If you have high blood pressure, you may be able to tame it by losing weight if you're overweight and changing your diet to get less sodium and more potassium-rich fruits and vegetables and calcium-rich dairy foods. But if lifestyle changes don't work well enough, your doctor may recommend that you start taking blood pressure medications.
If you need to go on medication for your high blood pressure - also called hypertension - odds are good that you'll need to take more than one. Your doctor may start you on one drug, then add another if you don't reach your goal. Or the doctor may suggest several drugs right away rather than starting with just one. This may be necessary if, for example, your blood pressure is especially high.
However, if your doctor recommends more than one drug, it doesn't mean that you're extra sick. After all, 70 percent of people with hypertension require several drugs to manage it.
And taking multiple drugs can have benefits:
- You may reach your blood pressure goal more quickly.
- You may have fewer side effects if you're taking lower doses of each drug, or the drugs may help improve each others' adverse effects
- You may avoid the hassle of having to switch to different drugs until you find a regimen that works for you.
If you do need more than one medication, your doctor may be able to prescribe a combination of drugs in the same pill rather than separate pills. This may save you money and make your medication regimen easier to follow.
Many types of blood pressure drugs are available
Your doctor can choose from many different hypertension drugs in different classes, which as you might imagine work in a variety of ways to lower your blood pressure. Doctors often start people with hypertension on a type of drug called a thiazide diuretic. Diuretics cause you to lose more sodium, along with water, from your body.
Other types of blood pressure drugs include:
ACE inhibitors, which cause your blood vessels to relax by preventing your body from making a hormone called angiotensin II, which in turn causes these vessels to narrow.
Alpha blockers, which decrease nerve impulses going to your blood vessels so the blood can pass through with less difficulty.
Angiotensin II receptor blockers, which keep angiotensin II from causing your blood vessels to narrow.
Beta-blockers, which make the heart beat slower and less forcefully.
Calcium channel blockers, which help your blood vessels stay relaxed by keeping calcium from entering their cells.
Centrally-acting drugs, which work on your nervous system to cause your heart rate to slow down and your blood vessels to widen.
Vasodilators that cause your blood vessels to grow wider by making the muscles in their walls relax.
Your doctor may decide on the proper drugs based on whether you have other conditions, such as diabetes, kidney disease, heart failure, or high risk of heart disease, or if you've had a stroke or heart attack in the past. Some drugs work better than others in these situations.
If you don't have any of these problems, your doctor may simply recommend a combination of drugs that has been shown to work particularly well together.
Some side effects that people may encounter when they take blood pressure medications include headache, lightheadedness or dizziness, fatigue, or changes in heart rhythm. If these become worrisome or interfere with your daily life, discuss them with your doctor.
For more information, see:
The National Institutes of Health
The American Family Physician
The American Heart Association
Learn more about stroke.
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