Side Effects
Possibly the most important factor that physicians consider when prescribing high blood pressure medication is the potential side effects. There are many different kinds of blood pressure-lowering medications and each has its own side effects. For example, many diuretics (which reduce the liquid blood volume) cause patients to urinate more frequently and develop muscle cramps resulting from potassium loss. Beta blockers can cause insomnia, slowed heart rate and cold hands and feet. Other medications (such as ACE inhibitors) can cause patients to develop a dry cough. The severity of these side effects varies from patient to patient, and so physicians may have to try different medications to see which ones produce minimal side effects.
Effectiveness
Different kinds of high blood pressure medications work using different mechanisms. Diuretics, for example, cause the body to expel more liquid through urination, which lowers blood pressure by reducing the blood's volume. Other medications work by causing the blood vessels to relax or inhibit signals that cause the blood vessels to narrow. Because each one works differently doctors often prescribe more than one medications to enhance their effect. For example, ACE inhibitors and beta blockers are more effective when paired with a diuretic. Different combinations may be tried until the blood pressure is lowered to an acceptable level.
Other Medical Conditions
Another factor that doctors consider when choosing high blood pressure medication is the patient's other health problems. Patients with diabetes often have elevated blood glucose levels if they take diuretics. Patients with asthma may have their condition exacerbated by beta blockers. On the other hand, patients with kidney problems often benefit from taking ACE inhibitors or angiotensin II receptor blockers, because they act on the kidneys and can help prevent further damage. In addition, many high blood pressure medications should not be taken by women who are or trying to become pregnant.
