While high blood pressure (hypertension) may be managed through diet, exercise and other lifestyle modifications, additional treatment with blood pressure medication is sometimes necessary. All these medications work to lower hypertension; however, different medication classes achieve this by acting on the heart, blood vessels and other muscles, tissues and organs in different ways. Common blood pressure medications are listed below.
Diuretics
Diuretics (sometimes called "water pills") help regulate kidney function, prompting them to remove excess sodium from the body through urine. Diuretics are often prescribed in combination with other drugs for optimum regulation of blood pressure. Common ones include chlorothiazide, hydrochlorothiazide, furosemide, metolazone, indapamide and chlorthalidone. Potassium-sparing diuretics (those that cause the kidneys to hold in potassium to avoid excess potassium loss along with sodium) include amiloride hydrochloride, triamterene and spironolactone, while bumetanide is a commonly prescribed loop diuretic (potassium-depleting diuretic often given to those with congestive heart failure). Combination diuretics sometimes prescribed include triamterene + hydrochlorothiazide, amiloride hydrochloride + hydrochlorothiazide and spironolactone + hydrochlorothiazide.
Blood Vessel Dilators (Vasodilators)
Vasodilators relax the muscles of the blood vessel walls to directly lower blood pressure. Hydralazine hydrochloride and minoxidil are two common blood vessel dilators.
Alpha Blockers
Alpha blockers relax the muscles of blood vessel walls, causing them to open up and reduce blood pressure. Common alpha blockers include doxazosin meslyate, prazosin hydrochloride and terazosin hydrochloride.
Beta-Blockers
Beta-blockers lower blood pressure by reducing heart rate and the output of blood by the heart. Beta-blockers to treat high blood pressure include timolol maleate, betaxolol, carteolol hydrochloride, atenolol, bisoprolol fumarate, metoprolol tartrate, solotol hydrochloride, pindolol, penbutolol sulfate, nadolol, propranolol hydrochloride, metoprolol tartrate and metoprolol succinate. Hydrochlorothiazide and bisoprolol is a combination beta-blocker and diuretic.
Alpha and Beta-Blocker Combinations
Alpha-beta-blockers slow the heartbeat and reduce the amount of blood pumped through the veins. They are generally used in intravenous (IV) drip form for patients in a hypertensive emergency, or in oral form for those at risk of congestive heart failure. Carvedilol and labetolol hydrochloride are two common combinations of alpha and beta-blockers.
Calcium Channel Blockers
Calcium channel blockers lower blood pressure by decreasing calcium in the smooth muscle cells of the heart, causing the heart to pump slower and the blood vessels to open up. Bepridil, amlodipine besylate, felodipine, isradipine, nicardipine, nifedipine, nisoldipine and diltiazem hydrochloride are common calcium channel blocking medications.
ACE Inhibitors and Angiotensin II Receptor Blockers (ARBs)
Angiotensin-converting enzyme inhibitors, or ACE inhibitors, lower blood pressure by lowering the production of a chemical called angiotensin, which causes the blood vessels to narrow. Common ACE inhibitors include ramipril, quinapril hydrochloride, trandolapril, benazepril hydrochloride, enalapril maleate, lisinopril, captopril, fosinopril sodium and moexipril.
Angiotensin II Receptor Blockers (ARBs) lower blood pressure by blocking the receptors for angiotensin, giving it nowhere to bind and thus preventing it from causing blood vessels to restrict. ARBs include irbesarten, candesartan, eprosartan meslyate, valsartan, telmisartan and losartin potassium.
Central Agonists
Central agonists work to limit a blood vessel's ability to constrict, thereby lowering blood pressure. Common central agonists include alpha methyldopa, clonidine hydrochloride, guanabenz acetate and guanfacine hydrochloride.
Peripheral Adrenergic Inhibitors
Chemical messengers in the brain called neurotransmitters send signals that tell the blood vessels to constrict. Peripheral adrenergic inhibitors work to lower blood pressure by stopping these neurotransmitters from sending the signal. These drugs are less commonly prescribed and some may cause dizziness or lightheadedness upon standing or being in the sun. Some peripheral adrenergic inhibitors include guanadrel, reserpine and guanethidine monosulfate.
