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Medications for Hypertension Your doctor has informed you that you must begin taking high blood pressure medications or hypertension medications. How does the doctor determine what medications for hypertension he/she will prescribe for you? The doctor considers the following basic factors in making the hypertension medication choice: Age Ethnic origin Previous blood pressure medicines the patient may have taken Other medical problems the patient may experience Possible side effects Ease of use Medicines that treat hypertension or high blood pressure are called antihypertensive agents. Normally, a doctor starts a patient on a low dose of a hypertension medication. If the blood pressure is still elevated after several weeks, the doctor will increase the medicine. If high doses of a particular high blood pressure medicine don't work, a different class of medicine can be added to the first. Different medicine classes act in different ways. It may be necessary to add a third medicine. Most new hypertension medications can be taken one or two times daily. Side effects vary, but most patients are able to tolerate them. Diuretics Diuretics, or water pills, are generally the doctor's first choice and are the less costly option. They are the oldest hypertension medication and the most researched. Diuretics help the kidneys remove salt and water, decreasing the fluid volume in the bloodstream and the pressure on the arteries. The main side effect of diuretics is more frequent urination. An increased amount of potassium may also be passed through the urine. For low potassium, patients should eat bananas or consider a potassium supplement. Beta Blockers Beta Blockers slow down the heart contractions. By slowing the pumping of the blood in the arteries, Beta Blockers decrease blood pressure. They also help patients with coronary artery disease, heart attacks and congestive heart failure. Possible main side effects for this hypertension medication include slowing the heart rate too much and worsening heart failure. Calcium Channel Blockers Calcium Channel Blockers such as Diltiazem and Verapamil act like Beta Blockers by somewhat slowing heart contractions and the pumping of blood in the arteries, thus decreasing blood pressure. They also open up the arteries, decreasing blood flow resistance and therefore decreasing pressure. The newer medications' primary purpose is to dilate the arteries. These medicines may have serious side effects. Those patients with pulmonary arterial hypertension should be particularly careful. Diltiazem and Verapamil could worsen congestive heart failure, and Verapaml may cause constipation, particularly in the elderly. Many channel blockers also cause headaches and swelling of the feet and ankles. ACE Inhibitors ACE (Angiotensin Converting Enzyme) Inhibitors dilate the arteries, increasing blood flow and, therefore, lowering blood pressure. They help patients with congestive heart failure. Studies have shown this hypertension medication helps heart failure symptoms, lowers the chance of a future hospital stay, lowers the risk of a future heart attack and lowers the chance of death from heart failure. The major side effect of this hypertension medication is a possible chronic, nonproductive cough, which occurs in about 10 percent of patients. Kidney function and possible raised potassium levels should be watched. Angiotensin-Receptor Blockers Angiotensin-Receptor Blockers (ARBs) are a new medicine class that acts similarly, in some cases, to ACE Inhibitors. Both medications affect the arteries, lower blood pressure, make the heart pump blood easier through the body, help congestive heart failure, lower future hospitalization chances and extend life. Studies are looking into the possibility of ARBs and ACE Inhibitors working together, and doctors are considering using both for heart failure patients. There are generally no major side effects to this new medicine. Two other hypertension medications are Direct-Acting Vasodilators and Central Acting Agents. The Effectiveness of Hypertension Medications According to a study sponsored by the National Heart, Lung and Blood Institute, using diuretics to treat high blood pressure in diabetic patients is as effective as using ACE Inhibitors and Calcium Channel Blockers in safeguarding the heart against an attack. The study found that diuretics were: More effective against congestive heart failure by about 1/6 against the ACE Inhibitors and 1/3 against Calcium Channel Blockers, whether the patient had diabetes or not. Better than the other two for lowering systolic blood pressure, regardless of the diabetic factor. At least as equally protective as the others in fighting fatal coronary heart disease or non-fatal heart disease in diabetic patients, patients with elevated fasting glucose levels and patients without diabetes. Equally protective regarding all death causes, end-stage kidney disease or cancer in diabetic patients, patients with elevated fasting glucose levels and patients without diabetes. Talking to Your Doctor about Hypertension Medications What are some specific questions you should ask your doctor about high blood pressure medications? What is the name of the drug? What is its purpose? How, when and how long should I take the high blood pressure medications? What food, drinks, activities or other medications should I avoid while taking this medication? What are the possible side effects? What should I do if side effects occur? How will I know if the medicine works? What are the risks? What are the risks of not taking the hypertension medication? Are there less expensive medicines?

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