There are eight different kinds of drugs used to care for hypertension. Your physician will determine which type of medicine is appropriate for you.
Types of Hypertension Medications
Below are the various types of medications used in the treatment of hypertension. These medications are classified mostly by their mechanisms of action:
- Water pills (diuretics) help your body remove extra salt (sodium) and fluids so your blood vessels don't need hold so much liquid. A few examples of water pills include chlorthalidone (brand: Thalitone), furosemide (brand: Lasix), hydrochlorothiazide (brand: Esidrix) and indapamide (brand: Lozol). Your physician may also order a combination of water pills, like hydrochlorothiazide combined with triamterene (brands: Dyazide, Maxzide).
- Beta-adrenergic blockers delay the heart beat so that blood goes through your blood vessels with less force. A few examples of beta-adrenergic blockers include acebutolol (brand: Sectral), atenolol (brand: Tenormin), carvedilol (brand: Coreg), metoprolol (brands: Lopressor, Toprol XL), nadolol (brand name: Corgard), propranolol (brand name: Inderal) as well as timolol (brand name: Blocadren).
- ACE inhibitors (short for angiotensin converting enzyme inhibitors) restrain your body from producing angiotensin II, a chemical that causes blood vessels to constrict. A few examples of ACE inhibitors are benazepril (brand: Lotensin), enalapril (brand: Vasotec), lisinopril (brands: Prinivil, Zestril), quinapril (brand: Accupril), ramipril (commercial name: Altace) and trandolapril (brand: Mavik).
- ARBs (short for angiotensin II receptor blockers) defend your blood vessels from the impacts of angiotensin II. Some examples of ARBs include candesartan (brand: Atacand), irbesartan (brand: Avapro), losartan (brand: Cozaar), olmesartan (brand: Benicar), telmisartan (brand: Micardis) and valsartan (brand: Diovan).
- Calcium blockers (also called CCBs) serve to keep your blood vessels from narrowing (constricting) by barricading calcium from getting into your cells. Some examples of CCBs are amlodipine (commercial name: Norvasc), diltiazem (brands: Cardizem, Cartia, Dilacor, Tiazac), felodipine (brand name: Plendil), nicardipine (brand: Cardene), nifedipine (brands: Adalat, Procardia) and verapamil (a number of brands: Calan, Covera, Isoptin, Verelan).
- Alpha-adrenergic blockers serve to relax your blood vessels by repressing specific nerve impulses. This permits your blood to flow more easily. A few examples of alpha-adrenergic blockers are doxazosin (brand: Cardura), prazosin (brand: Minipress) and terazosin (commercial name: Hytrin).
- Centrally acting medications force your central nervous system to decrease the nerve impulses that could cause your blood vessels to constrict. Some examples of centrally acting drugs are clonidine (commercial name: Catapres) and methyldopa.
- Direct vasodilators (drugs that dilate the blood vessels) relax the muscles in the blood vessel walls, and as the name suggests, broaden the blood vessels. Some examples of vasodilators include hydralazine (commercial name: Apresoline) and minoxidil (commercial name: Loniten).
ACE inhibitors cause very few side effects. The most common side effect is an irritating dry cough. It is important to take these blood pressure medicines daily as prescribed. Because high blood pressure often has no symptoms, it is easy for someone to forget to take ACE inhibitor pills.
In people who have high blood pressure and heart failure, ACE inhibitors may be a good first choice. Medicines in this class may help protect against kidney damage in people who have diabetes and diabetic nephropathy.
If a patient already has severe kidney failure caused by diabetic nephropathy, ACE inhibitors must be used carefully. A low dose can be tried first, if and when recommended by a physician. Potassium levels and kidney function tests are evaluated closely in case the dosages need to be increased.
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References:
De Leeuw PW (1999). “How do angiotensin II receptor antagonists affect blood pressure?” American Journal of Cardiology. 84 (2A): 5K–6K.
Elliot WJ, et al. (2004). “Hypertension: Epidemiology, pathophysiology, diagnosis, and treatment.” In: V Fuster et al. “Hurst's The Heart.” (11) 2; 1531–1573. New York: McGraw-Hill.
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