High Blood Pressure Drugs and How They Work

For most people, medication is a major part of the plan to lower their blood pressure. These drugs, also called "anti-hypertensive" medicine, won't cure high blood pressure. But they can help bring it back down to a normal range.

Which medicine you should take depends on things like:

  • How high your blood pressure is
  • What's causing it
  • How your body responds to the drugs
  • Other health problems you have

Many people need more than one type of medication to control their high blood pressure. It may take some time working with your doctor to find the drugs and doses that work best for you.

Diuretics

These are often called "water pills." They're usually the first type of high blood pressure medicine that your doctor will try.

They help your kidneys take salt and water out of your body. Because you have less total fluid in your blood vessels, like a garden hose that's not turned on all the way, the pressure inside will be lower.

  • Amiloride (Midamor)
  • Bumetanide (Bumex)
  • Chlorthalidone (Hygroton)
  • Chlorothiazide (Diuril)
  • Furosemide (Lasix)
  • Hydrochlorothiazide or HCTZ (Esidrix, Hydrodiuril, Microzide)
  • Indapamide (Lozol)
  • Metolazone (Mykrox, Zaroxolyn)
  • Spironolactone (Aldactone)
  • Triamterene (Dyrenium)

Sometimes you can get more than one diuretic in a single pill.

  • Amiloride + hydrochlorothiazide (Moduretic)
  • Spironolactone + hydrochlorothiazide (Aldactazide)
  • Triamterene + hydrochlorothiazide (Dyazide, Maxzide)

 

Beta-Blockers

They'll slow down your heartbeat and keep your heart from squeezing hard. This makes blood go through your vessels with less force.

  • Acebutolol (Sectral)
  • Atenolol (Tenormin)
  • Betaxolol (Kerlone)
  • Bisoprolol (Zebeta)
  • Carteolol (Cartrol)
  • Metoprolol (Lopressor, Toprol XL)
  • Nadolol (Corgard)
  • Nebivolol (Bystolic)
  • Penbutolol  (Levatol)
  • Pindolol (Visken)
  • Propranolol (Inderal)
  • Solatol (Betapace)
  • Timolol (Blocadren)

 

Alpha-Blockers

These stop nerve signals before they can tell your blood vessels to tighten. Your vessels stay relaxed, giving the blood more room to move and lowering your overall blood pressure.

  • Doxazosin (Cardura)
  • Prazosin (Minipress)
  • Terazosin (Hytrin)

 

ACE Inhibitors

Angiotensin-converting enzyme inhibitors prevent your body from making a hormone that tells blood vessels to tighten. With less of this hormone in your body, your blood vessels stay more open.

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

 

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ARBs

Angiotensin II receptor blockers stop that same hormone from working. Your body makes it, but ARBs prevent the hormone from attaching to the muscles around your blood vessels, like putting chewing gum in a lock.

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

 

Direct Renin Inhibitors

These target the same process that ACE inhibitors and ARBs do, so your blood vessels don't tighten up. But they work on the enzyme renin instead. They stop it from triggering reactions before the hormone gets made.

Aliskiren (Tekturna) is a direct renin inhibitor.

Calcium Channel Blockers

They're sometimes called CCBs for short, or calcium antagonists. They don't let calcium into certain muscle cells in your heart and blood vessels, so it's harder for electrical signals to pass. Some CCBs keep blood vessels from tightening. Others slow your heart rate or make your heart ease up on how hard it squeezes to push blood.

  • Amlodipine (Norvasc)
  • Bepridil (Vasocor)
  • Diltiazem (Cardizem, Dilacor, Tiazac)
  • Felodipine (Plendil)
  • Isradipine (DynaCirc)
  • Nicardipine (Cardene)
  • Nifedipine (Adalat, Procardia)
  • Nisoldipine (Sular)
  • Verapamil (Calan, Covera, Isoptin, Verelan)

 

Central Agonists

They stop your brain from sending signals that speed up your heart rate and narrow your blood vessels. These drugs are also called central-acting agents, central adrenergic inhibitors, and central alpha agonists.

  • Clonidine (Catapres)
  • Guanabenz (Wytensin)
  • Guanfacine (Tenex)
  • Methyldopa (Aldomet)

 

Peripheral Adrenergic Blockers

They prevent signals that your brain sends from getting to your blood vessels and telling them to tighten. Doctors don't prescribe these drugs often.

  • Guanadrel (Hylorel)
  • Guanethidine (Ismelin)
  • Reserpine (Serpasil)

 

Vasodilators

These relax the muscles in your blood vessel walls. The vessels widen, and blood can flow through more easily.

  • Hydralazine (Apresoline)
  • Minoxidil (Loniten)

 

Combinations

Some medicines combine different kinds of drugs.

  • Bisoprolol + hydrocholorthiazide (Ziac), beta-blocker and diuretic
  • Carvedilol (Coreg), alpha-blocker and beta-blocker
  • Labetalol (Normodyne, Trandate), alpha-blocker and beta-blocker
  • Olmesartan + hydrocholorthiazide (Benicar), ARB and diuretic

 

WebMD Medical Reference Reviewed by James Beckerman, MD, FACC on May 02, 2017

Sources

American Academy of Family Physicians: "Blood Pressure Medicines and High Blood Pressure: Things You Can Do to Help Lower Yours."

American Heart Association: "Types of Blood Pressure Medications."

National Heart, Lung, and Blood Institute: "High Blood Pressure."

National Library of Medicine.

Mayo Clinic: "High blood pressure (hypertension): Central-acting agents."

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