Blood Pressure Medications: Types and Side Effects


Blood pressure, a crucial indicator of heart health, is the force exerted by circulating blood on the walls of blood vessels. Properly managing blood pressure is key to maintaining overall health, as both high and low levels pose risks in cardiology. Understanding medications for blood pressure control empowers individuals to make informed health choices, manage side effects, and collaborate with healthcare providers for optimal outcomes.

High or low blood pressure often has no symptoms until significant damage occurs. Among medications, ACE inhibitors are popular for their effectiveness in relaxing blood vessels and reducing high blood pressure. Enalapril, known as Vasotec, is well-known for managing high blood pressure and heart failure risk, generally with few severe side effects, although a dry cough can occur.

For low blood pressure, fludrocortisone is commonly prescribed to raise blood pressure by increasing blood volume. Regular monitoring, like using Oxiline Pressure X Pro or CheckMe BP2 monitors, is recommended for effective management. In emergencies, lying down with feet elevated can temporarily raise blood pressure, but consulting a doctor for long-term management is crucial.

Treating high blood pressure is essential to prevent complications such as heart attacks, strokes, and kidney diseases. Being informed about medications allows for proactive heart care and improved health outcomes.

What are the types of blood pressure medications?

Blood pressure medications vary from those affecting blood vessels to those regulating heart cell functions, reducing heart disease and stroke risks. Knowing these medications is vital for effective blood pressure management.

The Mayo Clinic lists various medication types, including:

  • Angiotensin-converting enzyme (ACE) Inhibitors
  • Diuretics
  • Angiotensin II receptor blockers (ARBs)
  • Alpha-blockers
  • Alpha-beta-blockers
  • Beta-blockers
  • Calcium-Channel Blockers
  • Central Agonists
  • Vasodilators

Each medication works differently and is prescribed based on individual health needs and medical history.

ACE inhibitors

For example, ACE inhibitors lower blood pressure by dilating blood vessels and have been proven effective in various studies and by the American Heart Association (AHA) and Mayo Clinic. They are particularly beneficial in treating high blood pressure, heart failure, and providing kidney protection, especially for individuals with diabetes.

Common ACE inhibitors include lisinopril, enalapril, ramipril, and captopril.

They are suitable for adults with conditions like hypertension, heart failure, or kidney disease, but should be avoided during pregnancy, by those with a history of angioedema or severe kidney disease, and during certain treatments. Pregnant women and children should exercise caution with these drugs.


Diuretics, another type of medication, are effective in removing excess salt and water from the body, thereby lowering blood pressure. They are especially useful in treating high blood pressure and heart failure.

Common diuretics include thiazide, loop, and potassium-sparing diuretics, and carbonic anhydrase inhibitors.

They are generally safe for most people, including older adults, but should be used carefully in those with severe kidney or liver problems, electrolyte imbalances, allergies to diuretics, and during pregnancy and breastfeeding.

Angiotensin II Receptor Blockers (ARBs)

Angiotensin II Receptor Blockers (ARBs) are another class of medications that lower blood pressure by blocking angiotensin II, a hormone that constricts blood vessels. They are beneficial for patients with high blood pressure and heart failure and help prevent strokes and kidney problems related to diabetes.

Common ARBs include Losartan, Valsartan, and Irbesartan.

They are suitable for adults with high blood pressure and heart failure but should be avoided by patients with a history of angioedema, severe kidney disease, liver problems, or those allergic to ARBs. Pregnant women, especially in the second and third trimesters, should avoid ARBs, and their use in children is not well established.


Alpha-blockers, used to lower blood pressure and treat prostate problems in men, work by inhibiting alpha-receptors in cells, especially in blood vessels, leading to dilation and lower blood pressure.

Common alpha-blockers include non-selective options like phenoxybenzamine and selective A1 blockers like alfuzosin, doxazosin, prazosin, silodosin, tamsulosin, and terazosin.

They are suitable for individuals with hypertension and benign prostatic hyperplasia but should be avoided by people undergoing cataract surgery, with a history of orthostatic hypotension, kidney disease, or circulatory issues, and breastfeeding women. Pregnant women and children should use them cautiously under medical supervision.

Alpha-beta blockers

Alpha-beta adrenergic blockers combine the effects of alpha and beta-blocker medicines and are used to manage blood pressure. They act on receptor cells in blood vessels, blocking catecholamines that narrow arteries, thus relaxing blood vessels and lowering blood pressure. They also slow the heart rate and reduce the force of heartbeats.

Common alpha-beta blockers include Carvedilol and Labetalol.

They are recommended for individuals with hypertension and conditions like benign prostatic hyperplasia but should be used cautiously in patients with a history of depression, certain heart conditions, or those taking certain erectile dysfunction medications. Pregnant women and children should use these blockers only under medical supervision.


Beta-blockers are used for controlling irregular heart rhythms and protecting the heart after a heart attack. They inhibit the impact of epinephrine on the heart and blood vessels, reducing blood pressure, heart rate, and stress on the heart.

Common beta-blockers include propranolol, metoprolol, atenolol, and bisoprolol.

They are prescribed for individuals with cardiovascular conditions such as high blood pressure, angina, heart failure, and irregular heart rhythms but are not recommended for people with asthma, COPD, certain heart block conditions, or bradycardia. Caution is advised in diabetic patients, as beta-blockers can mask signs of low blood sugar. Pregnant women and children should use them cautiously, and they should not be stopped abruptly.

Calcium-channel blockers

Calcium-channel blockers are used primarily to manage high blood pressure, angina, and certain heart rhythm disorders. They block the entry of calcium into cells in the heart and blood vessel walls, leading to lower blood pressure and reduced heart muscle workload.

Common calcium-channel blockers include amlodipine, diltiazem, and verapamil.

They are recommended for adults with hypertension, angina, and heart rhythm irregularities but should be avoided by individuals with severe low blood pressure, heart failure, or certain heart block conditions. Pregnant women and children should use these medications cautiously, and they should not be used during pregnancy unless necessary.

Central agonists

Central agonists are used to treat high blood pressure by acting on receptors in the brain to reduce signals that cause blood vessels to constrict or the heart to beat faster. They are effective in lowering high blood pressure and can be particularly useful in patients with severe hypertension or those who have not achieved control with other antihypertensive drugs.

Common central agonists include clonidine, methyldopa, and guanfacine.

They are typically prescribed for adults with high blood pressure, particularly those who have not achieved control with other medications, but should be avoided by individuals with a history of depression or certain heart conditions, pregnant or breastfeeding women, and those taking certain medications. Central agonists should be used with caution in pregnant women and children and should only be used under medical supervision.


Vasodilators widen blood vessels, leading to decreased blood pressure and improved blood circulation. They are used to manage conditions such as hypertension, heart failure, and certain forms of angina. Vasodilators work by relaxing muscles lining the walls of blood vessels, especially arteries, allowing them to expand and lower blood pressure.

Common vasodilators include hydralazine and nitroglycerin.

They are primarily prescribed for adults with high blood pressure, heart failure, or angina but should be avoided by individuals with low blood pressure, certain heart valve diseases, or those prone to hypotension. Pregnant women and children should use vasodilators with caution, and they should be used under specialist supervision in children.

Vasodilators are available in various forms, including oral tablets, capsules, sublingual tablets, and injections, and are used to treat high blood pressure, heart failure, certain types of angina, pulmonary hypertension, and in certain diagnostic procedures involving blood vessel dilation. Side effects include headaches, swelling of the legs or ankles, dizziness, rapid heartbeat, flushing, nasal congestion, significant drops in blood pressure, and heart complications.

Vasodilators can interact with other medications, including blood pressure drugs, erectile dysfunction medications, and certain over-the-counter cold and flu medications, as well as alcohol, which can amplify the blood pressure-lowering effects and lead to dizziness or fainting.

What are the best medications for high blood pressure?

Selecting the best medication for high blood pressure hinges on individual factors like health, age, gender, and existing medical conditions.

Thiazide diuretics, such as hydrochlorothiazide, are typically recommended for general hypertension due to their effectiveness and minimal side effects.

For patients with kidney issues, especially those with diabetes, ACE inhibitors like lisinopril or ARBs such as losartan are preferred for their kidney-protective qualities.

Heart disease patients often benefit from beta-blockers like metoprolol to reduce heart strain, while calcium channel blockers like amlodipine are used for angina or when beta-blockers are insufficient.

Diabetic patients usually receive ACE inhibitors or ARBs for their protective effect on the kidneys.

Elderly individuals and African-American patients often find calcium channel blockers and thiazide diuretics most effective.

For pregnant women, methyldopa and nifedipine are commonly prescribed due to their safety during pregnancy.

What are the best medications for low blood pressure?

For low blood pressure (hypotension), treatment varies based on underlying causes and symptom severity.

Dr. Amy C. Arnold and Dr. Cyndya Shibao suggest in their review “Current Concepts in Orthostatic Hypotension Management” that non-pharmacological interventions are preferred initially, followed by medications.

Mild hypotension often responds to increased salt intake and hydration, with medications like fludrocortisone or midodrine reserved for severe cases. Beta-blockers, such as propranolol, can regulate heart rate and blood pressure, while intravenous fluids and vasopressors are used in hospital settings for shock-induced hypotension.

Adjusting or changing medication causing hypotension is a common first step. Non-drug treatments, including compression stockings and increased fluid and salt intake, are often recommended, especially during pregnancy, due to safety concerns with medications.

Can you drink alcohol while on blood pressure medications?

Alcohol consumption while on blood pressure medications can lead to negative interactions, as highlighted by Dr. Rowena Sobczyk, MD.

Alcohol can decrease the effectiveness of blood pressure medications, potentially leading to dizziness, drowsiness, and dangerously low blood pressure.

Dr. Sobczyk notes that the interaction varies with different medications, such as beta-blockers and ACE inhibitors, and advises consulting with a doctor for personalized recommendations.

In many cases, moderation or complete avoidance of alcohol is advised for those on blood pressure medications.

How long after drinking alcohol can I take blood pressure medications?

The timing for taking blood pressure medications after alcohol consumption depends on the type of medication and the amount of alcohol ingested.

A common guideline is to wait at least 2 hours after moderate drinking.

However, a study in Current Hypertension Reports by Dr. Flávio Danni Fuchs et al. found that alcohol can temporarily lower blood pressure for up to 12 hours, followed by an increase, suggesting a cautious approach.

To avoid potential interactions and risks, such as a significant drop in blood pressure, it’s best to consult with a doctor for personalized advice.

Which blood pressure medications should you avoid when you have kidney disease?

In patients with kidney disease, caution is necessary when prescribing certain blood pressure medications.

A University of Virginia School of Medicine study raised concerns about potential kidney damage from prolonged use of hypertension and heart failure medications like ACE inhibitors and ARBs.

Although these drugs are kidney-protective in non-kidney disease patients, long-term use was linked to kidney vessel hardening in mice and humans.

However, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) notes that ACE inhibitors and ARBs can significantly delay kidney disease progression in many patients.

This paradox highlights the need for careful management and monitoring of these medications in kidney disease patients.

Which blood pressure medications should be avoided when you have liver disease?

Patients with liver disease, especially decompensated cirrhosis, should avoid or use certain blood pressure medications cautiously.

A report by a Samford University professor team on US Pharmacist advises against using ACE inhibitors and ARBs in individuals with decompensated cirrhosis due to potential kidney dysfunction.

In compensated cirrhosis, these drugs can be used but require frequent blood pressure monitoring.

Calcium channel blockers (CCBs) are also used in liver disease patients but should be administered at the lowest possible dose and monitored closely due to reduced hepatic clearance.

Can dietary supplements interfere with blood pressure medication?

Dietary supplements can interfere with blood pressure medications.

An American Heart Association editorial titled ‘Medication Interactions: Food, Supplements, and Other Drugs,’ warns that foods and supplements, like grapefruit and St. John’s Wort, might disrupt the effectiveness of certain blood pressure medications.

This interference can lead to increased drug levels in the bloodstream and heighten the risk of side effects. Vitamin E, known to enhance the blood-thinning effects of anticoagulants like Coumadin, could increase the risk of internal bleeding.

Over-the-counter antihistamines can also interact with blood pressure medications, potentially causing an increase in blood pressure and heart rate.

What lifestyle changes can make blood pressure medication more beneficial?

Lifestyle changes can significantly enhance the effectiveness of blood pressure medication.

A Zhengzhou University study in the Journal of Clinical Hypertension outlined the effects of lifestyle modifications on hypertension control.

Key changes include maintaining a healthy BMI, dietary adjustments, reducing alcohol and smoking, regular exercise, and stress management.

These changes can lower systolic reading by approximately 3.5 mmHg, thus reducing the risk of cardiovascular disease by roughly 30%, irrespective of genetic susceptibility to hypertension.

What should you do if your blood pressure medication doesn’t work?

If blood pressure medication is ineffective, consult your doctor to review medication usage and address potential issues like incorrect medication intake or drug interactions.

Dietary changes, such as adopting a low-sodium DASH diet, and lifestyle modifications like weight loss and increased physical activity, can be beneficial.

If these measures are insufficient, your doctor may explore other medical conditions or refer you to a specialist.

Meditation, yoga, and exercise regimens can also be adjunct methods for managing blood pressure.

When should you stop taking blood pressure medication?

Discontinuing blood pressure medication should always be done under medical supervision.

A 2023 study in Clinical Hypertension by Prof. Hae-Young Lee et al. found that some patients whose blood pressure has been well-controlled for an extended period might reduce or discontinue their medication.

However, this depends on individual health conditions and should be done cautiously.

What if you took blood pressure pills twice?

Accidentally doubling a dose of blood pressure medication can have varying effects, as explained by Dr. Milena Locci de Oliveira, Pharmacist and Doctor of Philosophy in Sciences from the University of São Paulo (USP).

Immediate consequences can include a decreased heart rate, hypotension, and, in cases of certain drugs like beta-blockers and diuretics, more severe reactions such as significant bradycardia or bronchoconstriction.

Common symptoms of overdose are nausea, dizziness, chest tightness, and, in sensitive individuals, severe dizziness or loss of consciousness.

Dr. Oliveira emphasizes the importance of adhering to prescribed dosages to avoid these risks.

How often should you monitor blood pressure while on medication?

Monitoring blood pressure while on medication is key to managing hypertension effectively.

The American College of Cardiology’s 2017 Guidelines for High Blood Pressure in Adults recommend varying frequencies of monitoring based on the stage of hypertension and risk factors.

Individuals with stage 1 hypertension and high ASCVD risk should check their blood pressure in 1 month, as should those with stage 2 hypertension, combining nonpharmacologic therapy and antihypertensive drugs.

The Mayo Clinic advises starting home blood pressure monitoring twice daily, once in the morning before eating or taking medications and again in the evening, taking two or three readings each time for accuracy.

Blood pressure can fluctuate during the day, often higher in the morning, and may be slightly lower at home than in a medical office.

It’s important to consult with your doctor for an accurate monitoring strategy.

What are the best and most accurate blood pressure monitors to use at home?

For home use, the best and most accurate blood pressure monitors are Oxiline Pressure X Pro and CheckMe BP2.

These smart monitors can be paired with mobile devices for efficient monitoring.

A comparison of these products reveals that Oxiline Pressure X Pro, with FDA 510(k) approval, offers advanced features like mobile app support, a VIBRA™ TX sensor for detecting arterial pressure, and Bluetooth connectivity, supporting multiple users and storing 120 readings on the device and unlimited readings on the app.

The CheckMe BP2, known for its lightweight, cuffless design, and smartphone connectivity, offers similar app support and stores 50 BP readings and 10 EKG readings on the device.

Other models like Withings BPM Connect, Omron Silver, and QardioArm are also available, but ensuring calibration for accurate readings is crucial.

What your blood pressure reading mean according to AHA’s BP chart?

Understanding blood pressure readings according to the AHA’s blood pressure chart is important.

  • Normal blood pressure is below 120/80 mm Hg.
  • Elevated blood pressure ranges from 120-129 systolic and less than 80 diastolic.
  • Hypertension Stage 1 is 130-139 systolic or 80-89 diastolic, while Stage 2 is consistently at or above 140/90 mm Hg.
  • A hypertensive crisis, over 180/120 mm Hg, requires immediate medical attention.

Both systolic and diastolic readings are important in diagnosing high blood pressure, with systolic pressure receiving more focus, especially in individuals over 50.

How to lower blood pressure instantly?

To lower blood pressure instantly, Carmen Pope, Clinical Pharmacologist for, recommends deep breathing exercises, resting for 10 minutes, dietary changes rich in greens, fruits, and whole grains, intermittent fasting, regular moderate exercise, and lifestyle adjustments like limiting alcohol, quitting smoking, and reducing salt intake.

Why should you treat high blood pressure?

Treating high blood pressure is crucial to prevent serious health complications.

The AHA and CDC guidelines state that managing high blood pressure can reduce cardiovascular diseases, protect organs, prevent heart disease and strokes, and maintain kidney health.

Treatment involves medications, lifestyle changes, and natural approaches, with constant monitoring and adherence to doctor’s recommendations being essential.

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