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High Blood Pressure Medications

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High blood pressure is a cardiovascular condition that requires immediate treatment. The drugs used to treat high blood pressure are summarized in this article.

Medically reviewed byDr. Prashant Valecha
Published At October 28, 2022
Reviewed AtSeptember 4, 2024

Introduction:

High blood pressure, also known as high BP, is a cardiovascular condition that results in increased pressure on the heart to pump blood to the rest of the body. If not corrected, high blood pressure may lead to the formation and prevalence of several consequential health and cardiac issues, such as episodes of heart attack, heart failure, stroke, and kidney malfunctioning.

The early detection and management of high blood pressure are vital to prevent such health problems. Several kinds of medications have the potential to aid in the treatment of high blood pressure. These medications and drugs are referred to as antihypertensives. Antihypertensive drugs have been classified into various categories due to their different mechanisms of action as well as side effects. Since there are quite a lot of antihypertensive medications available today, finding the right fit may require multiple tests and diagnostic tools. This will eventually help the healthcare provider to suggest the most effective antihypertensive drug.

What Are the Symptoms of High Blood Pressure?

When a patient is diagnosed with high blood pressure for an extended period of time, they are known as hypertensive patients. The symptoms of high blood pressure vary between individuals; nevertheless, there are a few classic symptoms of high blood pressure that are mentioned below.

  • Headache, especially at the back of the head.

  • Restlessness.

  • Dry mouth.

  • Occasions of dehydration.

  • Palpitations.

  • Rapid eye movement.

  • Nausea.

  • Confusion.

What Are the Different Categories of Blood Pressure Medications?

Antihypertensives or high blood pressure medications are divided into several categories based on their route of action and the side effects they may have. Mentioned below are the different categories of blood pressure medications.

  • Diuretics - A diuretic is one of the most commonly prescribed antihypertensive medications used to correct high blood pressure. Diuretics work by helping the kidneys to discard excess sodium and water in the body. This drastically drops the quantity of blood that passes through the blood vessels and thus helps in dropping blood pressure. Diuretics are of three types- potassium sparing diuretics, thiazide diuretics and loop diuretics. Out of all these diuretics, thiazide is the one that has the least amount of side effects when prescribed in a lower dosage.

  • Beta-Blockers - The electrical signals to the heart are slowed down by the beta-blockers. This helps the heart to beat at a more regular pace and decreases the amount of force. Eventually, the blood pressure is reduced since the heart has to pump less volume of blood.

  • ACE Inhibitors - Angiotensin-converting enzyme inhibitors or ACE inhibitors do not allow the body to freely form a hormone called angiotensin II. Angiotensin II inhibitor hormone results in the blood vessels turning narrow and thus increases blood pressure. Hence, blood pressure is reduced and maintained by decreasing the action of this particular enzyme.

  • Angiotensin II Receptor Blockers - These medications prevent blood vessels from contacting angiotensin II. Angiotensin II works by attaching itself to the receptor site. Angiotensin II receptor blockers get in between these receptor sites and thus avoid the binding of this particular hormone, which eventually drops blood pressure.

  • Calcium Channel Blockers - All muscles require calcium in order to move and function. Calcium flows in and out of the muscular cells. Calcium channel blockers are the drugs that block the entry of calcium into the smooth muscles of the heart as well as blood vessels and thus lower the blood pressure because the heart is made for relaxing.

  • Alpha-Blockers - Catecholamines are the hormones produced within the body in certain circumstances. Catecholamines tend to bind to alpha receptors, a crucial part of the cells. This binding of the cell and hormone results in an increased heart rate. Alpha-blockers are medications that block the mechanism of catecholamines, and thus, they do not bind with the alpha receptors. Due to this, blood can flow at a normal pace within the blood vessels, and thus, the blood pressure is maintained on the lower side.

  • Alpha-2 Receptor Agonists - Alpha-two receptor agonists, also called alpha beta-blockers, have a combined effect of blocking catecholamines from binding to cells or alpha and beta receptors. As a result, blood vessels do not constrict, and the heart does not require a lot of force to pump blood, leading to a decrease in blood pressure.

  • Aldosterone Receptor Antagonists - These drugs bring about their action by blocking a chemical compound in the body called aldosterone. The blocking results in reducing the bodily fluids from being retained and thus lowers the blood pressure.

  • Central Agonists - These medications control the brain and instruct it not to produce or release a hormone called catecholamines. Due to this instruction from the central nervous system, the heart does not have to work with much force, and thus the blood flows with a reduced pressure onto the blood vessels.

  • Direct Renin Inhibitors - DRIs, or direct renin inhibitors, are the latest medications to lower blood pressure. These drugs block the chemical renin in the body. As a result, the blood vessels widen, allowing the blood to flow freely and thus reducing high blood pressure.

  • Vasodilators - These drugs are known to relax the inner walls of the blood vessels. They chiefly act on arterioles, the tiny arteries in the body. The direct result of this is a drastic decrease in blood pressure.

What Lifestyle Changes Can Help Prevent Hypertension?

It is advised to adopt healthy lifestyle practices to regulate and manage high blood pressure. If the blood pressure is high or just a little bit higher than normal, leading a healthy lifestyle may help one avoid or use medication less.

Try applying these suggestions.

  • Consume a balanced diet high in fruits, vegetables, lean meats, whole grains, and low-fat dairy products.

  • Reduce the salt usage.

  • Keep stress under control.

  • Sustain a healthy weight.

  • Establishing sound sleeping practices will help one get a good night's sleep.

  • Engage in regular exercise. Try to get 30 minutes of moderate exercise on most days of the week. It is acceptable to divide the daily activity into three 10-minute blocks.

  • Refrain from or use alcohol sparingly.

Conclusion:

High blood pressure is a cardiovascular condition where the heart and the blood vessels exert more force in order to function efficiently. This condition must be corrected and reversed, or else it may lead to permanent injury to the heart. Lowering blood pressure can be done with several high blood pressure medications. At times, the healthcare provider may combine two kinds of high blood pressure medications for a more direct and immediate change. Living a healthy and active lifestyle may be an added advantage in decreasing high blood pressure.

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Frequently Asked Questions

In the US, ACE (angiotensin-converting enzyme) inhibitors are the most commonly prescribed class of antihypertensive drugs. Among the class drugs, Lisinopril is the most commonly prescribed, which is recommended to be taken once a day. Lisinopril is also prescribed for heart failure. Metoprolol is the second most common antihypertensive drug.
Low-dose Thiazides are found to be ideal first-line pharmaceutical drugs for controlling hypertension. Additionally, this class of antihypertensives is relatively inexpensive. The drugs act by causing a change in sodium concentration in the distal part of the distal convoluted tube of the nephron.
The blood pressure shows a rhythmic variation. It is usually the lowest when the individual wakes up and then gradually rises. The pressure usually peaks during midday and drops in the late afternoon and evening hours and is the lowest while sleeping.
Some of the ways to rapidly decrease blood pressure are:
- Take a warm shower for at least 15 minutes. This also helps relieve muscle tension.
- Breathing exercises.
- Relaxation techniques like stretching, reading a book or meditating.
There is always a small difference in blood pressure when measured on both arms. This difference is usually insignificant, according to researchers. Therefore, it is recommended for right-handed people to have their pressures measured in the left hand and vice versa. This can be followed unless the clinician advises otherwise.
Sudden spikes in blood pressure can be a result of the following:
- Caffeine intake.
- NSAIDs (non-steroidal anti-inflammatory drugs).
- Cocaine use.
- Overactive adrenal gland.
- Smoking.
- Stress or anxiety.
- Thyroid issues.
According to a study, an average difference of 5 mm Hg between digital blood pressure monitors and mercury sphygmomanometers has been noted. These differences are harmless for casual blood pressure monitoring but can be quite drastic for those requiring regular monitoring.
Automatic or digital blood pressure monitors work with an error margin of 5 to 15 percent, an average of 5.7 mm Hg difference. These readings are usually higher than what is obtained at the doctor's office. This difference may be attributed to differences in stress levels.
According to studies, using a tight or a small cuff for measuring blood pressure can offset the reading by 10 to 40 mm Hg higher than the actual. This misreading is found in almost 40 percent of readings with smaller cuffs. Alternatively, a larger cuff results in missing a hypertensive reading in more than 22 percent of the hypertensive cases.
Blood pressure can be checked manually with a sphygmomanometer and a stethoscope instead of a widely available digital pressure monitor. However, with these instruments, one can measure their pulse, not the pressure. In addition, several mobile applications and smartwatches claim to check blood pressure, but their accuracy is questionable
Hydration is one of the key elements of the non-pharmacological management protocol for hypertension. Drinking six to eight glasses of water daily is one of the simplest ways to manage hypertension. Adequate hydration must be included in the lifestyle modification list to ensure long-term hypertension management.
The first reading of a blood pressure monitor will almost always be higher than subsequent readings due to a wide range of factors, which include stress, bladder pressure, white coat syndrome, and other psychological and environmental factors. It is stated that the average of the second and third readings is the most accurate.
 
Home blood pressure monitors work with an error rate of 5 to 15 percent. Additionally, they continue to give results with an accuracy range of up to two to three years. To validate the monitor's accuracy, compare the reading with a manual sphygmomanometer at the doctor's office. The monitor may be stamped as accurate if the results are within 10 unit discrepancy.
The worst times to measure blood pressure include situations like
- Right after waking up.
- Mid-day.
- Within 30 minutes of food, caffeine, or alcohol intake.
- After any activity, exercise, jogging, or walking.
- After nicotine use.
Blood pressure can shoot up without any prodromal symptoms. However, late signs of elevated blood pressure can be felt. These include moderate or severe headaches, anxiety, shortness of breath, nosebleeds, palpitations, or feeling of pulsations in the neck.
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Dr. Prashant Valecha from iCliniq
Dr. Prashant Valecha

Cardiology

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