An informative guide on blood pressure medications

What is Blood Pressure?

Blood pressure is also termed as hypertension and affects approximately one-third of the Americans.

Blood Pressure is defined as “the force that moves blood through our circulatory system.” Blood pressure is important as it provides antibodies and white blood cells (WBCs) to maintain the immunity and insulin which is a hormone.

Blood pressure is also important as, without this force, the oxygen and nutrients would not be sent to the circulatory system for the nourishment of different organs and tissues.

Blood Pressure has two readings i.e. systolic and diastolic. Systolic pressure is a result of the contraction of the heart and is the higher reading and diastolic pressure is lower reading which occurs in-between the relaxation interval of the heart-beat.

According to the National Institutes of Health, appropriate blood pressure should be 120 mm Hg (systolic) and 80 mm Hg (diastolic).

High Blood Pressure

With high blood pressure, “too much force is exerted on the arteries as blood is pumped through.” This would result in harming the blood vessels and different organs of the body as a result of stress.

This condition might result in various health-related issues like heart attack, heart failure, stroke and kidney problems. To prevent the above problems or diseases, it is important to treat high blood pressure at the earliest.

Several medicines guide in the prevention of increased blood pressure. These medicines are termed as “anti-hypertensive.”

There are a variety of medicines, each of them would work distinctly and have their side-effects. Since there are several varieties available, one needs to be patient and have time to select the “best-one” appropriate to the condition. The physician would help you and guide you to get the best plan for treatment which consists of “one or more” medicines.

Medications for Blood Pressure

There are various categories of medicines for blood pressure. Each category helps lower the blood pressure distinctly.

Diuretics

This is a very common drug that is taken into consideration for the treatment of hypertension. These medicines would increase urine output and decreased fluid and sodium levels in the body. In other words, they help kidneys (excretory organs), to remove the extra water, sodium or salt. By this process, the volume of blood decreases and helps in a decrease in the blood pressure. If hypertension is mild, the treatment would be done by taking into consideration only diuretics. Though these medicines are majorly used along with other medicines for blood pressure.

Some of the diuretics include Bumetanide (Bumex), Chlorthalidone (Hygroton), Chlorothiazide (Diuril), Ethacrynate (Edecrin), Furosemide (Lasix), Hydrochlorothiazide HCTZ (Esidrix, Hydrodiuril, Microzide), Indapamide (Lozol), Methyclothiazide (Enduron), Metolazone (Mykroz, Zaroxolyn). Torsemide (Demadex).

A side-effect of diuretic includes potassium loss, which is thrown out of the body via urine along with the loss of sodium. The need for potassium is for the appropriate movement of the muscles. If there is a lack/insufficiency of potassium it leads to tiredness, weakness, cramps in the legs, and issues with the heart.

Initially individuals with “traditional diuretics”, would be asked to consume potassium enhanced food or would recommend supplements for potassium.

Certain medications are termed as “potassium-sparing diuretics.” These consist of amiloride (Midamor), spironolactone (Aldactone), and triamterene (Dyrenium).

There is also a mix of medicines with a combination of “potassium-sparing actions” and “traditional diuretics.” These medicines consist of amiloride hydrochloride and hydrochlorothiazide HCTZ (Moduretic), Spironolactone and HCTZ (Aldactazide) and triamterene and HCTZ (Dyazide, Maxzide).

Beta-Blockers

These help by obstructing the activity of chemicals in the body that motivates your heart. This causes the beating of the heart to slow down with the pace and power/strength. Hypertension reduces by less pumping of the blood via heart via the blood vessels “with each beat.” This decreases the blood pressure by working straight on the individual’s heart. These consist of:

  • Acebutolol (Sectral)
  • Nadolol (Corgard)
  • Atenolol (Tenormin)
  • Nebivolol (Bystolic)
  • Propranolol (Inderal)
  • Esmolol (Brevibloc)
  • Bisoprolol Fumarate (Zebeta)
  • Penbutolol Sulfate (Levatol)
  • Sotalol (Betapace)
  • Metoprolol Tartrate (Lopressor) and Metoprolol Succinate (Toprol-XL)
  • Carvedilol (Coreg): Combination of Alpha and Beta Blocker)
  • Labetalol (Trandate, Normodyne): Combination of Alpha and Beta Blocker)
  • HCTZ and Bisoprolol (Ziac): This a mix of diuretic and beta-blocker.

Angiotensin-Converting Enzyme (ACE) Inhibitors

This is a hormone that results in the narrowing of the blood vessels. The ACE Inhibitors reduce the making of angiotensin and helps reduce the blood pressure. These medicines would help control the blood pressure by helping the blood vessels to expand from narrowing for blood to flow through. Some of the ACE Inhibitors consists of:

  • Captopril (Capoten)
  • Benazepril (Lotensin)
  • Fosinopril (Monopril)
  • Enalapril (Vasotec)
  • Perindopril (Aceon)
  • Ramipril (Altace)
  • Quinapril (Accupril)
  • Trandolapril (Mavik)
  • Lisinopril (Prinivil, Zestril)
  • Moexipril (Univasc)

Angiotensin II Receptor Blockers (ACE)

Hormone Angiotensin constricts the blood vessels, but to complete its work it might require a place to attach. This is where the angiotensin II receptor blocker comes into the picture. They avoid angiotensin from attaching to the receptors on the blood vessels and this results in reducing hypertension. These consist of:

  • Candesartan (Atacand)
  • Valsartan (Diovan)
  • Olmesartan (Benicar)
  • Irbesartan (Avapro)
  • Azilsartan (Edarbi)
  • Eprosartan Mesylate (Teveten)
  • Losartan Potassium (Cozaar)
  • Telmisartan (Micardis)

Calcium Channel Blockers

Calcium helps increase the power and strength of contractions that are there in the heart and blood vessels. Its effect is reduced by clogging the entrance into the smooth tissues of the muscle. This category of medicine helps reduce hypertension by helping in the relaxation of the blood vessels and decreasing the rate of the heart. The calcium blocker channel consists of:

  • Amlodipine Besylate (Norvasc, Lotrel)
  • Verapamil Hydrochloride
  • Diltiazem Hydrochloride
  • Isradipine (DynaCirc, DynaCirc CR)
  • Felodipine (Plendil)
  • Clevidipine (Cleviprex)
  • Nicardipine (Cardene, SR)
  • Nisoldipine (Sular)
  • Nifedipine (Procardia XL)
  • Nimodipine (Nimotop, Nymalize)

Alpha-Blockers

In some conditions, the body produces a hormone named as catecholamines. These hormones attach to an area of the cells termed as alpha-receptors. This causes the narrowing of the blood vessels and an increase in the speed of the beating of the heart with extra power/strength. This results in hypertension. These category of medicines, help by stopping the catecholamines from attaching to the alpha-receptors. This results in an easy flow of blood via the blood vessels quite easily and the beating of the heart occurs naturally. This causes the blood pressure to lower down.

These medications would result in dilation of blood vessels, resulting in blood pressure to lower down. Similar medicines are used for the treatment of “prostate enlargement in men.” These consist of prazosin hydrochloride, terazosin hydrochloride, and doxazosin mesylate.

Alpha-Beta Blockers

These medicines affect in combination. They stop the attachment of catecholamine (hormone) to “alpha and beta receptors.” These also help reduce the blood vessels to constrict, similar to alpha-blockers. This helps reduces the speed and strength of beating the heart similar to beta-blockers. These include:

  • Carvedilol (Coreg)
  • Labetalol

Central Agonist

These categories of medicines inform the brain to not send messages to the nervous system for it to produce catecholamines. Therefore, the pumping of the heart is not with that force and the flow of blood is easy, thereby reducing blood pressure.

These consist of methyldopa (Aldomet), clonidine (Catapres) and guanfacine (Tenex)

Vasodilators

These help in the relaxation of the muscles in the blood vessel walls, majorly in the tiny arteries, termed as arterioles. This increases the width of the blood vessels and results in the flow of blood via them quickly and properly. This results in the reduction of blood pressure. These consist of hydralazine and minoxidil.

Aldosterone Receptor Antagonists

These help in blocking a chemical termed as aldosterone. This decreases the quantity of fluids/water that the body holds back, which helps reduce blood pressure. These consist of eplerenone and spironolactone.

Direct Rennin Inhibitors

This category of medicine blocks the chemical in an individual’s body termed as renin. This helps increase the width of the blood vessels that helps decrease hypertension. There is only a single type of Renin available in the USA is aliskiren.

Treatment Plans for Blood Pressure (using medications)

The initial option for medicine would be thiazide diuretic. For some individuals, the only diuretic is not sufficient for controlling blood pressure. In these situations, diuretic is combined with a beta-blocker, ACE Inhibitor, Angiotensin II receptor blocker or calcium channel blocker. Only diuretic is not that efficient/ effective as if we combine two medications. This also guides you to take lower dosages of each of the medicines that help decrease the side-effects of the medicines.

Combination of Drugs

If a physician thinks that the individual might require more than one medication, they would give a combined medication. For example, they might prescribe a diuretic with a beta-blocker or an ARB with a calcium channel blocker.

These medications in combination would be more comfortable than taking various medicines every day.

  • Triamterene/Hydrochlorothiazide (Dyazide): These are both diuretics.
  • Valsartan/ Hydrochlorothiazide (Diovan HCT): Valsartan is an ARB and Hydrochlorothiazide is a diuretic.

Best High Blood Pressure Medications

To get the best medications for treating blood pressure depends on several various things such as the overall health of the patients, age, background, any underlying medical conditions/diseases, insensitive to certain drugs.

For example, if patients are suffering from asthma, it would not be right to recommend beta-blocker, as that could increase the harm/damage to respiratory issues. In another case, if the patient is prone to constipation, the use of few calcium channel blockers in combination with diuretics results in aggravating the condition of constipation (no proper bowel movement).

There are particular drugs used for the particular category of patients. These consist of:

Pregnant women, African-American and Elderly patients.

Common Side-Effects of blood pressure medications

Diuretics

While taking these medicines important to inform the physician if breast-feeding. These medicines would transfer to the breast-milk. If individuals are having an issue with the kidney or liver, pregnant women or an elderly should first talk to the physician related to the consumption of diuretics.

These could result in potassium loss i.e. Hypokalemia, which affects the heart muscles and overall function of the muscles resulting in cramps in the muscles. It could also result in gout and weakness. There could be increased in the urine output and dehydration, blood sugars might get abnormal, skin allergies, upset stomach, pain in the head. There could be enlargement of breast in males if consumption of potassium-sparing diuretic i.e. spironolactone (Aldactone).

Beta-Blockers

These medications result in slowing down of the heart, faint feeling, tiredness, weakness, stomach upset, constipation or diarrhea, and light-headedness. It could also affect the respiratory system, it could result in breathlessness, problems in breathing and pain in the chest. These medications should not be stopped immediately as that could lead to a heart attack or immediate death.

ACE Inhibitors

This could also result in a dry cough. This also results in a decrease in blood pressure i.e. hypotension, pain in the head, faint feeling, decrease in the function of the kidney.

Angiotensin II Receptor Blockers

Side-effects result in a higher level of potassium in the blood i.e. hyperkalemia. Also undergoes dizzy sensations and tiredness. There could also be issues of respiratory infections, gastrointestinal issues like stomach being upset and diarrhea.

Calcium Channel Blockers

One-third of the individuals suffer from side effects such as ankles and other extremities being swollen, dizzy sensations. It could also result in nausea, weak feeling, pain in the head and feeling warm (flushed)

Renin Inhibitors

One of the side-effects of this drug is diarrhea. Women who are planning to get pregnant or already pregnant should inform the physician before using this particular drug. Individuals with issues of kidney need to talk to their physician before using this medicine. Inform the physician if consuming any kind of water-pills, anti-hypertensive drugs, medicines for heart, and medications for treatment of fungus.

Alpha-Blockers

This could result in hypotension. This also causes dizzy feeling, fainting, also results in heart rate is increased, and pain in the head, nausea, and weakness.

Methyldopa

This is majorly tolerated well but sometimes could result in dizzy feeling, drowsy sensations, weak feeling, nausea, and weakness.

Central Agonists

Individuals who consume clonidine, 40% of them result in dry mouth and one-third of them result in drowsy feeling, pain in the head and sleepy sensations. Other symptoms include constipation (improper bowel movement), dizzy feeling, and skin allergies.

Vasodilators

If we take minoxidil, it leads to extra growth of hair, weight gain and dizzy feeling. If taking hydralazine it leads to pain in the head, heart palpitations, and fluffiness around the eyes, pains, and aches in the joint, growth in the body hair.

Treatment for multiple conditions

The physician would prescribe medications that might also depend on the health conditions that individuals have. If individuals have coronary artery disease and increased blood pressure, the physician might prescribe a beta-blocker. If an individual is having diabetes, the physician might prescribe you with ACE Inhibitor or an ARB, these medicines help to save the kidney from damage due to diabetes by decreases the blood pressure in an individual’s kidney.

Is it safe to consume high blood pressure medications during pregnancy?

Hypertensive medications should be avoided during pregnancy as it might be a danger to the mother and baby. These drugs consist of ACE Inhibitors and Angiotensin II Receptor Blockers. Drug named reserpine would be dangerous during pregnancy, it should be taken only when no other option available. Medications that are safe to be used are Methyldopa, few of diuretics and beta-blockers that includes labetalol.

Is it safe to consume alcohol when on blood pressure medications?

Few of the hypertensive drugs causes drowsy feeling, dizzy feeling, and light-headedness also could cause fainting. Initially, the body needs to get adjusted to the “effect of medication” and there is a disappearance of side-effects. If consuming alcohol at the initial phase of anti-hypertensive treatment, it would be harmful and result in a dizzy feeling, drowsy feeling, and light-headedness.

Consumption of alcohol results in a temporary rise in blood pressure that could be constant if the consumption of alcohol is more than moderation.

Does High Blood Pressure results in weight gain?

Few of the hypertension medicines do cause gain in weight. The reason could be that the drugs cause patients too feel fatigue and resulting in lowering of the work-out and diet. Weight gain anti-hypertensive medicines include minoxidil tablets, Doxazosin. In some cases, medications like diuretics cause weight loss.

Important to converse with the doctor

Hypertension is a severe disease that needs treatment to avoid serious health issues. Do take the help of the physician to get an idea about the drugs/medications which would be the best for the individual with hypertension. It would be great to work together with the physician on a plan of action/treatment to get blood pressure in control.