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ACE inhibitors | ARBs | Diuretics | Beta blockers | Calcium channel blockers | Efficacy | Safety | Warnings and Contraindications | FAQs
High blood pressure or hypertension affects millions of people in the United States. As it presents no noticeable symptoms, high blood pressure is often called a “silent killer.” High blood pressure can lead to severe consequences, including heart attacks, heart failure, and strokes if left untreated. However, high blood pressure is entirely treatable with lifestyle changes and medications.
Blood pressure medications, also known as antihypertensives, may be prescribed to help control blood pressure. Numerous blood pressure medications may work in various ways. These medications include angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), and beta blockers. The best treatment option will vary depending on your underlying health condition, other medications you may be taking, and other factors.
Continue reading to learn about some of the most commonly prescribed high blood pressure medications.
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Commonly prescribed blood pressure medications
High blood pressure medications may work differently to help lower blood pressure. For example, they might dilate or relax the blood vessels to allow blood to flow more freely, reduce excess water and salts from the body, or slow down the heart rate to lower blood pressure.
Blood pressure medications are available with a prescription only. However, they’re widely accessible as generic drugs that are usually cheaper than brand-name alternatives. The following are some commonly prescribed blood pressure medications by drug class.
ACE inhibitors
ACE inhibitors are a type of medication that lowers blood pressure by blocking the production of angiotensin II, a hormone that causes blood vessels to constrict. By preventing this constriction, ACE inhibitors help blood vessels to relax and widen, making it easier for blood to flow and ultimately reducing blood pressure.
Zestril, Prinivil (lisinopril)
Lisinopril, sold under the brand names Zestril and Prinivil, is an ACE inhibitor that lowers blood pressure by relaxing blood vessels. Usually taken once a day, the dosage can differ depending on an individual’s needs. Common side effects of this medication include dizziness, dry cough, and headache.
Vasotec (enalapril)
Enalapril is a medication commonly used to treat high blood pressure and heart failure. It is also used to reduce the risk of heart failure in people with left ventricular dysfunction without any symptoms. It is typically taken once or twice daily, although the standard dosage may vary. Some common side effects of enalapril include headache, dizziness, and dry cough.
ARBs
Angiotensin II receptor blockers (ARBs) selectively block the hormone angiotensin II from binding to its receptors, thus blocking its ability to narrow blood vessels. This makes it easier for your blood to flow, reducing stress on your heart and kidneys.
Cozaar (losartan)
Losartan is a medication used to treat high blood pressure and protect the kidneys from damage due to diabetes. It is also used to reduce the risk of stroke in people with high blood pressure and certain heart problems. It is typically taken once daily. While side effects are generally mild, some people may experience dizziness, back pain, or nasal congestion.
Diovan (valsartan)
Diovan, also known as valsartan, is a medication used to treat high blood pressure and heart failure. It is typically taken once daily with a common dosage ranging from 80 to 320 mg, depending on an individual’s needs. Some side effects specific to this drug include dizziness, headache, and fatigue.
Diuretics
Diuretics, also known as water pills, are medicines that help your body get rid of extra water and salt through increased urination. They do this by making your kidneys release more sodium, which pulls more water out of your body, lowering fluid build-up and blood pressure.
Microzide (hydrochlorothiazide)
Hydrochlorothiazide is a medication commonly prescribed to help manage high blood pressure. Typically taken once a day, the usual dosage ranges from 12.5 to 50 mg, depending on a person’s treatment goals. Possible side effects may occur, such as dizziness, dehydration, or electrolyte imbalances.
Lasix (furosemide)
Furosemide is a diuretic medication often prescribed to treat high blood pressure and fluid retention. It is generally taken once or twice a day, with a typical dosage ranging from 20 to 80 mg, depending on the patient’s condition. Potential side effects of furosemide include dizziness, increased urination, and weakness.
Beta blockers
Beta blockers are a class of medications that work by blocking the effects of stress hormones, such as adrenaline, on the heart and blood vessels. This helps to lower blood pressure, reduce heart rate, and decrease the overall workload on the heart, ultimately improving cardiovascular health.
Lopressor (metoprolol tartrate)
Metoprolol tartrate is a beta blocker medication often used to treat high blood pressure, chest pain, and heart failure. It is typically taken once or twice daily, with 25 to 100 mg dosages. Some common side effects include dizziness, tiredness, and slow heart rate.
Zebeta (bisoprolol)
Bisoprolol is a beta blocker medication commonly prescribed to manage high blood pressure and reduce the risk of heart-related issues. The normal dosage can range from 2.5 to 20 mg once daily. Some potential side effects of bisoprolol include dizziness, slow heart rate, and headache.
Tenormin (atenolol)
Atenolol is a beta blocker medication prescribed to treat high blood pressure and prevent chest pain caused by angina. It is also approved to reduce the risk of death after a heart attack. It is generally taken once a day, with dosages ranging from 25 to 100 mg per day. Some common side effects of atenolol include dizziness, nausea, and slow heart rate.
Calcium channel blockers
Calcium channel blockers are a class of medications that block calcium’s movement into the cells of the heart and blood vessels. This action helps to relax and widen blood vessels, which helps lower blood pressure and reduce the workload on the heart.
Norvasc (amlodipine)
Amlodipine is a calcium channel blocker medication commonly used to treat high blood pressure and chest pain. Typically taken once daily, the usual dosage ranges from 2.5 to 10 mg per day. Some potential side effects of amlodipine include dizziness, swelling of the ankles or feet, and flushing.
Blood pressure medications |
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|---|---|---|---|---|
| Drug (generic) | Form | Dosage | Side Effects | Savings Options (coupons) |
| Zestril, Prinivil (lisinopril) | Tablet | 5-40 mg once daily | Headache, dizziness, cough, low blood pressure | Zestril coupons |
| Vasotec (enalapril) | Tablet | 10-40 mg once daily in one or two divided doses | Headache, dizziness, dry cough, upset stomach | Vasotec coupons |
| Cozaar (losartan) | Tablet | 50 mg once daily | Dizziness, nasal congestion, back pain | Cozaar coupons |
| Diovan (valsartan) | Tablet | 80-320 mg once daily | Dizziness, headache, fatigue | Diovan coupons |
| Microzide (hydrochlorothiazide) | Capsules, tablets | 12.5-50 mg once daily | Dizziness, dehydration, weakness, nausea | Hydrochlorothiazide coupons |
| Lasix (furosemide) | Tablets | 20-80 mg once or twice daily | Weakness, Increased urination, nausea | Lasix coupons |
| Lopressor (metoprolol tartrate) | Tablets | 100 mg once daily or 50 mg twice daily | Dizziness, tiredness, slow heart rate | Lopressor coupons |
| Zebeta (bisoprolol) | Tablets | 2.5-20 mg once daily | Dizziness, slow heart rate, headache | Bisoprolol coupons |
| Tenormin (atenolol) | Tablets | 25-100 mg once daily | Dizziness, nausea, slow heart rate | Tenormin coupons |
| Norvasc (amlodipine) | Tablets | 2.5-10 mg once daily | Dizziness, swelling of the ankles or feet, flushing | Norvasc coupons |
How do blood pressure medications work?
Blood pressure medications are effective in reducing blood pressure and subsequent complications. The best blood pressure medication will depend on different factors, including treatment goals and other medical conditions.
A calcium channel blocker or thiazide diuretic is recommended for African American patients for first-line therapy. For people with chronic kidney disease and heart failure, an ACE inhibitor or ARB is typically recommended first.
Many people with a blood pressure of over 140/90 mmHg may be prescribed a high blood pressure medication, especially if lifestyle changes don’t work. According to the American Heart Association (AHA), one or a combination of high blood pressure medications are used to reach a target blood pressure of less than 140/90 mmHg. People with a blood pressure of 130–139/80–89 mmHg and an increased risk of heart disease may also be prescribed a high blood pressure medication.
High blood pressure medications are generally more effective with lifestyle changes, including a healthy diet and regular exercise. The DASH diet involves eating more fruits, vegetables, whole grains, and low-fat, lean proteins while reducing salt, unhealthy fats, and added sugars. Combining high blood pressure medications with the DASH diet and regular exercise may help improve blood pressure control and overall heart health.
It’s always a good idea to consult a healthcare provider for the best treatment option if you have high blood pressure.
Are blood pressure medications safe?
Blood pressure medications are generally considered safe when prescribed by a healthcare provider. Like any medication, blood pressure drugs may cause side effects, which can vary depending on the individual and the specific medication being used.
It’s important to discuss any concerns or questions with your healthcare provider before starting a blood pressure medication. They will consider your overall health, medical history, and potential benefits and risks to determine the best treatment plan.
Side effects of blood pressure medicine
Side effects may vary depending on the drug class. Examples of the most common side effects by drug class include the following.
Side effects of diuretics
- Dehydration
- Dizziness
- Electrolyte imbalances
- Increased urination
Side effects of beta blockers
- Dizziness
- Fatigue
- Slow heart rate
- Cold hands or feet
Side effects of calcium channel blockers
- Dizziness
- Headache
- Swelling of the ankles or feet
Side effects of ACE inhibitors
- Persistent dry cough
- Dizziness
- High potassium levels in the blood
Side effects of ARBs
- Dizziness
- Headache
- High potassium levels in the blood.
In some cases, blood pressure medications may cause serious side effects, especially in people with certain health conditions or taking certain medications. Blood pressure medications may need to be avoided or monitored in certain people.
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Warnings and Contraindications
Allergic reactions
Before starting any blood pressure medication, inform your healthcare provider about any allergies or previous reactions to medications. Your healthcare provider will prescribe an alternative medication if you have a known allergy to a specific drug.
Pregnancy and breastfeeding
Some blood pressure medications may not be suitable for pregnant or breastfeeding women. Consult your healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding, as they will recommend the appropriate medication for your situation.
Drug interactions
Blood pressure medications can interact with other medications, supplements, or over-the-counter drugs, which may lead to increased side effects or reduced effectiveness. Provide your healthcare provider with a complete list of all the medications and supplements you are taking to avoid potential interactions.
Medical conditions
Inform your healthcare provider about your medical history, including any kidney, liver, or heart problems, as these conditions may affect the choice of blood pressure medication. Your healthcare provider will consider your overall health and medical history to determine the most appropriate treatment.
Lifestyle factors
Some blood pressure medications may have specific lifestyle recommendations, such as limiting alcohol intake or avoiding certain foods. Follow your healthcare provider’s advice regarding any lifestyle changes that may be necessary while taking blood pressure medication.
If you experience any side effects while taking blood pressure medication, consult your healthcare provider. Always follow your healthcare provider’s instructions and never stop taking prescribed medication without their guidance.
Frequently asked questions about blood pressure medications
Is it safe to take high blood pressure medication while pregnant or breastfeeding?
Some blood pressure medications, including ACE inhibitors and ARBs, are not safe to take while pregnant or breastfeeding. These medications may cause kidney problems for a developing baby. However, others may be safe for managing blood pressure while pregnant or breastfeeding. A healthcare provider may instead recommend labetalol, nifedipine, or methyldopa as safe and effective options.
Who should avoid blood pressure medications?
People who are allergic to any ingredients of blood pressure medications should avoid using them. Other contraindications will depend on the medication. For example, people with kidney problems may need to avoid ACE inhibitors, while people with a slower heart rate than normal (bradycardia) may need to avoid beta blockers. Consult a healthcare provider to determine which blood pressure medication may be right for you, especially if you have other health problems.
Is it safe to drink alcohol while taking high blood pressure medications?
It’s not recommended to drink alcohol while taking high blood pressure medications. Alcohol can amplify the side effects of high blood pressure medications, such as dizziness, headache, drowsiness, and potential heart problems. In addition, alcohol may contribute to high blood pressure.
What is the safest blood pressure drug?
The safest blood pressure drug will depend on a person’s blood pressure, health condition, and other factors. A healthcare provider will recommend the safest and most effective option based on your overall condition. If you have risk factors for certain health problems, a healthcare provider will tailor the management of hypertension to your specific needs.
Can you stop blood pressure medication once you start?
Stopping blood pressure medication without a doctor’s guidance can lead to complications, such as increased strain on the heart muscle and irregular heartbeats, which may increase the risk of stroke or heart attack. In most cases, blood pressure treatments are long-term. Always consult a doctor or healthcare provider for medical advice and information on discontinuing blood pressure medication.
