High Blood Pressure (Hypertension) Medications (cont.)
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
In this Article
- What is high blood pressure (hypertension)?
- High blood pressure medication list
- Beta blockers
- ACE inhibitors
- Angiotensin II receptor blockers
- Calcium channel blockers
- Alpha blockers
- Alpha-2 receptor agonist
- Central agonists
- Peripheral adrenergic inhibitors
- What are the most common blood pressure medications?
- What is the best high blood pressure medication?
- What are common high blood pressure side effects?
- Is it safe to take high blood pressure medication during pregnancy?
- Is it safe to drink alcohol while taking high blood pressure medications?
- Does high blood pressure lead to weight gain?
What is the best high blood pressure medication?
Selecting the "best" high blood pressure medication depends on several things, including the general health of the patient, his or her age, ethnicity, and whether or not they have any co-existing medical issues or drug sensitivities.
For example, in a hypertensive patient with asthma, it may be inadvisable to prescribe a beta blocker, as these drugs can aggravate that respiratory condition. Similarly, in patients prone to constipation (the elderly, for example) use of certain calcium channel blockers might best be avoided -- along with diuretics -- as both these classes of drugs can inhibit proper bowel function.
African-American patients respond to some antihypertensive medications better than others.
Certain groups of patients require use of a specific class of high blood pressure medication. These include:
The drug of choice for hypertensive, pregnant women is one of the oldest high blood pressure medications on the market. Methyldopa, which works to lower blood pressure through the central nervous system, has the lowest risk of harming the mother and developing fetus. Other possible safe options include labetalol, beta blockers, and diuretics. Two classes of drugs which should never be used during pregnancy include the ACE inhibitors and the angiotensin II receptor blockers.
Hypertension in African-Americans tends to occur earlier in life and tends to be more severe. Plus, some medications that work to lower blood pressure in other ethnicities may have limited effect on African-Americans. Thiazide diuretics (such as HCTZ) or a calcium channel blocker are recommended first choices along with the possible add-on of a second drug from either the ACE inhibitor class or the angiotensin II receptor blocker group.
With age, comes an increased risk for systolic hypertension which can be aggravated by severe atherosclerosis. According to one study, the diuretic chlorthalidone (Hygroton) had significant benefit in elderly patients with systolic hypertension. Along with a diuretic, some calcium channel blockers, ACE inhibitors and angiotensin II receptor blockers may also be good choices. However, beta blockers may not be as effective for hypertension in those over 60; though they may be good choices if co-existing heart disease is present. It also may be preferable in elderly patients to give two high blood pressure medications at a low dose versus one at a higher dose.
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