Medications for Hypertension
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The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.
Many different medications are available to lower your blood pressure. Your doctor will discuss the options with you and help you select a medication plan to meet your needs. Many times more than one drug is needed to control blood pressure.
Blood pressure medications must be taken daily. Do not stop taking your medication on your own. If you develop side effects, notify your doctor. She may be able to adjust the treatment such as by changing the dose or choosing another drug to help minimize side effects while controlling your blood pressure.
Hypertension can be controlled, not cured. Taking your medications as ordered is vital to controlling this condition and reducing the risk of complications. It may be necessary to take the medications indefinitely. Be sure to discuss these issues with your doctor.
Prescription Medications
- Hydrochlorothiazide (Hydrodiuril, Microzide)
- Indapamide (Lozol)
- Spironolactone (Aldactone)
- Atenolol (Tenormin)
- Propranolol hydrochloride (Inderal)
- Metoprolol (Toprol)
- Nadolol (Corgard)
- Betaxolol (Kerlone)
- Acebutolol (Sectral)
- Pindolol (Visken)
- Bisoprolol (Zebeta)
Angiotensin-converting enzyme inhibitors (ACE inhibitors)
- Benazepril hydrochloride (Lotensin)
- Captopril (Capoten)
- Enalapril maleate (Vasotec)
- Quinapril (Accupril)
- Perindopril (Aceon)
- Ramipril (Altace)
- Trandolapril (Mavik)
- Fosinopril (Monopril)
- Moexipril (Univasc )
- Lisinopril (Zestril and Prinivil)
- Irbesartan (Avapro)
- Losartan potassium (Cozaar)
- Valsartan (Diovan)
- Candesartan (Atacand)
- Olmesartan (Benicar)
- Telmisartan (Micardis)
- Eprosartan (Teveten)
- Verapamil hydrochloride (Calan SR)
- Diltiazem hydrochloride (Cardizem CD)
- Amlodipine (Norvasc)
- Sustained release nifedipine (Procardia XL, Adalat CC)
- Felodipine (Plendil)
- Nisoldipine (Sular)
- Prazosin (Minipress)
- Terazosin (Hytrin)
- Doxazosin
- Labetalol (Normodyne, Trandate)
- Carvediol (Coreg)
Centrally acting nervous system drugs
- Clonidine (Catapres)
- Methyldopa (Aldomet)
- Hydralazine hydrochloride (Apresoline)
Prescription Medications
Diuretics
Common names include:
- Hydrochlorothiazide (Hydrodiuril, Microzide)
- Indapamide (Lozol)
- Spironolactone (Aldactone)
Diuretics help the kidneys get rid of excess water and sodium. These medications are sometimes referred to as “water pills.”
Possible side effects include:
- Dizziness
- Frequent urination
Beta-blockers
Common names include:
- Atenolol (Tenormin)
- Propranolol hydrochloride (Inderal)
- Metoprolol (Toprol)
- Nadolol (Corgard)
- Betaxolol (Kerlone)
- Acebutolol (Sectral)
- Pindolol (Visken)
- Bisoprolol (Zebeta)
Beta-blockers reduce demands on the heart by reducing the rate and force of contraction and help lower blood pressure.
Possible side effects include:
- Low blood pressure
- Slow heart rate
- Fatigue
Based on a review of 13 trials, beta-blockers should not be relied upon as first-line treatment for hypertension. Compared to a placebo, the medication had only a slight affect on stroke risk and no affect on coronary heart disease . Beta-blockers also appeared to be less effective at reducing the risk of stroke than the other medications. *
Angiotensin-converting Enzyme (ACE) Inhibitors
Common names include:
- Benazepril hydrochloride (Lotensin)
- Captopril (Capoten)
- Enalapril (Vasotec)
- Quinapril (Accupril)
- Perindopril (Aceon)
- Ramipril (Altace)
- Trandolapril (Mavik)
- Fosinopril (Monopril)
- Moexipril (Univasc )
- Lisinopril (Zestril, Prinivil)
ACE inhibitors relax the blood vessels and lower blood pressure by blocking the production of a hormone that causes the blood vessels to constrict.
Possible side effects include:
- Headache
- Dizziness
- Cough
Angiotensin II Receptor Antagonists
Common names include:
- Irbesartan (Avapro)
- Losartan potassium (Cozaar)
- Valsartan (Diovan)
- Candesartan (Atacand)
- Olmesartan (Benicar)
- Telmisartan (Micardis)
- Eprosartan (Teveten)
Angiotensin antagonists relax the blood vessels and lower blood pressure by shielding the blood vessels from a hormone that causes the blood vessels to constrict.
Possible side effects include:
Calcium Channel Blockers
Common names include:
- Verapamil hydrochloride (Calan SR)
- Diltiazem hydrochloride (Cardizem CD)
- Amlodipine (Norvasc)
- Sustained release nifedipine (Procardia XL, Adalat CC)
- Felodipine (Plendil)
- Nisoldipine (Sular)
Calcium channel blockers relax the blood vessels and lower blood pressure by blocking some activities of heart and blood vessel muscle cells.
Possible side effects include:
- Dizziness
- Constipation
- Swelling in the legs
Alpha-blockers
Common names include:
Alpha-blockers lower blood pressure by decreasing nerve impulses to the blood vessels. This relaxes the blood vessels and helps lower blood pressure.
Possible side effects include:
- Dizziness
- Headache
Alpha-beta Blockers
Common names include:
- Labetalol (Normodyne, Trandate)
- Carvedilol (Coreg)
Alpha-beta blockers lower blood pressure by decreasing nerve impulses to the blood vessels. They also slow the heart rate and decrease the force of contraction. This decreases the work load of the heart and helps lower the blood pressure.
Possible side effects include:
- Dizziness
- Postural hypotension (blood pressure falls when standing up)
Centrally Acting Nervous System Drugs
Common names include:
- Clonidine (Catapres)
- Methyldopa (Aldomet)
Nervous system drugs lower blood pressure by controlling nerve impulses and relaxing blood vessels. These drugs can be taken orally; Catapres is available through a skin patch.
Possible side effects include:
- Dry mouth
- Drowsiness
- Dizziness
- Redness, itching, and skin irritation with skin patch
Vasodilators
Common names include:
- Hydralazine (Apresoline)
Vasodilators lower blood pressure by directly relaxing blood vessel walls.
Possible side effects include:
- Fluid retention
- Rapid heart rate
Special Considerations
If you are taking medications, follow these general guidelines:
- Take your medication as directed. Do not change the amount or the schedule.
- Do not stop taking them without talking to your doctor.
- Do not share them.
- Know what the results and side effects. Report them to your doctor.
- Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medication and herb or dietary supplements.
- Plan ahead for refills so you don’t run out.
When to Contact Your Doctor
Contact your doctor if you:
- Develop side effects to any of the medications
- Check your own blood pressure and it regularly runs higher or lower than the target blood pressure range set by your doctor
References:
Conn HF, Rakel. Conn’s Current Therapy. 54th ed. Philadelphia, PA: WB Saunders Company; 2002: 720-721.
High blood pressure. American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=2114. Accessed June 18, 2009.
High blood pressure. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/Hbp/HBP_WhatIs.html. Updated November 2008. Accessed June 18, 2009.
Mosby’s Drug Consult. St. Louis, MO: Mosby Inc; 2002.
The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report. JAMA. 2003;289:2560-2572.
*¹5/8/2007 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : CS Wiysonge, H Bradley, BM Mayosi, et al. Beta-blockers for hypertension [review]. The Cochrane Library website. Available at: http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD002003/frame.html. Published 2007. Accessed May 8, 2007.
Last reviewed June 2009 by Rosalyn Carson-DeWitt, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.