High Blood Pressure and Heart Disease: Treatment Overview

Reviewed by the Office of Clinical Evaluation and Policy (OCEP), Evernorth

High blood pressure and heart disease are common conditions that affect the blood vessels and heart. Left untreated, high blood pressure and heart disease can lead to complications such as heart attack and stroke. Heart disease and stroke are the leading cause of death in the United States.

There are several types of heart disease. The most common is coronary artery disease (CAD) which causes narrowing or blockage of the blood vessels that supply blood to the heart. CAD is the main reason for heart attacks. You can reduce your risk of heart disease through lifestyle modifications such as not smoking, eating a healthy diet, maintaining a healthy weight and exercising; however, many people will also require medications like blood pressure-lowering and cholesterol-lowering medications to manage heart disease.

Continue reading to learn more about high blood pressure and heart disease treatments.

Medications for high blood pressure

Many blood pressure-lowering medications help widen and/or relax the blood vessels and reduce the stress on the heart.

ACE inhibitors

ACE inhibitors, or angiotensin-converting enzyme inhibitors, work by blocking the production of an angiotensin II substance that narrows the blood vessels. ACE inhibitors help widen the blood vessels to allow blood to flow more freely. Examples include benazepril (Lotensin®), lisinopril (Zestril®, Prinivil®), and quinapril (Accupril®).

ARBs

ARBs, or angiotensin receptor blockers, work by blocking the action of angiotensin II on the blood vessel walls. These medications bind to the angiotensin II receptor, which stops angiotensin II from binding to the receptor therefore it helps widen the blood vessels to allow blood to flow more freely. Examples of ARBs include candesartan (Atacand®), losartan (Cozaar®), and valsartan (Diovan®).

Diuretics

Also known as water pills, diuretics help your body get rid of excess salt and water. Decreasing fluid can help reduce blood volume and overall blood pressure or stress on the heart. Diuretics include furosemide (Lasix®), bumetanide (Bumex®), spironolactone (Aldactone®) and hydrochlorothiazide (usually abbreviated as HCTZ).

Calcium channel blockers

Calcium channel blockers, or CCBs, limit the amount of calcium that enters the blood vessel walls and heart. Calcium is needed to contract the muscles in the blood vessels and heart. CCBs help relax the blood vessel walls and muscles of the heart. Examples include amlodipine (Norvasc®), nifedipine (Procardia®), and diltiazem (Cardizem®).

Beta-blockers

Beta-blockers work by blocking the effects of the stress hormones adrenaline and noradrenaline. Blocking these hormones causes the heart to beat more slowly and with less force which lowers blood pressure and reduces stress on the heart. Examples of beta-blockers include atenolol (Tenormin®), nebivolol (Bystolic®), and bisoprolol (Zebeta®).

Other Medications

Statins

Statins are drugs that help lower cholesterol levels in the blood. Lowering cholesterol can help prevent certain events, such as heart attacks and strokes caused by heart disease. Examples of statins include atorvastatin (Lipitor®), lovastatin (Altoprev), and rosuvastatin (Crestor®).

Blood thinners

Blood thinners may work in different ways to prevent blood clots or the formation of platelets. People with heart disease may need to take a blood thinner to reduce the risk of a blood clot, which can clog a blood vessel and cause a stroke. Examples of blood thinners include warfarin (Coumadin®), apixaban (Eliquis®), and clopidogrel (Plavix®).

Vasodilators

Vasodilators help treat high blood pressure, angina (chest pain) and other medical conditions. They work by dilating (widening) blood vessels so that blood flows more easily to various organs in the body. Examples include nitroglycerin (Nitrostat®), isosorbide dinitrate (Isordil Titradose®) and hydralazine.

Non-pharmacological options

Surgery

Surgical treatment is recommended in severe cases. For patients with heart disease that causes an irregular heart rhythm, small electronic devices may need to be implanted in the chest to help the heart beat at a normal rate and rhythm. A device called a pacemaker prevents the heart from beating too slowly. When a pacemaker senses an irregular or slow heartbeat, the pacemaker sends an electrical signal to your heart to correct the beat.

Another specialized electronic device, called an implantable cardioverter-defibrillator (ICD), is used to detect life-threatening tachycardia (rapid heartbeat). If an abnormal heartbeat occurs, the device delivers an electric shock to the heart (defibrillation) to reset the heart rhythm.

Coronary artery bypass graft (CABG) is an open-heart surgery performed to treat coronary heart disease. The procedure restores blood flow from blocked arteries by creating another route or bypass around the blockage. This reduces the risk of heart attack and sudden cardiac death.

Diet and lifestyle changes

Eating a healthy diet, regularly exercising, maintaining a healthy weight and avoiding smoking are often recommended to help control blood pressure and protect the heart. A healthcare provider may recommend limiting salt intake to 1,500 mg per day for most adults as salt can contribute to high blood pressure. Exercising can help you maintain a healthy weight. People who are overweight or obese may be at an increased risk of heart and blood pressure problems. Quitting smoking immediately reduces your risk of heart disease and other serious disorders, with the benefit increasing over time.

Takeaway

It is important to talk to your doctor or healthcare provider for proper evaluation and diagnosis. Early recognition and identification of the cause can help prevent complications. While medication is typically required to treat high blood pressure and heart disease, diet and lifestyle changes could help keep you healthier. Most health insurance plans help cover the cost of high blood pressure and heart disease medications. Without insurance, you may have to pay the full cash price of the medication. Fortunately, a savings option like the Inside Rx card could help lower the cost of brand and generic medications.