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High Blood Pressure (Hypertension) Medications (cont.)

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What are common high blood pressure side effects?

Different classes of blood pressure medications have different side effects.

Diuretics

Diuretics can lead to an increase in potassium loss, known as hypokalemia, which, in turn can affect muscular function -- including the muscles of the heart. There is also an increased risk for gout with diuretics -- as well as the possibility of weakness, thirst, dehydration, and increased urination. Changes in blood sugar levels are also possible. Skin reactions, some severe, are possible with thiazide diuretics (such as hydrochlorothiazide). Potassium-sparing diuretics, such as spironolactone (Aldactone) may cause breast enlargement in males.

Beta blockers

Beta-blockers cause the heart to slow down and so some of their side effects can be traced to that mechanism of action. Dizziness, weakness, fatigue, and fainting are possible. Beta-blockers also affect the respiratory system, so other side effects include shortness of breath, difficulty breathing, and chest pain. Beta-blockers should not be withdrawn suddenly, as that could result in a heart attack or sudden death.

ACE inhibitors

The most common side effect from ACE Inhibitors is also an unusual one -- a dry cough. Usually it goes away with continued use of the drug, but that could take weeks. ACE Inhibitors could reduce blood pressure too much, resulting in hypotension which could, in turn lead to headache, dizziness, fainting, and reduced kidney function.

Angiotensin II receptor blockers

The most common side effect from the angiotensin receptor blockers (ARBs) is an increased potassium level in the blood, known as hyperkalemia. Dizziness is also common, along with fatigue. Upper respiratory tract infections have also been reported -- along with gastrointestinal issues such as upset stomach and diarrhea.

Calcium channel blockers

Up to a third of patients may experience the following side effects with calcium channel blockers: Swelling of the ankles and other extremities, flushing, and dizziness. Other common side effects include heartburn and nausea.

Alpha blockers

A common, transient, but distressing initial side effect of the alpha blockers is postural hypotension. This is a sudden drop in blood pressure when standing up. It can be severe enough to cause dizziness or even fainting. In addition, the alpha blockers can result in increased heart rate, headache, nausea, and weakness.

Methyldopa

Methyldopa is mostly well tolerated, but some patients may experience dizziness, drowsiness, weakness, headache, and dry mouth.

Central agonists

Up to 40% of patients taking clonidine (Catapres) will experience dry mouth and about a third will have drowsiness, headache, and sleepiness. Other common side effects include constipation, dizziness, and local skin reactions with use of the Catapres-TTS skin patch. Reserpine use is linked with possible side effects including nightmares, stuffy nose, depression, and an inability to fall asleep. Diarrhea and heartburn are also possible. Guanadrel and guanethidine can cause diarrhea and other gastrointestinal issues – as well as dizziness and drowsiness.

Vasodilators

Taking minoxidil might result in excessive body hair growth, as well as weight gain and dizziness. Hydralazine is linked to headaches, heart palpitations, swelling around the eyes, and aches and pains in the joints.

Medically Reviewed by a Doctor on 5/30/2014


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