There are many medications that are available to treat hypertension. Each medication has its unique advantages, disadvantages, and side effects. The specific medication that is chosen will take into account many factors about the patient including severity of hypertension, other medications the patient may be using, other medical problems, unique lifestyle needs of the patient. Medications used for hypertension do not lessen the need for lifestyle modifications but are used in conjunction with these lifestyle changes. Some of the common classes of medications that are used to treat hypertension include diuretics, calcium channel blockers, angiotensin converting enzyme inhibitors (ACE inhibitors), and beta blockers. Within each class there are multiple drugs to choose from that all have subtle differences. In many cases a single medication is adequate to lower blood pressure to treatment goals.In some cases more than one drug is needed. Certain medications can work synergistically together so that by combining the medication less of each drug is needed to give a greater effect. This can improve blood pressure while decreasing side effects. In rare cases where three or more medications does not lower blood pressure adequately a secondary cause of hypertension may be to blame.
There are several types of diuretics available. Thiazide diuretics are the most common type that is used for hypertension and Hydrochlorothiazide (HCTZ) is the most common medication in this class. Diuretics work by stimulating the kidney to make more urine thus decreasing the blood volume and in turn lowering blood pressure. Diuretics tend to increase the need to urinate after taking them and so they are most commonly prescribed to be taken in the morning. Diuretics tend to work well along side other medications and there are many examples of hypertensive medication that is a combination of a diuretic and another medication.
Calcium channel blockers is another common class of medication to treat hypertension. Calcium channel blockers have several effects on the body helping them to reduce blood pressure. They act on the arteries to decrease the stiffness of the arteries increasing the diameter of the arteries (vasodilitation), The act on the heart muscle to decrease the force the heart uses to pump out blood, they also act on the electrical system of the heart to decrease the heart rate. There are many different calcium channel blockers to choose from. Each has their own properties and will have more or less of each of these three effects. The correct one will be decided by you and your doctor depending on your specific needs.
Angiotensin converting enzyme inhibitors (ACE inhibitors) are also commonly used to treat hypertension. They are frequently combined with other medication such as diuretics to increase their effects. ACE inhibitors lower blood pressure by decreasing the stiffness of the blood vessels and allowing them to open up. ACE inhibitors are particularly beneficial for diabetics with hypertension because of their beneficial effects on the kidneys.
Another class of medication used to treat hypertension are the beta blockers. Beta blockers block epinephrine (adrenalin) and norepinephrine from effecting certain tissues. This effect decreases heart rate and can dilate blood vessels. These effects in turn lower blood pressure. Beta blockers are especially helpful in patients with hypertension and heart disease. There are several different types of beta blockers and each has its unique characteristics that can be beneficial for different unique conditions.
Medication for hypertension is commonly prescribed but it never replaces lifestyle modifications. Some patients think that if they take blood pressure they can stop working on a healthier lifestyle, this is a mistake. Lifestyle changes are key to get the most benefit from any hypertensive treatment and should always be maintained in any treatment papproach.