Types of Blood Pressure Medications

Updated:Aug 14,2014

Types Of Blood Pressure Medication Graphic Text

Many medications known as antihypertensives are available by prescription to lower high blood pressure. There are a variety of classes of HBP medications, and they include a number of different drugs.

Discuss Medication With Your Doctor Graphic Text

* 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.

The classes of blood pressure medications include:

Diuretics

 
Diuretics help the body get rid of excess sodium (salt) and water and help control blood pressure. They are often used in combination with additional prescription therapies.

 
 Generic nameCommon brand names 
 chlorthalidoneHygroton* 
 chlorothiazideDiuril* 
 furosemideLasix* 
 hydrochlorothiazideEsidrix*, Hydrodiuril*, Microzide* 
 indapamideLozol* 
 metolazoneMykrox*, Zaroxolyn* 
    
 Potassium-sparing diuretics 
 amiloride hydrochlorideMidamar* 
 spironolactoneAldactone* 
 triamtereneDyrenium* 
    
 Loop diuretic 
 bumetanideBumex* 
    
 Combination diuretics 
 amiloride hydrochloride + hydrochlorothiazideModuretic* 
 spironolactone + hydrochlorothiazideAldactazide* 
 triamterene + hydrochlorothiazideDyazide*, Maxzide* 
    
 

Some noted possible side effects from diuretics:
 


  • Some of these drugs may decrease your body's supply of the mineral potassium. Symptoms such as weakness, leg cramps or being tired may result. Eating foods containing potassium may help prevent significant potassium loss. If your doctor recommends it, you could prevent potassium loss by taking a liquid or tablet that has potassium along with the diuretic. Diuretics such as amiloride (Midamar)*, spironolactone (Aldactone)* or triamterene (Dyrenium)* are called "potassium sparing" agents. They don't cause the body to lose potassium. They might be prescribed alone, but are usually used with another diuretic. Some of these combinations are Aldactazide*, Dyazide*, Maxzide* or Moduretic*.
  • Some people suffer from attacks of gout after prolonged treatment with diuretics. This side effect isn't common and can be managed by other treatment.
  • People with diabetes may find that diuretic drugs increase their blood sugar level. A change in medication, diet, insulin or oral anti-diabetic dosage corrects this in most cases.
  • Impotence may occur.
 

Beta-blockers

 
Beta-blockers reduce the heart rate, the heart's workload and the heart's output of blood, which lowers blood pressure.
 
 
 Generic nameCommon brand names 
 acebutololSectral* 
 atenololTenormin* 
 betaxololKerlone* 
 bisoprolol fumarateZebeta* 
 carteolol hydrochlorideCartrol* 
 metoprolol tartrateLopressor* 
 metoprolol succinateToprol-XL* 
 nadololCorgard* 
 penbutolol sulfateLevatol* 
 pindolol*Visken* 
 propranolol hydrochloride*Inderal* 
 solotol hydrochlorideBetapace* 
 timolol maleate*Blocadren* 
    
 Combination beta-blocker/ diuretic  
 hydrochlorothiazide and bisoprololZiac* 
    
 Some noted possible side effects of beta-blockers:

  • Insomnia
  • Cold hands and feet
  • Tiredness or depression
  • Slow heartbeat
  • Symptoms of asthma
  • Impotence may also occur
  • If you have diabetes and you're taking insulin, have your responses to therapy monitored closely.
  • If you have been prescribed beta-blockers, consult your healthcare provider prior to conception if you are considering pregnancy or if there is a chance you could become pregnant. If you discover that you are pregnant consult your healthcare provider as soon as possible to determine the safest medication for you at this time.
 

ACE inhibitors

 
Angiotensin is a chemical that causes the arteries to become narrow, especially in the kidneys but also throughout the body. ACE stands for Angiotensin-converting enzyme. ACE inhibitors help the body produce less angiotensin, which helps the blood vessels relax and open up, which, in turn, lowers blood pressure.
 
 
 Generic nameCommon brand names 
 benazepril hydrochlorideLotensin* 
 captoprilCapoten* 
 enalapril maleateVasotec* 
 fosinopril sodiumMonopril* 
 lisinoprilPrinivel*, Zestril* 
 moexiprilUnivasc* 
 perindoprilAceon* 
 quinapril hydrochlorideAccupril* 
 ramiprilAltace* 
 trandolaprilMavik* 
    
 Some noted possible side effects of ACE inhibitors:
  • Skin rash
  • Loss of taste
  • Chronic dry, hacking cough
  • In rare instances, kidney damage
  • Women who are taking ACE inhibitors or ARBs for high blood pressure should not become pregnant while on this class of drugs. If you're taking an ACE inhibitor or an ARB and think you might be pregnant, see your doctor immediately. These drugs have been shown to be dangerous to both mother and baby during pregnancy. They can cause low blood pressure, severe kidney failure, excess potassium and even death of the newborn.
 

Angiotensin II receptor blockers

 
These drugs block the effects of angiotensin, a chemical that causes the arteries to become narrow. Angiotensin needs a receptor- like a chemical "slot" to fit into or bind with- in order to constrict the blood vessel. ARBs block the receptors so the angiotensin fails to constrict the blood vessel. This means blood vessels stay open and blood pressure is reduced.
 
 
 Generic nameCommon brand names 
 candesartanAtacand* 
 eprosartan mesylateTeveten* 
 irbesartenAvapro* 
 losartin potassiumCozaar* 
 telmisartanMicardis* 
 valsartanDiovan* 
    
 Some noted possible side effects of Angiotensin II receptor blockers:

  • May cause occasional dizziness.
  • ARBs should not be used during pregnancy. Medications that act directly on the renin-angiotensin system can cause injury or even death to a developing fetus. When pregnancy is detected, consult your healthcare professional as soon as possible.
 

Calcium channel blockers

 
This drug prevents calcium from entering the smooth muscle cells of the heart and arteries. When calcium enters these cells, it causes a stronger and harder contraction, so by decreasing the calcium, the hearts' contraction is not as forceful. Calcium channel blockers relax and open up narrowed blood vessels, reduce heart rate and lower blood pressure.  
 
 Generic nameCommon brand names 
 amlodipine besylateNorvasc*, Lotrel* 
 bepridilVasocor* 
 diltiazem hydrochlorideCardizem CD*, Cardizem SR*, Dilacor XR*, Tiazac* 
 felodipinePlendil* 
 isradipineDynaCirc*, DynaCirc CR* 
 nicardipineCardene SR* 
 nifedipineAdalat CC*, Procardia XL* 
 nisoldipineSular* 
 verapamil hydrochlorideCalan SR*, Covera HS*, Isoptin SR*, Verelan* 
    
 Some noted possible side effects of calcium channel blockers:

  • Palpitations
  • Swollen ankles
  • Constipation
  • Headache
  • Dizziness
 

Alpha blockers

 
These drugs reduce the arteries' resistance, relaxing the muscle tone of the vascular walls. 

 
 
 Generic nameCommon brand names 
 doxazosin mesylateCardura* 
 prazosin hydrochlorideMinipress* 
 terazosin hydrochlorideHytrin* 
    
 Some noted possible side effects of alpha blockers:

  • Fast heart rate
  • Dizziness
  • A drop in blood pressure when you stand up
 

Alpha-2 Receptor Agonist

 
These drugs reduce blood pressure by decreasing the activity of the sympathetic (adrenaline-producing) portion of the involuntary nervous system. Methyldopa is considered a first line antihypertensive during pregnancy because adverse effects are infrequent for the pregnant woman or the developing fetus.

 
 
 Generic nameCommon brand names 
 methyldopa  
    
 Some noted possible side effects of Alpha-2 Receptor Agonists:

  • Methyldopa can cause drowsiness or dizziness
 

Combined alpha and beta-blockers

 
Combined alpha and beta-blockers areused as an IV drip for those patients experiencing a hypertensive crisis. They may be prescribed for outpatient high blood pressure use if the patient is at risk for heart failure.

 
 Generic nameCommon brand names 
 carvedilolCoreg* 
 labetolol hydrochlorideNormodyne*, Trandate* 
   
 A noted possible side effect of combined alpha and beta-blockers:

  • May cause a drop in blood pressure when you stand up
 

Central agonists

 
Central agonists also help decrease the blood vessels' ability to tense up or contract. The central agonists follow a different nerve pathway than the alpha and beta-blockers, but accomplish the same goal of blood pressure reduction.

 
 Generic nameCommon brand names 
 alpha methyldopaAldomet* 
 clonidine hydrochlorideCatapres* 
 guanabenz acetateWytensin* 
 guanfacine hydrochlorideTenex* 
   
 Some noted possible side effects of central agonists:

  • Alpha methyldopa (Aldomet)* may produce a greater drop in blood pressure when you're in an upright position (standing or walking), and it may make you feel weak or faint if the pressure has been lowered too far. This drug may also cause drowsiness or sluggishness, dryness of the mouth, fever or anemia. Male patients may experience impotence. If this side effect persists, your doctor may have to change the drug dosage or use another medication.
  • Clonidine (Catapres)*, guanabenz (Wytensin)* or guanfacine (Tenex)* may produce severe dryness of the mouth, constipation or drowsiness. If you're taking any of these drugs, don't stop suddenly because your blood pressure may rise quickly to dangerously high levels.
 

Peripheral adrenergic inhibitors

 
These medications reduce blood pressure by blocking neurotransmitters in the brain. This blocks the smooth muscles from getting the "message" to constrict. These drugs are rarely used unless other medications don't help.

 
 Generic nameCommon brand names 
 guanadrelHylorel* 
 guanethidine monosulfateIsmelin* 
 reserpineSerpasil* 
   
 Some noted possible side effects of peripheral adrenergic inhibitors:

  • Reserpine may cause a stuffy nose, diarrhea or heartburn. These effects aren't severe, and no treatment is required other than to change the dosage. If you have nightmares or insomnia or get depressed, tell your doctor; you should stop using the drug.
  • Guanadrel (Hylorel)* or guanethidine (Ismelin)* may cause some diarrhea, which may persist in some people. This side effect usually becomes less of a problem if you continue treatment. These drugs reduce blood pressure more when you stand. Consequently, you may get dizzy and lightheaded and feel weak when you get out of bed in the morning or stand up suddenly. If you notice any of these reactions and if they persist for more than a minute or two, contact your doctor. He/she may instruct you to reduce or omit the next dose of the medication.
  • When taking guanethidine, don't stand in the hot sun or at a social gathering if you begin to feel faint or weak. These activities cause low blood pressure. Male patients may experience impotence. Contact your doctor if this occurs.
 

Blood vessel dilators (vasodilators)

 
Blood vessel dilators, or vasodilators, can cause the muscle in the walls of the blood vessels (especially the arterioles) to relax, allowing the vessel to dilate (widen). This allows blood to flow through better.

 
 Generic nameCommon brand names 
 hydralazine hydrocholorideApresoline* 
 minoxidilLoniten*† 
   
 Some noted possible side effects of vasodilators:

  • Hydralzine (Apresoline)* may cause headaches, swelling around the eyes, heart palpitations or aches and pains in the joints. Usually none of these symptoms are severe, and most will go away after a few weeks of treatment. This drug isn't usually used by itself.
  • Minoxidil (Loniten)* is a potent drug that's usually used only in resistant cases of severe high blood pressure. It may cause fluid retention (marked weight gain) or excessive hair growth.


† Used in severe cases or when kidney failure is present.

 

This content was last reviewed on 08/04/2014.

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