High Blood Pressure MedicationsAt some point in the lives of most people, diet, exercise, and good living are not enough to keep blood pressure at “normal,” safe levels. (See Blood Pressure Lifestyle Modifications). At this point, medical therapy for blood pressure can be not only helpful but also essential for maintaining a healthy life.
There are a large number of different blood pressure medications available. These medications work in a variety of different ways and are frequently used in combination to achieve optimal blood pressure control. There are far too many blood pressure medications to go through individually, however. So, we will briefly cover some of the more common general classes of blood pressure medications, including examples of each.
- 1. Diuretics:
- Work at the level of the kidneys to increase fluid removal by the kidneys and thus decrease intravascular volume
- Several different types that work in different ways
- Often work best in conjunction with a second medication, such as an ACE inhibitor or beta blocker
- Examples include HCTZ, Furosemide, and Spironolactone
- 2. Alpha Blockers:
- Block alpha adrenergic (stimulant) receptors in arteries and veins causing them to relax and thus lowering blood pressure
- Examples include Terazosin and Doxazosin
- 3. Beta Blockers:
- Block primarily beta adrenergic (stimulant) receptors (duh) in the blood vessels and in the heart
- Decreases the amount of work the heart does and relaxes blood vessels at the same time
- Some also block alpha adrenergic receptors as well (can be either an advantage or a disadvantage depending on the situation)
- Examples include Metoprolol, Carvedilol, and Labetalol among many others
- 4. ACE Inhibitors (ACEI’s)
- Block angiotensin converting enzyme, which normally converts angiotensin I to angiotensin II
- This ultimately decreases levels of aldosterone in the body and decreases blood vessel constriction and consequently decreases blood pressure
- Examples include Captopril, Lisinopril, and Enalopril
- 5. ARB’s (Angiotension II Receptor Blockers)
- Block angiotensin II receptors which stimulate blood vessel constriction and stimulate the release of aldosterone, thus decreasing blood pressure
- These were developed for people who are intolerant of ACE Inhibitors
- Examples include Valsartan, Losartan, and Azilsartan
- 6. Calcium Channel Blockers
- Block calcium channels in the heart and blood vessels causing relaxation
- Some of them also slow the heart rate (like beta blockers)
- These may be more effective for black people
- Examples include Amlodipine and Diltiazem
- 7. Vasodilators
- Cause both arteries and vein to relax decreasing the work load of the heart
- Commonly used for fast relief of angina chest pain
- Examples include Nitroglycerin and Nitroprusside
- 8. Other less commonly used agents include Peripheral Vasodilators (Hydralazine, Minoxidil), Centrally Acting Alpha-2 Adrenergic Agonists (Clonidine, Methyldopa), Direct Renin Inhibitors (Aliskiren), and Dopamine Agonists (Fenoldopam)
For more in depth information on blood pressure therapies, please consult your physician or other healthcare provider.
References1. Riaz K, Batuman V. Hypertension. http://emedicine.medscape.com/article/241381-overview.: Medscape Reference; 2012.