Table of ContentsView AllTable of ContentsCommonly Used DrugsTypes of DrugsDrug CombinationsWhen Medication Is Needed
Table of ContentsView All
View All
Table of Contents
Commonly Used Drugs
Types of Drugs
Drug Combinations
When Medication Is Needed
Here’s a list of blood pressure medications prescribed to lower high blood pressure (hypertension). No single drug works the same or “best” for everyone.
The wide range of high blood pressure medications to choose from also means that, as long as you and your healthcare provider are patient and persistent, it is highly likely you’ll find an effective and well-toleratedtreatment regimen.
This article discusses different types of blood pressure medications, their side effects, and when they’re prescribed.
Verywell / JR Bee
Common Blood Pressure Medications
While there are many different types of medications for hypertension, there are four major categories of drugs that are frequently prescribed:
Sometimes combination therapy (more than one medication) is needed.
Combination therapy would involve taking two antihypertensive medications, each from a different drug category.
Generally speaking, drugs from each of these classes tend to work equally well in controlling hypertension.
That said, individuals may respond quite differently.
Healthcare providers have no way of predicting this ahead of time, so patients must settle for an educated trial-and-error approach.
For example, individuals with hypertension who also have diabetes or chronic kidney disease withalbuminuria(when a person’s urine contains high levels of the protein albumin) are generally prescribed an ACE inhibitor or an ARB (if an ACE inhibitor is not tolerated).
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Classes of Blood Pressure Medications
Listing every high blood pressure medication here is impossible, but the following list provides a comprehensive overview of available options.
Diuretics
Thiazide diuretics
Potassium-sparing diuretics
Loop diuretics
Carbonic anhydrase inhibitors
Aldosterone receptor antagonists
Possible side effects of diuretics include:
Angiotensin-Converting Enzyme (ACE) Inhibitors
Popular ACE inhibitors include:
Side effects may include:
Angiotensin II Receptor Blockers (ARBs)
ARBs are generally superior to ACE inhibitors due to better efficacy and fewer adverse effects.
Options include:
Beta-Blockers
Beta-blockersare no longer considered a first-line, single-drug therapy for hypertension unless a patient has ischemic heart disease, heart failure, orarrhythmias.
These drugs block the effect of adrenaline on the cardiovascular system, slow the heart rate, and reduce stress on the heart and the arteries.
Some beta-blockers include:
Combined Alpha and Beta-BlockersIn addition to blocking beta receptors,combined alpha and beta-blockerscan also block alpha receptors. These medications can further lower blood pressure and heart rate.Examples of combined alpha and beta-blockers include:Coreg (carvedilol)Normodyne, also sold as Trandate (labetalol)
Combined Alpha and Beta-Blockers
In addition to blocking beta receptors,combined alpha and beta-blockerscan also block alpha receptors. These medications can further lower blood pressure and heart rate.Examples of combined alpha and beta-blockers include:Coreg (carvedilol)Normodyne, also sold as Trandate (labetalol)
In addition to blocking beta receptors,combined alpha and beta-blockerscan also block alpha receptors. These medications can further lower blood pressure and heart rate.
Examples of combined alpha and beta-blockers include:
Calcium Channel Blockers
Examples of calcium channel blockers include:
Alpha blockers
Examples of alpha-blockers include:
Side effects include:
Vasodilators
Vasodilators help relax the muscle tone of the vascular walls, allowing the vessels to widen so that blood can flow through better.
Examples of vasodilators include:
Alpha-2-receptor agonists
These drugs stimulate alpha-2 adrenergic receptors in the central nervous system, which decreases sympathetic nervous system activity.
This causes a drop in blood pressure and heart rate.
Examples of alpha-2-receptor agonists include:
Direct renin inhibitors
Aliskiren is the only direct renin inhibitor available.
Combination Drugs for Hypertension
Research has found that combining blood pressure medications has a significantly more significant effect (about five times greater) on lowering a person’s blood pressure than simply doubling the dose of a single medication.
The best scientific evidence (from the ACCOMPLISH trial) suggests that clinical outcomes (including the risk of stroke,heart attack, and cardiovascular death) are most improved with combination therapy when a long-acting calcium channel blocker is used with an ACE inhibitor or an ARB.
Thus, most healthcare providers will try this combination first.
That said, there are many single-pill combinations (single tablets that contain two or more medications). They include:
Suppose the blood pressure remains elevated with combination therapy using a calcium channel blocker plus an ACE inhibitor or ARB drug.
In that case, a thiazide drug will usually be added as a third drug.
If this combination fails to control the blood pressure, a fourth drug (usually spironolactone, a non-thiazide diuretic) may be added.
When Are Blood Pressure Medications Prescribed?
The American College of Cardiology and the American Heart Association define and stage hypertension as follows:
Blood pressure (BP) is measured in millimeters of mercury (mmHg).
Blood Pressure ClassificationSystolicDiastolicNormalLess than 120 mmHgLess than 80 mmHgElevated120 to 129 mmHgLess than 80 mmHgHypertension stage 1130 to 139 mmHgBetween 80 to 89 mmHgHypertension stage 2At least 140 mmHgAt least 90 mmHg*Classification only requires one of the listed criteria to be present.If there is a difference between the systolic pressure (top number) and diastolic blood pressure (bottom number), the higher one determines the stage.Understanding Systolic and Diastolic Blood PressureMost treatment goals involve achieving blood pressure less than 120/80 mmHg.The first step to treating high blood pressure involves making lifestyle changes that have been shown to reduce blood pressure.This includes eating aheart-healthy diet, losing weight (if needed), exercising regularly, etc.These changes may be done alone, or they may be used in combination with one or more high-blood pressure medications.The initiation of a single antihypertensive medication is reasonable in adults with stage 1 hypertension and a BP goal of <130/80 mmHg.However, if you have stage 2 hypertension and your average blood pressure is more than 20 mmHg above goal, your healthcare provider may recommend combination drug therapy.Deciding whether or not to start medication for your high blood pressure requires a discussion with your healthcare provider. In some cases, the decision is clear-cut.For example, medication is strongly advised if a patient has hypertension and another medical condition, like type 2 diabetes mellitus.SummaryStandard classes of hypertension drugs include diuretics, ACE inhibitors, ARBs, calcium channel blockers, and beta-blockers.With so many treatment options, you should expect your healthcare provider to find a therapeutic regimen that will significantly decrease your risk of a bad outcome from hypertension—without disrupting your everyday life.However, any of the drugs used to treat hypertension have the potential to cause side effects. If you are experiencing any troublesome side effects, talk to your practitioner about finding a treatment regimen you can tolerate better.
If there is a difference between the systolic pressure (top number) and diastolic blood pressure (bottom number), the higher one determines the stage.
Understanding Systolic and Diastolic Blood Pressure
Most treatment goals involve achieving blood pressure less than 120/80 mmHg.
The first step to treating high blood pressure involves making lifestyle changes that have been shown to reduce blood pressure.
This includes eating aheart-healthy diet, losing weight (if needed), exercising regularly, etc.
These changes may be done alone, or they may be used in combination with one or more high-blood pressure medications.
The initiation of a single antihypertensive medication is reasonable in adults with stage 1 hypertension and a BP goal of <130/80 mmHg.However, if you have stage 2 hypertension and your average blood pressure is more than 20 mmHg above goal, your healthcare provider may recommend combination drug therapy.
The initiation of a single antihypertensive medication is reasonable in adults with stage 1 hypertension and a BP goal of <130/80 mmHg.
However, if you have stage 2 hypertension and your average blood pressure is more than 20 mmHg above goal, your healthcare provider may recommend combination drug therapy.
Deciding whether or not to start medication for your high blood pressure requires a discussion with your healthcare provider. In some cases, the decision is clear-cut.
For example, medication is strongly advised if a patient has hypertension and another medical condition, like type 2 diabetes mellitus.
Summary
Standard classes of hypertension drugs include diuretics, ACE inhibitors, ARBs, calcium channel blockers, and beta-blockers.
With so many treatment options, you should expect your healthcare provider to find a therapeutic regimen that will significantly decrease your risk of a bad outcome from hypertension—without disrupting your everyday life.
However, any of the drugs used to treat hypertension have the potential to cause side effects. If you are experiencing any troublesome side effects, talk to your practitioner about finding a treatment regimen you can tolerate better.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Mann JFE, Flack JM.Choice of drug therapy in primary (essential) hypertension. UpToDate.American Heart Association.Types of blood pressure medications.Lin Z, Wong LYF, Cheung BMY.Diuretic-induced hypokalaemia: An updated review.Postgraduate Medical Journal. 2022;98(1160):477-482. doi:10.1136/postgradmedj-2020-139701National Kidney Foundation.Angiotensin-converting enzyme (ACE) inhibitors & angiotensin receptor blockers (ARBs).Mann JFE.Patient education: High blood pressure treatment in adults (Beyond the Basics). UpToDate.MedlinePlus.Aliskiren.Guerrero-García C, Rubio-Guerra F.Combination therapy in the treatment of hypertension.DIC. 2018;7:1-9. doi:10.7573/dic.212531Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNAGuideline for the Prevention, Detection, Evaluation, and management of high blood pressure in adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Circulation.2018;138(17):e426-e483. doi:10.1161/CIR.0000000000000597American Heart Association.Changes you can make to manage high blood pressure.
Mann JFE, Flack JM.Choice of drug therapy in primary (essential) hypertension. UpToDate.
American Heart Association.Types of blood pressure medications.
Lin Z, Wong LYF, Cheung BMY.Diuretic-induced hypokalaemia: An updated review.Postgraduate Medical Journal. 2022;98(1160):477-482. doi:10.1136/postgradmedj-2020-139701
National Kidney Foundation.Angiotensin-converting enzyme (ACE) inhibitors & angiotensin receptor blockers (ARBs).
Mann JFE.Patient education: High blood pressure treatment in adults (Beyond the Basics). UpToDate.
MedlinePlus.Aliskiren.
Guerrero-García C, Rubio-Guerra F.Combination therapy in the treatment of hypertension.DIC. 2018;7:1-9. doi:10.7573/dic.212531
Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNAGuideline for the Prevention, Detection, Evaluation, and management of high blood pressure in adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Circulation.2018;138(17):e426-e483. doi:10.1161/CIR.0000000000000597
American Heart Association.Changes you can make to manage high blood pressure.
Blood Pressure Lowering Treatment Trialists' Collaboration, Turnbull F, Neal B, Ninomiya T, et al.Effects of different regimens to lower blood pressure on major cardiovascular events in older and younger adults: meta-analysis of randomised trials.BMJ. 2008;336(7653):1121-3. doi:10.1136/bmj.39548.738368.BE
Mancia G, Fagard R, Narkiewicz K, et al; Task Force Members.2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC).J Hypertens. 2013;31(7):1281-357. doi:10.1097/01.hjh.0000431740.32696.cc
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