Hypertension/High Blood Pressure Health Center

Key points

• Make your medicine schedule as simple as you can. Take your medicines when you are doing other things, like eating a meal or getting ready for bed. This will make it easier for you to remember to take them.
• Take a list of your medicines-or bring your medicines with you-when you visit your doctor. Include any medicines that were prescribed by other doctors and all your nonprescription medicines. Review the list with your doctor, and discuss any side effects you are having or need to watch for.
• Talk with your doctor if you are having problems with your medicine schedule. Your doctor may be able to change your medicines or change the times you take them.
• Talk with your doctor if you have any changes in your health that might affect your blood pressure, such as weight gain, side effects of medicines, or another medical problem.
• Consider daily or weekly pill containers. These can help you remember which medicines to take and when to take them.
• Follow healthy lifestyle habits. These include staying at a healthy weight, exercising, not smoking, and following a healthy eating plan. If you do these things, your doctor may be able to reduce the amount of medicine you take. And the medicines may work better.

Medicines help lower blood pressure. When blood pressure is high, it starts to damage the blood vessels, heart, and kidneys. This can lead to heart attack, stroke, kidney disease, and other problems.

When you have high blood pressure, you don't usually feel sick. It can be hard to think about taking your pills when you don't feel sick. But taking them exactly as directed helps lower your risk for more serious problems.

Medicines control-but don't cure-most cases of high blood pressure. So you will need to take them for the rest of your life. Many people need to take more than one kind of pill to control their blood pressure. The types of blood pressure medicines include:

• Diuretics . These pills cause the kidneys to remove more sodium and water from the body. As a result, there is less blood circulating through the body. And that lowers blood pressure, especially systolic blood pressure. Diuretics are often combined with other blood pressure medicines.
• ACE inhibitors . These drugs block an enzyme needed to form a substance that causes blood vessels to narrow. As a result, blood vessels relax and widen. This makes it easier for blood to flow through the vessels, which reduces blood pressure. Also, these drugs increase the release of water and sodium to the urine, which also lowers blood pressure.
• ARBs . These block the action of a hormone that causes blood vessels to narrow. These drugs also increase the release of sodium and water into the urine.
• Beta-blockers . These pills lower the heart rate, the amount of blood the heart pumps out with each beat, and the force of the heartbeat, all of which lower blood pressure.
• Calcium channel blockers . These work by reducing the amount of narrowing of the blood vessels caused by high blood pressure. This makes it easier for blood to flow through the vessels and lowers blood pressure.
• Other medicines including alpha-blockers and vasodilators. These work by opening up the blood vessels. This makes it easier for blood to flow and lowers blood pressure.
• Direct renin inhibitors . These block the enzyme renin from starting a process that helps regulate blood pressure. As a result, blood vessels relax and widen.

If you don't take your medicines properly, your blood pressure may not be controlled. This can lead to:

• Heart attack.
• Stroke.
• Kidney disease.
• Eye damage (retinopathy).
• Peripheral arterial disease.

It can take some time to find the right combination of medicines with the fewest side effects. Take your medicines exactly as your doctor tells you to. And don't be surprised if your doctor decides to change your medicines. Just keep following his or her directions.

Some medicines should not be combined with other prescription or nonprescription medicines. Make sure your doctor knows all of the medicines you are taking.

Medicines work really well to control high blood pressure in most people. But they won't work if you don't take them as directed. Here's how you can get started on taking your medicines properly.

Get organized

It may not be too hard for most people to remember to take just one pill a day. But if you start adding more pills-pills that you need to take at different times and in different doses-it can get confusing.

A key to taking your medicines properly is to stay organized:

• Make a list. Make a written or typed list of every medicine you take, including things like aspirin and vitamins. Keep it up to date. Take a copy with you every time you go to the doctor. Use this form(What is a PDF document?), or make up your own. Include space to write down any side effects you have.
• Make a schedule. Make a written or typed daily schedule of when you should take each of your medicines. Put it where you can easily see it every day-on the door of your medicine cabinet, for example. Use this daily planner(What is a PDF document?), or make up your own. Take it along when you travel.
• Use a pillbox. Pillboxes can really help you keep track of your pills. Some hold a week's worth, with separate compartments for morning, noon, evening, and bedtime.
• Use alarms. Set your computer, wristwatch, or cell phone to beep when it's time to take your pills.
• Simplify. Ask your doctor if you can make your pill schedule simpler. For example, maybe you could take one longer-acting pill every day instead of several shorter-acting ones.
• Control costs. Compare prices between several drugstores, and consider mail-order drugstores. Ask your doctor if there is a generic brand you can take to save money.

Become an expert

The more you know about your medicines, the easier it will be to stay on your schedule and take your pills properly.

• Know your medicines. Have your doctor clearly explain what each medicine does. Write down both the brand and generic names. Have your doctor check the list. You can use this list to verify that the medicines you get from the pharmacy are correct.
• Store medicines properly. Your doctor or pharmacist can tell you how to store your medicines. Don't let your medicines get too hot or too cold. Always store them out of the reach of children.
• Watch for side effects. Ask your doctor or pharmacist about what side effects to expect. Write them down if you don't think you'll be able to remember them. Be sure to tell your doctor if you have side effects.
• Have a plan for missed doses. Talk with your doctor about what you should do if you accidentally miss a dose of a medicine. Discuss what to do for each medicine, because it may be different for each one. Write it down.
• Talk to your doctor before you start taking other medicines. Many medicines can keep blood pressure medicines from working right. This will raise your blood pressure. Medicines that could cause a problem include:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (for example, Advil or Motrin), indomethacin (Indocin), ketoprofen, naproxen (for example, Aleve or Naprosyn), and piroxicam (Feldene).
  • Decongestants, such as pseudoephedrine (for example, Sudafed).
  • Herbal or homeopathic remedies.

For more information, see:

• Taking Medicines as Prescribed
• Dealing With Medicine Side Effects and Interactions

Now that you have read the information on taking your medicines properly for high blood pressure, you are ready to create your system for taking your medicines properly.

Talk with your doctor

If you have questions about this information, print it out and take it with you when you visit your doctor. You may want to use a highlighter to mark areas or make notes in the margins of the pages where you have questions.

If you don't have a medicine plan already, schedule a time with your doctor to create one.

Organization