Treating high blood pressure requires patience and care by both doctor and patient. It may be annoying to take pills and possibly have side effects, especially if you felt fine before treatment. Don't be discouraged if you must be treated indefinitely. Some people can reduce their drug dosages after achieving normal blood pressure and maintaining it for a year or more. (You usually can't stop treatment entirely.) Coping with the inconvenience of medication is still much better than suffering a stroke or heart attack. An appropriate diet and regular physical activity are important as part of the treatment, and for people with mild high blood pressure these could be enough to control blood pressure without medication.

*Some of the major types of commonly prescribed cardiovascular medications are summarized in this section. For your information and reference, we have included generic names as well as major trade names to help you identify what you may be taking; however, the AHA is not recommending or endorsing any specific products.  If your prescription medication isn't on this list, remember that your healthcare provider and pharmacist are your best sources of information.  It's important to discuss all of the drugs you take with your doctor and understand their desired effects and possible side effects.  Never stop taking a medication and never change your dose or frequency without first consulting your doctor.

Types of high blood pressure medications
Angiotensin-Converting Enzyme (ACE) Inhibitors
Diuretics
Beta Blockers
Angiotensin-2 Receptor Antagonists
Calcium Channel Blockers


Angiotensin-Converting Enzyme (ACE) Inhibitors
These are often preferred by healthcare providers for people with diabetes, because the medication has fewer side effects, does not affect blood sugar levels and provides additional kidney protection. ACE inhibitors expand blood vessels and decrease resistance, which lets blood flow more easily and makes the heart's work easier or more efficient. ACE inhibitors are used to treat symptoms of heart failure and to lower blood pressure. Your healthcare provider may perform blood tests to make sure there are no effects on your potassium levels or kidneys.

Side Effects:

• Dry cough
• Rash or itching
• Allergy-like symptoms
• Allergic reaction with generalized swelling (angioedema)
• Excess potassium in the body (hyperkalemia), especially in people with kidney failure

Commonly prescribed ACE inhibitors include:

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

Diuretics
Diuretics lower blood pressure by causing the body to rid itself of excess fluids and sodium through urination. If diuretics alone don't bring the desired effects, they may be combined with other blood pressure medications. In people with diabetes, diuretic drugs may increase the blood sugar level. A change in drug, diet, insulin or oral antidiabetic dosage corrects this in most cases. Your doctor can change your treatment. Most of the time the degree of increase in blood sugar doesn't change much.

Some of these drugs may decrease your body's supply of a mineral called potassium. Eating foods containing potassium may help prevent significant potassium loss. You can prevent potassium loss by taking a liquid or tablet that has potassium along with the diuretic, if your doctor recommends it.

Side Effects:

• Fatigue
• Leg cramping
• Decreased potassium levels

Some commonly prescribed diuretics include:

• Amiloride (Midamor)*
• Bumetanide (Bumex)*
• Chlorothiazide (Diuril)*
• Chlorthalidone (Hygroton)*
• Furosemide (Lasix)*
• Hydrochlorothiazide (Esidrix, Hydrodiuril)*
• Indapamide (Lozol)*
• Spironolactone (Aldactone)*

Beta Blockers
Beta blockers decrease the heart rate and cardiac output, which lowers blood pressure. They're also used with therapy for cardiac arrhythmias and in treating angina pectoris.

For people with diabetes, beta blockers may hide some of the warning signs of low blood sugar. When you take a beta blocker, your heart rate may not increase in response to a low blood sugar level. You will need to check your blood sugar levels carefully after you start taking a beta blocker. If you have low blood sugar often, your doctor may want to change the dosages of your diabetes medicine.

Side effects:

• Insomnia
• Cold hands and feet
• Fatigue
• Depression
• Slow heartbeat
• Symptoms of asthma

Some commonly prescribed medications include:

• Atenolol (Tenormin)*
• Betaxolol (Kerlone)*
• Bisoprolol/hydrochlorothiazide (Ziac)*
• Bisoprolol (Zebeta)*
• Carteolol (Cartrol)*
• InsoAcebutolol (Sectral)*
• Metoprolol (Lopressor, Toprol XL)*
• Nadolol (Corgard)*
• Propranolol (Inderal)*
• Sotalol (Betapace)*
• Timolol (Blocadren)*

Angiotensin-2 Receptor Antagonists
Angiotensin-2 (AT-2) receptor antagonists have been shown to produce effects similar to those produced by ACE inhibitors. They may be better tolerated because they produce less cough. Rather than lowering levels of angiotensin II (as ACE inhibitors do), angiotensin II receptor blockers prevent this chemical from having any effects on the heart and blood vessels. This keeps blood pressure from rising.

For people with diabetes, this medication is often preferred because of the extra protection for the kidneys.

Side effects:

• Dizziness/Lightheadedness
• Decreased kidney function
• Increased potassium levels

Some common products in this category include:

• Candesartan (Atacand)*
• Eprosartan (Teveten)*
• Irbesartan (Avapro)*
• Losartan (Cozaar)*
• Telmisartan (Micardis)*
• Valsartan (Diovan)*

Calcium Channel Blockers
Calcium channel blockers, also known as "calcium antagonists," interrupt the movement of calcium into heart and vessel cells. Besides being used to treat high blood pressure, they're also used to treat angina (chest pain) and/or some arrhythmias (abnormal heart rhythms).

Side effects:

• Constipation
• Headache
• Rapid heartbeat
• Rash
• Drowsiness
• Nausea
• Swelling in the feet and legs

Some commonly prescribed calcium channel blockers include:

• Amlodipine (Norvasc, Lotrel)*
• Bepridil (Vascor)*
• Diltiazem (Cardizem, Tiazac)*
• Felodipine (Plendil)*
• Nifedipine (Adalat, Procardia)*
• Nimodipine (Nimotop)*
• Nisoldipine (Sular)*
• Verapamil (Calan, Isoptin, Verelan)*

This content is reviewed regularly. Last updated 10/22/09.