What To Expect From High Blood Pressure Medication

Nearly a third of American adults — 67 million people — have high blood pressure. The condition affects people of both genders, and of all ages and ethnic groups. Though hypertension is often preventable or curable with "home remedies" such as a better diet, decreased salt intake and weight loss, a sizable portion of hypertension patients will need medication to bring their blood pressure down to safe levels. 

What can you expect from hypertension medication? In this article, we'll take a closer look types of hypertension drugs, common side effects, and when to ask your doctor to switch your medication.

The Diagnosis

A high blood pressure diagnosis is not usually given after one blood pressure reading shows that your numbers are too high. Instead, your doctor will measure your blood pressure several times during multiple appointments. High blood pressure may be caught during a routine checkup or after you make an appointment because you aren't feeling well. You may also measure your blood pressure at home and see your physician if it's on the high side. 

So, when do you have high blood pressure? A blood pressure reading shows two numbers.

• If your blood pressure is 120/80 or lower, you have a normal blood pressure. 
• A systolic blood pressure of 120 to 139 and a diastolic pressure of between 80 and 89 indicates that you have prehypertension — you need to work on getting your blood pressure down and should see a doctor. 
• A blood pressure of 140/90 or more means you have hypertension. See your doctor. 
• People with a blood pressure of 160/100 or higher have stage 2 hypertension and need to take their condition very seriously. 

Those numbers look very definite, and are indeed often used as a guide. There is more to diagnosing hypertension than measuring blood pressure alone however, and it is good to keep in mind that blood pressure naturally rises with age. Before getting a diagnosis, your doctor might look at a number of different aspects of your overall health and ask you a list of questions. 

You can expect blood tests to find out about your kidney function, your calcium, potassium and cholesterol levels. You might be weighed and will definitely be asked about your diet and lifestyle. Stress can cause hypertension, but smoking is a huge offender. Your doctor will ask you if you smoke, and if so how much. Excessive alcohol consumption can also give you high blood pressure.

See Also: Hypertension drugs: Review & Comparison

Whenever possible, your doctor will suggest a plan to help you lower your blood pressure naturally. This might include helping you to give up smoking, a weight loss plan, tips about de-stressing, and the advice to reduce your salt intake. Regular exercise also benefits your blood pressure. 

Types Of Hypertension Drugs And Their Side Effects

Diuretics

Diuretics help your kidneys eliminate water and salt, thereby decreasing your overall blood volume and lowering your blood pressure. Sometimes called "water pills, diuretics are often the first thing that will be offered to you after your hypertension diagnosis. Diuretics can be offered as a stand-alone or in combination with other hypertension drugs. Chlorothiazide and Metolazone are examples of diuretics your doctor may prescribe you for high blood pressure.

Fortunately, changed urination does improve with time and users have told me that this side effect is really not too bothersome. Besides the increased urination, some users experience excessive thirst, low blood pressure upon changing positions, muscle cramps, skin rashes, increased uric acid levels, dizziness, irregular menstrual cycles and erectile problems. 

Beta Blockers

Beta blockers are another class of medication that is commonly offered to hypertension patients. They work by slowing your heart rate down and reducing the force with which the heart beats. Beta blockers additionally widen the blood vessels, making for a better blood flow. Acebutolol and Bisoprolol are some examples of beta blockers. 

Beta blockers aren't usually the first choice of medication for hypertension — you'll be offered beta blockers only if other drugs didn't work or didn't work well enough.

Possible side effects of beta blockers include fatigue, headaches, dizziness, cold hands, and digestive-system issues like diarrhea, constipation, or an upset stomach. Breathing difficulties and depression are rarer and more serious side effects. Beta blockers can also raise triglyceride levels and decrease good (HDL) cholesterol. These side effects are usually temporary, but they are the reason that folks with asthma or diabetes are also not be best candidates for beta blockers. 

If you do suffer from asthma, diabetes or both, your healthcare provider will weigh the risks and benefits of prescribing beta blockers, and monitor you more carefully if you are going to be using a beta blocker. 

ACE Inhibitors

Angiotensin-converting enzyme (ACE) inhibitors block the activity of an enzyme that narrows the blood vessels, thereby effectively widening them. Enalapril and Benazepril are two examples, and ACE inhibitors are frequently prescribed in combination with other hypertension drugs like diuretics and calcium channel blockers. 

If you do get side effects, they are likely to include a dry cough, fatigue, headaches, skin rashes and increased potassium levels. An irregular and rapid heart beat is one of the less desirable side effects of this class of medication, and you should let your doctor know if you experience changes in your heart rate. 

One important thing users should know about ACE inhibitors is that they cannot be combined with nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. This increases the patient's risk of experiencing side effects. 

Calcium Channel Blockers

Calcium channel blockers are also called calcium antagonists. As the name suggests, these drugs stop calcium from going into the heart and blood vessels walls and thus widening blood vessels. Some calcium channel blockers additionally slow your heart rate, like beta blockers. Examples are Felodipine and Isradipine.

See Also: How Is High Blood Pressure Treated?

While beta blockers are less effective for black and older people, calcium channel blockers tend to be a great option for these two groups — alone, or in combination with other drugs. Side effects may include constipation, headache, dizziness, nausea, swelling in the legs and feet, and a rapid heart beat. 

Less Common Hypertension Drugs And When To Switch

We've now covered the most common types of hypertension drugs. Your doctor will generally prescribe a drug from one or more of the above categories, but there are other types. These may be used in specific conditions, including if more common types of medication do not work for you. 

Here is a brief overview of less common hypertension drugs:

• Renin inhibitors slow the production of a kidney enzyme that triggers a range of actions that lead to high blood pressure. They cannot be taken with some other types of hypertension medication. 
• Angiotensin II receptor blockers stop the action of an enzyme that narrows the blood vessels. 
• Alpha blockers reduce nerve impulses to the blood vessels, in turn preventing the narrowing of the blood vessels and improving blood flow. 
• Alpha-beta blockers reduce nerve impulses and slow the heart beat. 
• Central-acting agents act on the brain — preventing signals that increase your heart beat and narrow your blood vessels. 
• Vasodilators work on the muscular wall of the arteries, preventing tightening and increasing blood flow. 

A Surgical Method

Some types of high blood pressure are hard to treat, and do not respond to medication. That sounds like bad news, but University of Bristol and the Bristol Heart Institute have found an alternative, surgical solution.

The procedure is carried out through through low-intensity radio frequency lesioning, and the team successfully treated high blood pressure that did not react to medication with this new method. The method is already available to the general public in some countries, and hypertension patients who do not seem to control their condition with drugs may ask their doctor about renal denervation. 

When To Switch 

Hypertension medication should always be used alongside the lifestyle changes that your doctor recommends. Many patients take two or three different drugs from different classes to keep their high blood pressure under control. If one hypertension drug is not lowering your blood pressure significantly or at all, doctors will usually add another medication to the existing regime rather than simply switching from one drug to another. Your dosage may also be increased. 

Persistent invasive side effects — which do not improve or subside with time — are a reason to ask your doctor to switch to another drug. You may be encouraged to see if side effects will improve if you are dealing with less serious symptoms, like headaches or fatigue. More serious side effects like breathing difficulties or an abnormal heart rhythm warrant more immediate action. 

See Also: Do Natural Hypertension Treatments Work?

Always discuss the circumstances under which you should seek immediate medical care with your doctor, the moment you are prescribed hypertension drugs.