Who should take high blood pressure medicines?
Not everyone who has high blood pressure needs to be treated with drugs – some people can control their blood pressure just by adopting healthy lifestyle habits, such as eating heart-healthy foods and exercising regularly. However, most people with high blood pressure have to take two or more medications in addition to lifestyle changes to get their blood pressure under control. Medicines to lower high blood pressure ( hypertension) are called antihypertensives. Research suggests that these medications work equally well in men and women.1
The goal of therapy with high blood pressure medications is to lower blood pressure and reduce the occurrence of health problems such as heart attack, heart failure, stroke, and kidney damage. Medications that can treat high blood pressure are also used to treat patients with other conditions such as heart attack, heart failure, or kidney disease, even if they have normal blood pressure.
How do blood pressure lowering drugs work?
There are several ways drugs can lower blood pressure, and some medications work in more than one way:
- Opening and widening the blood vessels (drugs that work in this way are called vasodilators)
- Preventing the blood vessels from narrowing
- Reducing the heart's workload
- Reducing the amount of fluid in the body
How do doctors decide which type of medication I should take?
Doctors choose which blood pressure medications to prescribe based on your medical history and other current medical conditions and symptoms.
Some types of high blood pressure medicine lower blood pressure and treat other medical conditions at the same time. Medical conditions that may affect the choice of blood pressure medicine include:
- heart failure
- previous heart attack
- previous stroke
- known coronary artery disease (or high risk for it)
- chronic kidney disease
- left ventricular hypertrophy (enlargement of the left pumping chamber of the heart)
Many types of high blood pressure drugs lower blood pressure and reduce the health problems caused by high blood pressure in men and women.2 Most people with high blood pressure and no other major diseases should be prescribed a thiazide diuretic, either alone combined with an ACE inhibitor, angiotensin receptor blocker, beta blocker, or calcium channel blocker. Large studies have shown that these drugs are best at reducing the risk of heart attack, heart failure, stroke, and kidney disease in men and women.1, 3 However, everyone responds differently to high blood pressure medications and what worked for most people in a study might not work for you. You may have to try various drugs or combinations of drugs to find the best treatment for you with the fewest side effects.
How long do I have to take my high blood pressure medications?
Blood pressure medications do not cure high blood pressure—your blood pressure is only lowered while you are taking the drugs regularly. It will shoot up again once you stop taking them. Since high blood pressure is a risk factor for heart attack and heart disease, you may need to take high blood pressure medications for the rest of your life.
It is important that you adopt a heart-healthy lifestyle such as eating heart-healthy foods and exercising in addition to taking your blood pressure medication regularly. A heart-healthy lifestyle can lower blood pressure as well as several other risk factors for heart disease. Some people can reduce the dosage or the number of medications they are taking after achieving and maintaining normal blood pressure for a year or more. If you haven't made enough heart-healthy lifestyle changes, this “step-down therapy” may not be possible for you.