What You Need to Know About Treatment and Medication for High Blood Pressure

High blood pressure, also called hypertension, affects half of all U.S. adults. Without proper treatment, it increases the risk of serious conditions such as:

• Stroke
• Heart attack
• Heart failure
• Kidney failure
• Vision loss

In nearly 95 percent of all cases, the cause of hypertension is not known. However, several factors increase the risk of developing this condition. These include having close blood relatives with high blood pressure, lack of physical activity, smoking and being overweight or obese.

Sadly, there is no cure for hypertension. However, there are some things you can do to control your blood pressure levels and reduce your risk of heart disease, stroke and other conditions linked to hypertension.

Read on to learn about how hypertension is managed and the factors doctors consider when determining the best medication for high blood pressure for your situation and your treatment goals.

How Hypertension Is Treated

Once you’ve been diagnosed with high blood pressure, your doctor will likely recommend that you make healthy lifestyle changes, such as:

Eating a Heart-Healthy Diet

This means increasing your intake of foods that promote heart health, like:

• Whole grains
• Vegetables and fruit
• Fatty fish rich in Omega-3, such as Atlantic mackerel, salmon, herring and sardines

This also means decreasing your intake of salt. Too much sodium has been linked to high blood pressure.

Exercising More Often

Regular exercise helps control blood pressure levels as well as help with weight management, which is also important for controlling hypertension. The Mayo Clinic recommends at least two and a half hours of moderate aerobic exercise or one hour and 15 minutes of vigorous activity a week.

Other Lifestyle Changes

Limiting your alcohol intake, quitting smoking and getting enough sleep–about seven to nine hours a day–may also help you control your blood pressure.

Medication for High Blood Pressure

Lifestyle changes alone may help people with only slightly elevated blood pressure. However, for most people with hypertension, medication is needed to keep blood pressure under control.

The following are some examples of commonly prescribed medications for blood pressure.

Beta-Blockers

This is a class of drugs often prescribed to individuals with high blood pressure as well as for atrial fibrillation, angina, heart attacks and heart failure. Beta-blockers work to reduce blood pressure by blocking the production of the hormones adrenaline and noradrenaline.

These hormones make the heart beat faster and harder. Beta-blockers slow down the heart and reduce the force of its beating. Doctors may prescribe beta-blockers if diuretics are ineffective at reducing a patient’s blood pressure.

The following are some examples of beta-blockers:

*No corresponding brand name/generic only

Angiotensin Receptor Blockers (ARBSs)

This class of high blood pressure medication helps relax blood vessels so that blood can flow through more easily. It does this by suppressing the action of angiotensin II.

Angiotensin II is a hormone that causes blood vessels to constrict and narrow, making it difficult for blood to pass through. Additionally, angiotensin II also causes the kidneys to retain sodium, and the excess sodium results in more fluid being kept in the blood rather than released into urine. Both actions increase blood pressure.

Examples of this type of high blood pressure medication include:

Diuretics

Also called “water pills,” diuretics are often the first kind of medication a doctor will prescribe to a person with hypertension. They work by helping the kidneys eliminate excess water and salt, reducing the amount of fluid in the blood vessels. In turn, this reduces blood pressure.

Diuretics are categorized into three: thiazide-like, loop and potassium-sparing. However, only thiazide-like and potassium-sparing diuretics are recommended to treat blood pressure. This is because further research is needed on loop diuretics as a treatment for hypertension. Currently, it is mainly used to treat edema caused by heart failure, kidney disease and liver disease.

Note that your physician will assess your health and other factors before prescribing a type of diuretic for you.

Thiazide-like diuretics cause a moderate amount of water loss and are suitable for long-term use. Examples include:

*No corresponding brand name/generic only

Meanwhile, potassium-sparing works similarly, with the added benefit of preventing potassium loss. Some examples are:

Calcium Channel Blockers

The blood vessels throughout the heart and body are lined with muscle as well as connective tissue. One of the functions of calcium in the blood is to contract the muscles in these linings.

Calcium channel blockers slow down the flow of calcium into the cells of the heart and blood vessel walls, reducing the amount of calcium that flows through their linings. This causes the blood vessels to relax and the heart to not have to work as hard, which in turn lowers blood pressure.

Some calcium channel blockers that a doctor may prescribe for hypertension include:

*No corresponding brand name/generic only

Central-Acting Agents

This type of high blood pressure medication works to reduce blood pressure and lower heart rate by blocking signals from the brain that constrict blood vessels and increase heart rate. Central-acting agents are also called central agonists, central adrenergic inhibitors and central alpha agonists.

Some examples are:

Choosing the Best Medicine for Hypertension

Ultimately, the best medication for high blood pressure is one that is proven to be effective via extensive research and testing as well as has as few side effects as possible. However, your doctor is the one who is in the ideal position to help you find the right medication for your condition.

To determine the best medication for high blood pressure, your doctor will consider factors such as your hypertension category, your age, lifestyle and medical history. They will also ask you about any allergies or sensitivities you might have to certain medications, as well as what medications and supplements you’re currently taking.

If medication cost is a concern, be sure to let your doctor know. They may be able to prescribe generic medications, consider other forms of medication and provide additional resources for saving money on prescription drugs, like a prescription discount card.

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Sources:

• https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure
• https://health.clevelandclinic.org/kidneys-salt-and-blood-pressure-you-need-a-delicate-balance
• https://pubmed.ncbi.nlm.nih.gov/10342782/
• https://www.merckmanuals.com/home/multimedia/image/regulating-blood-pressure-the-renin-angiotensin-aldosterone-system?ruleredirectid=475
• https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/angiotensin-ii-receptor-blockers/art-20045009
• https://my.clevelandclinic.org/health/drugs/23327-angiotensin-ii-receptor-blockers
• https://www.healthline.com/health/heart-disease/diuretics-hypertension#pharmaceutical-diuretics
• https://my.clevelandclinic.org/health/treatments/22316-calcium-channel-blockers