Hypertension Treatment Options

Dr Kathryn Basford

Medically reviewed by

Dr Kathryn Basford

Last reviewed: 10 Jun 2019

Types of drugs for high blood pressure

Man with his arm strapped to a monitor that shows high blood pressure is in need of treatment for hypertension

Key takeaways

  • There are two ways to reduce blood pressure: lifestyle changes and medications

  • There are over 100 different medications prescribed to treat high blood pressure

  • It is important to speak to your doctor to find the best suited prescription medication for you

  • If you have been diagnosed with high blood pressure, you can start your online consultation now and obtain your repeat prescription from one of our GMC-registered doctors

Different causes of high blood pressure need different treatments. This can involve different medications, different dosages, and lifestyle changes.

If you’ve been diagnosed with high blood pressure your doctor will tell you about the treatment you need. It’s important that you work with your doctor to control your blood pressure, because this will prevent long-term effects such as heart disease.

If you’ve been diagnosed with high blood pressure, you can start your online consultation now and obtain your repeat prescription from one of our GMC-registered doctors. This service is for patients who’ve been taking the same high blood pressure medication for at least 3 months.

How to treat hypertension - medications and lifestyle changes

There are two ways to reduce blood pressure:

Firstly, making some lifestyle changes:

  • Eat healthily, including less salt, less caffeine, and less alcohol
  • Quit smoking
  • Lose weight, if you’re overweight
  • Exercise more regularly

And secondly, using medications to control blood pressure and maintain it at a safe level. Medications do not cure the disease, though.

Medical treatments for hypertension give effective protection against stroke, heart attack, and other cardiovascular conditions. But to treat hypertension properly, you’ll also need to make some lifestyle changes that will help make you healthier in general.

Prescription hypertension medications

There are currently over 100 different drugs that are prescribed to treat high blood pressure. Which medication is best for you depends on a variety of factors such as your age, your ethnicity (Afro-Caribbeans and South Asians seem more at risk), pre-existing conditions and any other ongoing treatment. Some people might find that certain medications cause side effects for them.

That’s why a visit to your doctor is essential, not only to properly diagnose high blood pressure, but also to increase your chances of quickly finding the right medication. It’s not uncommon for patients to try one or two different drugs before finding the right one.

Many people also need a combination of two or more different treatments for hypertension in order to reach their target blood pressure level. However, even if you don’t reach your target level right away, do not worry. Any reduction in blood pressure will be beneficial to your body.

Many people also need a combination of two or more different treatments to reach their target blood pressure level.

The following medications are commonly prescribed to treat hypertension. More than one of these are sometimes used at the same time:

  • ACE inhibitors (ACE stands for angiotensin-converting enzyme)
  • ARBs (Angiotensin II receptor blockers)
  • CCBs (Calcium channel blockers)
  • Diuretics
  • Beta blockers
  • Alpha blockers

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ACE (angiotensin-converting enzyme) inhibitors

ACE inhibitors are the most commonly used first line blood pressure treatments. ACE is the name for enzymes in your body that cause your arteries to narrow. ACE inhibitors work by limiting how much these enzymes can do.

They’re particularly helpful for people who have heart failure, diabetes, and chronic kidney disease. When you take these medications, and before starting, your doctor will make sure you have blood tests monitored because of possible effects on the kidneys.

It’s important that you stay up to date with any blood tests that your doctor recommends.

Angiotensin II receptor blockers (ARBs)

Angiotensin II receptor blockers work in a similar way to ACE inhibitors, but they work on a different molecule. They are often used for people who get side effects with the ACE inhibitors.

Medications such as Losartan and Valsartan (Diovan®) are the most common forms of Angiotensin II Receptor Blockers.

Calcium channel blockers (CCBs)

Calcium channel blockers are often recommended when other treatments have failed, however they are also the first line treatment for patients over the age of 55 and for black African Caribbean patients Studies have shown that these treatments work better in these populations.

By controlling how much calcium is absorbed into the muscles, this medication causes your arteries to relax and your heart to pump with less strength. The overall result is a lower blood pressure.

The most common calcium channel blockers are amlodipine, verapamil, and diltiazem.

Diuretics (also known as water pills)

Diuretics are one of the oldest treatments for hypertension. Today, water pills are commonly used to complement other treatments for hypertension when a single drug isn’t effective enough. They are often combined with ACE inhibitors or calcium channel blockers.

Diuretics work by helping your body to get rid of more water and salt when you urinate. This helps to lower your blood pressure by lowering the amount of blood which circulates your body.

Thiazides are the most commonly-prescribed type of diuretics in the UK. They include indapamide and hydrochlorothiazide.

There are also other types of diuretics, like furosemide and spironolactone.

Alpha blockers

Alpha blockers work by blocking alpha receptors that are on muscles around blood vessels (e.g. arteries). This relaxes the blood vessels, helping to bring blood pressure down.

Doxazosin is a commonly used alpha-blocker. It’s are usually used together with ACE-inhibitors or other blood pressure treatments, if your blood pressure is not well controlled.

Beta blockers

Beta blockers cause the heart to pump blood at a slower pace and beat less hard, which means blood pressure gets lower. Beta blockers are often prescribed for angina but are not recommended for people who suffer from asthma or certain lung diseases, as well as certain cardiovascular conditions.

Beta blockers do not always work for everyone but can work very well in combination with other drugs for high blood pressure.

Combination treatments for hypertension

For about 50% of patients, taking only one medication for hypertension is enough to reduce their blood pressure to the target level. This means that the other 50% are only able to reach their target level by using two or more drugs for high blood pressure.

In about 30% of cases, at least three medicines are needed to substantially reduce blood pressure. Yet, even if you don’t reach your target level immediately, keep in mind that any reduction in your blood pressure means an improvement.

Your doctor will closely watch your blood pressure on the different treatments until you’re within the target range. It’s also important to think about lifestyle changes that you can make alongside your medications, to try to help bring your blood pressure down.

Side effects of treatments for hypertension

As you’ve seen, there are many factors that help your doctor decide between different treatments for hypertension. Your age, current treatments and pre-existing conditions can all have an impact on the medication you’re taking and its side effects.

Common side effects of treatments for hypertension are:

  • ACE Inhibitors can cause a persistent cough (1 in 10 patients), which is the main reason why people wish to change treatment
  • Angiotensin II Receptor Blockers can cause light-headedness
  • Beta-blockers sometimes cause fatigue, depression, insomnia and impotence
  • Calcium Channel Blockers also cause dizziness because of hypotension, along with possible heart failure and some mild discomforts such as flushing and constipation

Diuretics increase the risk of gout attacks (inflammatory arthritis – usually joints and tendons), although not at low dose. They also increase blood sugar and cholesterol. There is a risk of occasional impotence too

If the side-effects of these treatments for hypertension sound rather daunting, you must remember that these medications help treat very severe conditions such as cardiovascular disease as well as kidney problems.

Medically reviewed by:
Dr Kathryn Basford

Dr Kathryn Basford is a qualified GP who works as a GP in London, as well as with ZAVA. She graduated from the University of Manchester and completed her GP training through Whipps Cross Hospital in London.

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Last reviewed: 10 Jun 2019

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