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Antihypertensives: Medicines For Treating Hypertension

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Hypertension Medications
What Drugs Will I Be Prescribed?
Water Pills
ACE Inhibitors
ARBs
Beta Blockers
Calcium Channel Blockers
Renin Inhibitors
Vasodilators
Will I Ever Be Able To Stop Taking The Medications?


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Guide To Hypertension

Hypertension Medications

If you have tried lifestyle changes but are still unable to control your blood pressure, or if you are at high risk for complications, a doctor will prescribe one or more medications (called antihypertensives) to lower your levels. These drugs need to be taken continually, if you stop, your blood pressure (bp) will rise again. Most antihypertensives are extremely effective, not only in controlling hypertension, but also in lowering your risk of stroke and heart attack risk factors. There are many different types of drugs and drug combinations, and you will need to work closely with your doctor to find the correct one for you. If you have not been taking medications until now, and you feel quite healthy, you probably won't look forward to the idea of taking pills that may have side effects as well as being expensive. Try not to let this discourage you. The symptoms of hypertension are silent, yet they can be deadly. Taking bp drugs literally can save your life. If cost is a problem ask your doctor about generic (low-cost) drugs. Most bp medications have been around long enough now to be be available in generic form.

What Drugs Will I Be Prescribed?

If you have stage 1 hypertension (140/90 to 159/99 mm Hg) your doctor will recommend trying lifestyle changes for a few months. Only if these changes have no effect will medications be prescribed. A diuretic may be the only medication you need. But in some cases a doctor may also recommend another drug or prescribe an additional medication. If you have severe hypertension (stage 2, higher than 160/100 mm Hg) you are likely to be prescribed 2 or more medications immediately. If you need to take 3 or more medications to control your bp, you should talk to your doctor about testing for a secondary cause. It may be that your hypertension is a side effect of another underlying condition (like thyroid disease or kidney problems). Treating the underlying cause will often cause the hypertension to disappear.

Here is a summary of the main blood pressure medications:

Diuretics (Water Pills)
These are usually the first choice of treatment for all patients. Diuretics work by flushing out excess fluids and sodium (salt) from the body through urination. This lessens the volume of blood that your heart has to pump, thus lowering bp. Diuretics are also used in combination with other bp drugs to enhance the effects of those drugs. While there are different types of diuretics, thiazide diuretics are usually the first choice of treatment for high blood pressure. This is because they don't cause you to urinate as frequently, which means you don’t need to plan your day around the nearest toilet!

Angiotensin-Converting Enzyme (ACE) Inhibitors
ACE inhibitor drugs lower the level of a chemical in the body called angiotensin. Angiotensins narrow the blood vessels. If we lower their levels this allows the arteries to expand allowing blood to flow through more easily (reducing bp). ACE inhibitors have a low incidence of side effects although about 20 percent of patients develop a dry cough. They are often prescribed to people with both diabetes and hypertension because they don't appear to cause blood sugar spikes and may even help prevent diabetes complications such as kidney failure. If you are pregnant, you won't be able to take these medications (see hypertension during pregnancy).

Angiotensin II Receptor Blockers (ARB)
Where ACE inhibitors lower the levels of angiotensin, ARBs blocks it - but with the same effect. But because ARBs are a newer drug with fewer studies behind them, they are only usually given to people who can't tolerate ACE inhibitors.

Beta Blockers
Beta blockers are excellent drugs for both treating hypertension and preventing coronary heart disease. They work by stopping the blood vessels from narrowing, so blood can flow more easily. They are not usually used as a first line of treatment for hypertension, but rather are only given to people with high risk factors for heart disease. They are also commonly used for the treatment for angina. Tiredness is a common side effect.

Calcium Channel Blockers
Calcium channel blockers block the movement of calcium into your blood vessels which prevents narrowing of the arteries. Normally they are used as a second or third option if other drugs such as ACE inhibitors and beta blockers have failed to reduce bp levels adequately. Generally they are well tolerated although occasionally they can cause fatigue, nausea, constipation and swelling of the feet and ankles. They are primarily used as a treatment for chest pain and as an arrhythmia therapy.

Renin Inhibitors
These are new drugs (brand name Tekturna) which slow down the production of renin in the body. Renin is a natural occurring chemical that increases blood pressure. Tekturna should never be taken with ACE inhibitors or ARBs due to the risk of stroke. If you have been recently diagnosed with hypertension, you might find it useful to read about the causes of high blood pressure.

Vasodilators
These drugs cause the walls of the arteries to relax so that blood can flow more easily. Vasodilators are only used in medical emergencies where bp cannot be controlled quickly enough with other drugs (hypertensive crisis).

Women And Hypertension Drugs
Despite the increasing rate of hypertension in women, most clinical trials on high blood pressure have predominately only involved men. As a result, there is considerable debate about whether drugs routinely prescribed for hypertension are as effective in women as in men, and whether or not they produce the same side effects. Until more studies are completed however, women have no choice but to use the same drugs as men.

Will I Ever Be Able To Stop Taking The Medications?

This is a very common question. Let’s say you have been taking bp meds for the past year and your blood pressure readings have returned to normal. Does this mean you can stop taking your medications? Probably not. Most people are never able to stop treatment altogether. But the good news is, if your bp has returned to healthier levels it shows your drugs are working. Yet drugs are not a permanent fix - if you stop taking them, your bp is likely to start to rise again. That said if your levels have been low for at least a year, it is important for your doctor to look at his original hypertension diagnosis for any contributory factors. For example, if you were clinically obese at the time of your original diagnosis but have subsequently lost 7 to 10 percent of your body weight, this may have a natural effect in lowering your bp levels. In this instance your doctor might gradually reduce your dosage, monitoring your reaction closely. Occasionally some people who lose weight and adopt healthier lifestyle patterns (see hypertension prevention) do manage to stop taking meds altogether (although it is recommended that they continue to use a home blood pressure monitor to watch out for any changes). Remember: never stop taking bp medications or make any changes to your dosage without first consulting your doctor.

Related Questions
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How effective are blood pressure drugs?

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For more information or related articles, see the following:

Birth control pill and high blood pressure
Chest problems: symptom checker and list of health conditions
Recommended health screenings: for each life stage.

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