Choosing blood pressure medicines

Many medicines are available to treat high blood pressure. Choosing

the right one can be tricky. Learn how to find the best one for you.
By Mayo Clinic Staff

There are many different types of blood pressure medicines. Medicines

to treat high blood pressure are sometimes called antihypertensives.
Choosing the right blood pressure medicine can be challenging. Your
health care team may recommend more than one type of medicine to
treat high blood pressure.

Always take blood pressure medicines as directed and get regular

blood pressure checkups.

Lifestyle changes
Healthy lifestyle habits are suggested to control and manage high
blood pressure. If your blood pressure is high or slightly above what is
considered ideal, a healthy lifestyle might prevent or reduce your need
for medicine.

Try these tips.

 Eat a healthy diet rich in whole grains, fruits and vegetables,

lean meats, and low-fat dairy products.
 Use less salt.
 Manage stress.
 Maintain a healthy weight.
 Develop healthy sleeping habits so you get a good night's rest.
 Get regular exercise. Aim for 30 minutes of moderate activity
on most days of the week. It's OK to break up your activity
into three 10-minute sessions a day.
 Avoid or limit alcohol. If you choose to drink alcohol, do so in
moderation. For healthy adults, that means up to one drink a
day for women and up to two drinks a day for men.
Medicine options
Sometimes lifestyle changes are not enough to treat high blood
pressure. If not, your health care team may recommend blood pressure
medicine.

The type of medicine used to treat high blood pressure depends on

your overall health and how high your blood pressure is. Two or more
blood pressure medicines often work better than one. It can take some
time to find the best medicine or combination of medicines.

Medicines to treat high blood pressure include:

 Water pills, also called diuretics. These medicines remove

extra water and sodium from the body. So, there's less fluid
flowing through the veins and arteries. This reduces pressure
on the walls of the blood vessels. Types of diuretics include
thiazide, loop and potassium-sparing.
 Angiotensin-converting enzyme (ACE) inhibitors. These
medicines help relax blood vessels. They block the formation
of a natural chemical that narrows blood vessels.
 Angiotensin 2 receptor blockers (ARBs). These medicines
block the action of angiotensin. Angiotensin is a chemical the
body makes that narrows blood vessels.
 Calcium channel blockers. These medicines stop calcium
from entering the cells of the heart and arteries. This allows
the arteries to relax and open.
 Beta blockers. These medicines help the heart beat slower
and with less force.
 Renin inhibitors. Renin is a substance made by the kidneys. It
triggers a series of steps that increases blood pressure. Renin
inhibitors slow how much of this substance is made.
Other medicines for high blood pressure
If you cannot reach your blood pressure goal with one or more of the
above medicines, your doctor may prescribe:

 Aldosterone antagonists. These medicines often are used

with other blood pressure treatments, such as a diuretic. They
block a hormone called aldosterone. That hormone sometimes
causes sodium and fluid to build up in the body. This can
cause high blood pressure. Aldosterone antagonists may be
 prescribed if high blood pressure is difficult to control or if you
have diabetes or heart failure.
 Alpha blockers. These medicines prevent a hormone called
norepinephrine from tightening the muscles in the walls of
smaller arteries and veins. This lets the arteries and veins
stay open and relaxed.
 Alpha-beta blockers. These medicines work similarly to beta
blockers. They might be prescribed if you have high blood
pressure and are at risk of heart failure.
 Central-acting agents. These medicines stop the brain from
sending signals to the nervous system to speed up the heart
rate and narrow the blood vessels. As a result, the heart does
not pump as hard and the blood flows more easily through the
veins and arteries.
 Vasodilators. These medicines prevent the muscles in the
veins and arteries from tightening and narrowing. As a result,
blood flows more easily and the heart does not have to pump
as hard.