Hypertension

What medications are there for hypertension?

You’ll only be offered medications to help with hypertension if your blood pressure is at such a high level that you have a particularly high risk of suffering from other problems because of it, or if your risk of developing further issues is already high. The first suggestion will always be to make lifestyle changes, such as eating less salt, stopping smoking, drinking less caffeine, cutting down alcohol and exercising more. If you are prescribed a medicine to help lower your blood pressure, you’ll still need to do these things to keep your blood pressure at a healthy level. There are five main types of treatments prescribed for hypertension.

Diuretics (chlorthalidone, hydrochlorothiazide) 

Diuretics help your kidneys remove the extra fluid and salt from your body through urine. So, if you are taking diuretics, you can expect to be urinating more often than before. By removing more water from your body through urine, the volume of blood that passes through your blood vessels (veins, arteries and capillaries) decreases as a result. This, in turn, reduces the force (pressure) that the blood applies to your vein and artery walls as it travels around your body. In other words, increased urination equals less blood which equals more space in your blood vessels for the blood to travel through. This then lowers your blood pressure.

Beta-blockers (atenolol, metoprolol) 

These medicines lower blood pressure and make the heart beat slower. They block the effects of hormones adrenaline and noradrenaline in the body which often cause heart palpitations, stress, high blood pressure and excessive sweating. 

Calcium channel blockers (amlodipine, diltiazem)

These prescription medications relax the blood vessels and improve the circulation of blood and oxygen to the heart, and this in turn helps to lower blood pressure.

Angiotensin-converting enzyme inhibitors (lisinopril, ramipril)

Commonly known as ACE inhibitors, these medicines enlarge or dilate the blood vessels so blood can pass through more easily, and this reduces blood pressure.

Angiotensin II receptor blockers (valsartan, losartan) 

Known as ARBs, these prescription drugs work as angiotensin-converting enzyme inhibitors (ACE inhibitors). They relax the blood vessels and lower blood pressure. If a clinician does think you need treatment, there are a range of options to choose from, and their suitability will depend on different factors. For instance if you're under 55 years of age then you'll usually be offered an ACE inhibitor, or an angiotensin-2 receptor blocker (ARB). Whereas if you're aged 55 or older, or of African or Caribbean descent then you'll usually be offered a calcium channel blocker.

Is there a ‘best’ treatment for hypertension?

The ‘best’ treatment for hypertension will largely depend on how high your blood pressure is and your personal health needs. If your blood pressure is not excessively high, then the best treatment will simply be to exercise more and eat healthier. If you do need treatment, then this can be a very individual thing – some people are able to control their blood pressure with just one medication along lifestyle changes, while other people may need a combination of medicines for treatment to be effective. You’ll normally have your blood pressure monitored regularly if you’re on treatment, so a clinician can suggest tweaks if needed. So really, the best treatment is the one that’s most effective for you.

Does hypertension always need treatment?

No, hypertension doesn’t always need treatment. Sometimes a few lifestyle changes can help to keep it under control. Regular exercise, maintaining a healthy weight, having a healthy diet, reducing stress, and avoiding smoking and alcohol can all lower high blood pressure. Hypertension is a very dangerous health condition and often shows no symptoms. So, never let it go untreated. Consulting a clinician and taking advice is recommended. They can examine your medical history and then suggest the right high blood pressure treatment for you.