10 Drugs Commonly Prescribed for High Blood Pressure
This article looks at some commonly prescribed high blood pressure medications, classes of medications, and frequently asked questions about treating blood pressure.
If you have high blood pressure, you are one of about 116 million people in the United States who also have it.
However, many people do not know that they have high blood pressure because there are usually no obvious symptoms. Over time, the condition can lead to life threatening complications — such as heart attack, heart failure, and stroke — without producing any warning signs. This is why high blood pressure gets the name “silent killer.”
The only way to know your blood pressure is to measure it. Getting a blood pressure reading is a common procedure during a doctor’s visit. You can also measure your blood pressure at a pharmacy or at home with a blood pressure monitor.
Normal blood pressure is below 120/80 millimeters of mercury (mm Hg). Blood pressure that is consistently above normal may indicate high blood pressure.
Drugs that treat high blood pressure are known as antihypertensives. Blood pressure medications work by:
- reducing the amount of water and salt in your body
- causing the blood vessels to relax to keep them from narrowing
- hampering nerve activity that causes blood vessels to restrict
- lowering your heart rate and helping it beat with less force
There are several classes of antihypertensive medications, and each class includes several drug options. Your doctor will work with you to find the best treatment plan.
The following list provides the top 10 blood pressure medications by prescriptions written. The list includes a brief description of each drug, including its class, how to take it, and what it treats. The next section provides more information on drug classes.
The most common high blood pressure medications by total prescriptions written include:
- Lisinopril (Prinivil, Zestril): This medication is an angiotensin-converting enzyme (ACE) inhibitor. It is a drug that you usually take once per day. Most people find once-daily dosing to be convenient and easy to remember. Lisinopril is also a treatment option for heart failure.
- Metoprolol (Lopressor, Toprol XL): This medication is a beta-blocker. It comes in an immediate-release form and an extended-release form. It also helps lower the risk of repeat heart attacks and helps treat angina and congestive heart failure.
- Amlodipine (Norvasc): This medication is a calcium channel blocker. People usually take it once per day. Amlodipine is also a treatment option for angina.
- Losartan (Cozaar): This medication is an angiotensin II receptor blocker. In most cases, the dose is once per day. Doctors also use this drug to decrease the risk of stroke in people with an enlarged heart.
- Hydrochlorothiazide (Hydrodiuril, Microzide): This medication is a diuretic. It comes as a capsule or tablet that you typically take once per day. It also treats fluid retention, or edema, from conditions such as heart failure.
- Furosemide (Lasix): This medication is another diuretic. Your doctor may prescribe it for use once or twice per day. Furosemide, like other diuretics, can make your skin more sensitive to the sun. Like other diuretics, it also treats edema.
- Carvedilol (Coreg): This medication is another beta-blocker. It comes as a tablet for twice-daily dosing and an extended-release capsule for once-daily dosing. You take both forms with food.
- Atenolol (Tenormin): This medication is also a beta-blocker. The usual dose can be once or twice per day. Like other beta-blockers, this drug can help improve survival after a heart attack.
- Spironolactone (Aldactone): This medication is another diuretic. It comes as a tablet and in a liquid form. You take it either once or twice per day.
- Clonidine (Catapres): This medication belongs to the central agonist class. It comes as a tablet that you take twice daily. There is also an extended-release tablet for treating attention deficit hyperactivity disorder.
There are many classes of antihypertensive medications and many drugs within each class. This results in a large number of drugs that doctors can use to treat high blood pressure.
To assist doctors in choosing the best treatment, they typically follow guidelines and recommendations from experts in this medical field.
Some commonly prescribed classes of antihypertensive medications include:
- ACE inhibitors: These drugs block an enzyme to reduce the body’s amount of angiotensin. Having less angiotensin in the body helps the blood vessels relax. Some common side effects of ACE inhibitors include a rash and a dry cough. Examples include captopril, enalapril, and lisinopril.
- Angiotensin II receptor blockers: This class directly blocks angiotensin to relax the blood vessels. Common side effects include dizziness and lightheadedness, especially when standing up from a seated position. Examples include losartan and valsartan.
- Alpha-blockers: This class relaxes the blood vessels. The drugs can also relax the muscles in organs, such as the bladder and prostate gland. Dizziness, especially when rising, is a common side effect.
- Beta-blockers: These drugs block the effects of adrenaline. This lowers blood pressure by decreasing your heart rate and the force of each beat. Examples include atenolol, metoprolol, and propranolol.
- Calcium channel blockers: This class relaxes the blood vessels and decreases the heart rate. Possible side effects include heart palpitations, ankle swelling, constipation, headaches, and dizziness. Examples include amlodipine and felodipine.
- Central agonists: This class reduces the heart rate and relaxes the blood vessels by affecting certain nerve signals from the brain. Common side effects include dry mouth, constipation, and drowsiness. Examples include clonidine and guanfacine.
- Diuretics: These drugs work by increasing the amount of fluid the body eliminates through urination. Many people call diuretics “water pills.” By reducing your body’s volume of blood, the pressure inside the arteries decreases. Some common side effects of diuretics include increased urination, thirst, dizziness, and sensitivity to sunlight. Examples include furosemide and hydrochlorothiazide.
The following sections answer some frequently asked questions about the treatment of high blood pressure.
Which blood pressure medication is first-line therapy?
There are several classes of drugs that are first-line therapy for high blood pressure. These include thiazide diuretics, such as hydrochlorothiazide, ACE inhibitors, angiotensin II receptor blockers, and calcium channel blockers.
How do doctors decide on the best blood pressure medication?
When choosing from these classes, your doctor will consider many factors, including your other health conditions and your race.
For example, African American people seem to benefit most from starting treatment with a thiazide diuretic or a calcium channel blocker, studies suggest. However, someone with diabetes may benefit more from using an ACE inhibitor.
What is the target blood pressure when you start taking medication?
In general, the goal of taking high blood pressure medication is to lower your blood pressure to less than 130/80 mm Hg. Your doctor may adjust this goal depending on your age and other medical conditions.
How do doctors know if the high blood pressure medication is working?
After starting treatment, your doctor will regularly monitor your blood pressure. It may be necessary for them to adjust the dosage, change drugs, or add a second drug to control your blood pressure.
What are the most common side effects of high blood pressure medications?
Some classes have very specific side effects. For example, diuretics can increase urination, while ACE inhibitors can cause a dry cough.
If you notice any new or unusual symptoms after starting a new medication, contact your doctor.
There are many options available for treating high blood pressure. If you are experiencing side effects or are otherwise unhappy with your current medication, talk with your doctor. It may be possible to try a different drug and get better results.
Adopting healthy lifestyle habits can also help lower blood pressure. For example, doctors tend to prescribe regular physical activity and a low salt diet to complement the effect of your blood pressure medication.