometimes causes sodium and fluid to build up in the body. This can cause high blood pressure. Aldosterone antagonists may be prescribed if high blood pressure is difficult to control or if you have diabetes or heart failure.
• Alpha blockers. These medicines prevent a hormone called norepinephrine from tightening the muscles in the walls of smaller arteries and veins. This lets the arteries and veins stay open and relaxed.
• Alpha-beta blockers. These medicines work similarly to beta blockers. They might be prescribed if you have high blood pressure and are at risk of heart failure.
• Central-acting agents. These medicines stop the brain from sending signals to the nervous system to speed up the heart rate and narrow the blood vessels. As a result, the heart does not pump as hard and the blood flows more easily through the veins and arteries.
• Vasodilators. These medicines prevent the muscles in the veins and arteries from tightening and narrowing. As a result, blood flows more easily and the heart does not have to pump as hard.

Reaching your blood pressure goal

Both lifestyle changes and medicine are often needed to help control blood pressure. You may need to try several medicines or doses before finding what works best for you.

Regularly checking your blood pressure at home can help you and your health care team know if your treatment is working. Home blood pressure monitors are widely available. You do not need a prescription to buy one. Home blood pressure checks do not replace visits to a health care professional.

Talk to your health care team if you have any questions about your blood pressure and the medicines you take.