High Blood Pressure Medications

Beta-Blockers

These drugs block the effects of adrenaline in your body. That can keep your heart from beating too quickly or with too much force. 

Your doctor may suggest you try beta-blockers if another kind of high blood pressure medication doesn't work, or if you have other heart or circulation issues. But while beta-blockers have been safely used since the 1960s, they're not a good fit for everyone because of some side effects they can cause. For instance, your doctor may not prescribe beta-blockers if you have asthma because taking them could trigger an attack.

Alpha-Blockers

Also called alpha-adrenergic blocking agents or alpha-1 blockers, these blood pressure medications prevent nerve signals from telling your blood vessels to tighten up. This keeps the vessels relaxed, allowing blood to flow more easily and lowering your overall blood pressure.

Alpha-blockers are often prescribed with diuretics when water pills alone can't lower your blood pressure.

Common alpha-blocker blood pressure medications

Among the types you could be given are:

• Doxazosin (Cardura)
• Prazosin (Minipress)
• Terazosin (Hytrin)

Combined Alpha- and Beta-Blockers

Some drugs can block both alpha- and beta-receptors. That may help decrease your blood pressure more effectively than a pill that only blocks one. If you're pregnant and have high blood pressure, your doctor might try a combined alpha-beta blocker first.

Common combined alpha-blocker blood pressure medications

Among the medications you could be prescribed are:

• Carvedilol (Coreg)
• Labetalol (Trandate, Normodyne)

ACE Inhibitors

"ACE" stands for angiotensin-converting enzymes. This type of blood pressure medication prevents your body from making a chemical called angiotensin, which tells your blood vessels to tighten. As a result, your blood vessels stay more relaxed, lowering blood pressure.

While effective, ACE inhibitors shouldn't be taken while you're pregnant or if you're trying to have a baby. They can cause severe, and sometimes life-threatening, health issues.

Common combined ACE inhibitor blood pressure medications

Different types include:

• Benazepril (Lotensin)
• Captopril (Capoten)
• Enalapril (Vasotec)
• Fosinopril (Monopril)
• Lisinopril (Prinivil, Zestril)
• Moexipril (Univasc)
• Perindopril (Aceon)
• Quinapril (Accupril)
• Ramipril (Altace)
• Trandolapril (Mavik)

Angiotensin II Receptor Blockers (ARBs)

ARBs work by blocking the hormone angiotensin. Your body can still make it, but ARBs prevent angiotensin from constricting the muscles in your blood vessels. It's like putting chewing gum in a lock so a key can't open it.

Common ARB blood pressure medications

Your doctor could suggest that you take:

• Candesartan (Atacand)
• Eprosartan (Teveten)
• Irbesartan (Avapro)
• Losartan (Cozaar)
• Olmesartan (Benicar)
• Telmisartan (Micardis)
• Valsartan (Diovan)

Direct Renin Inhibitors

These blood pressure medications target the same process that ACE inhibitors and ARBs do. But they work on renin, an enzyme made by your kidneys, to stop angiotensin from being made. The result is the same: your blood vessels stay relaxed and open.

Aliskiren (Tekturna) is the only direct renin inhibitor approved by the FDA so far. It can be used by itself or taken with other hypertension medications. But it doesn't suit everyone. Before you start this drug, make sure your doctor knows if you're pregnant, nursing, or thinking of starting a family. Aliskiren can pose a serious risk to your baby's health. Your doctor may also choose to prescribe a different drug if you have any ongoing health issues, such as diabetes or kidney disease.

Calcium Channel Blockers (CCBs)

Sometimes called calcium antagonists, CCBs prevent calcium from entering certain muscle cells in your heart and blood vessels. That makes it harder for electrical signals to pass through. Some CCBs keep blood vessels from tightening. Others slow your heart rate or reduce the force with which your heart pumps blood.

Common channel blocker blood pressure medications

Some examples include:

• Amlodipine (Norvasc)
• Bepridil (Vasocor)
• Diltiazem (Cardizem CD, Cardizem SR, Dilacor XR, Tiazac)
• Felodipine (Plendil)
• Isradipine (DynaCirc)
• Nicardipine (Cardene SR)
• Nifedipine LA (Adalat CC, Procardia XL)
• Nisoldipine (Sular)
• Verapamil (Calan SR, Covera HS, Isoptin SR, Verelan)

Central Agonists

You might also hear these drugs called central-acting agents, central adrenergic inhibitors, or central alpha agonists. They stop your brain from sending signals that speed up your heart rate and narrow your blood vessels. 

Common central agonist blood pressure medications

You might be prescribed:

• Clonidine (Catapres, Duraclon, Kapvay, Nexiclon XR)
• Guanabenz (Wytensin)
• Guanfacine (Intuniv, Tenex)
• Methyldopa (Aldomet)

Peripheral Adrenergic Blockers

Like a few other kinds of blood pressure medications, peripheral adrenergic blockers lower blood pressure by blocking nerve signals from your brain that tell your blood vessels to tighten up. Doctors don't prescribe peripheral adrenergic blockers often, though.

Common peripheral adrenergic blocker blood pressure medications

The available options include:

• Guanadrel (Hylorel)
• Guanethidine (Ismelin)
• Reserpine (Serpasil)

Vasodilators

Also called blood vessel dilators, these medications relax the muscle cells in your blood vessel walls. This causes vessels to dilate (open), and blood can then flow through more easily.

Common vasodilator blood pressure medications

You could be given:

• Hydralazine (Apresoline)
• Minoxidil (Loniten)

Combinations

More than 70% of people need more than one treatment to manage their high blood pressure. Some manufacturers make that easier by combining two different drugs into one pill.

Common combination blood pressure medications

Medications that contain alpha- and beta-blockers are an example. Other combination treatments include:

• Bisoprolol + hydrochororthiazide (Ziac), which combines a beta-blocker and a diuretic
• Olmesartan + hydrochorothiazide (Benicar), which combines an ARB and a diuretic

High Blood Pressure Medications for Children and Adolescents

If your child has high blood pressure, your doctor may first suggest lifestyle changes. Getting more regular exercise can make a difference. So can eating more heart-healthy foods, such as whole grains, beans, fruits, and vegetables. It's also important to cut back on sweets and unhealthy fats often found in packaged or ready-made foods.

If that doesn't help enough or your child has very high blood pressure, their doctor will probably suggest that they take a blood pressure medication. When choosing which one to prescribe, they'll take a lot of factors into account, including your child's age, general health, and how easy it is for you to bring them in for check-ups or lab work.

Blood pressure drugs that are safe for children include some types of:

• ACE inhibitors
• CCBs
• Thiazide diuretics 
• ARBs
• Vasodilators

How to Choose the Right Hypertension Medications

When choosing a treatment for you, your doctor will need to consider:

• Your age
• Overall health
• Current blood pressure numbers
• Family history of heart disease, stroke, or heart attacks
• Ethnicity
• Lifestyle (for instance, whether you drink alcohol, use tobacco, or are pregnant or nursing)
• Any other medications you take
• Any blood pressure drugs you've taken before

They'll also think through the side effects you may have if you start taking a certain blood pressure medication.

You can ask your doctor:

• Why do you think this drug might be a good fit for me?
• What are the pros and cons of taking it?
• When will we know if it's working well or if I need to switch to a different medication?

Once you start a medication, your doctor will want to see you again to check your blood pressure and how you're feeling while taking it. They may also ask you to use a home monitor to check your blood pressure regularly at home. 

Managing high blood pressure can be an ongoing condition. Taking your medication exactly as prescribed will be key. It's also important to talk openly with your doctor about any concerns you have.

Are there nonprescription antihypertensive medications available?

Despite what you might see in ads or online, there is no supplement, vitamin, or other over-the-counter product that can lower your blood pressure. In fact, some may even raise your blood pressure instead.

If you have concerns about taking blood pressure medicine, talk to your doctor. They can help you understand how to avoid or manage any side effects. 

Simple choices you make every day can also help bring your blood pressure into a healthy range. For instance, you could:

Try to get to a healthier weight. Your blood pressure may go down 1 point with every 2.2 pounds of weight you lose. Start with very small changes so you don't feel overwhelmed — for instance, try swapping out soda at meals with flavored seltzer.

Put more healthy foods on your plate. Try whole grains, fresh fruits and vegetables, and lean proteins like beans and chicken. Look for recipes that follow the Dietary Approaches to Stop Hypertension (DASH) diet.

Move more. Aim for aerobic exercise such as walking, jogging, or dancing, as well as strength training. Every minute counts, so find ways to fit movement into your day, like walking around your house for five minutes while you're on the phone.

Keep your stress levels from spiking. You can't get rid of all the stress in your life, but you can learn new ways to deal with it. Talking to a therapist may help.

Takeaways

High blood pressure doesn't typically cause symptoms, but if left untreated, it can raise your risk for serious health issues such as heart attacks and strokes. Take your medication exactly as prescribed, and contact your doctor if you have any questions or need help managing side effects. You may need to try different medications or doses before you find what works best for you. Also, making healthy choices every day can help improve your blood pressure.