The Different Types of High Blood Pressure Medications

Thursday 24 December 2020
Cardiovascular Disorders

Medically reviewed by

Stefan Reiner, PharmD, RPh
on 27 January 2021

Table of Contents


I. The Purpose of HBP Medications

II. Classes, Functions, and Side Effects of HBP Drugs

III. How Do You Choose the Right Medications?


The Purpose of HBP Medications

All high blood pressure (HBP) drugs work toward the goal of lowering your blood pressure. HBP, also known as hypertension, can lead to serious health threats like heart failure, heart attack, kidney disease, and stroke. To prevent HBP from deteriorating your health, early treatment is required. [1] Prescription medications like Cozaar (losartan) and Aldactone (spironolactone) are available to control your blood pressure.

Medications that treat HBP are called antihypertensives. Even though they have the united purpose of lowering your blood pressure levels, HBP drugs come in many different classes to offer different approaches to the same goal. These different approaches can result in different side effects. Read on to learn which HBP drugs might be best suited for you.

Classes, Functions, and Side Effects of HBP Drugs

Each antihypertensive drug has its pros and cons. [2] Common types of HBP drugs include:  

  • Diuretics
  • ACE inhibitors
  • Angiotensin II receptor blockers
  • Calcium channel blockers
  • Alpha-blockers
  • Beta-blockers
  • Alpha-2 receptor agonists
  • Central agonists
  • Vasodilators [3]

Diuretics are also called water pills. These drugs lower blood pressure by reducing blood volume. Diuretics reduce blood volume by helping your kidneys eliminate sodium and water. Your doctor may recommend diuretics as a first choice or as an add-on medication for your treatment plan. [4]

Some diuretics can have the side effect of lowering your body’s potassium levels. Insufficient potassium can lead to weakness, cramps, or fatigue. This side effect can usually be countered by eating more foods that are high in potassium. Another possible side effect is gout if you use diuretics for long periods. If you have diabetes, note that some diuretics may increase your blood sugar level. For men, diuretics may cause erectile dysfunction. [3]

a man suffering from a headache

ACE inhibitors lower your blood pressure because they help your blood vessels relax. Your body produces a chemical called angiotensin II, which causes your arteries to narrow. ACE stands for angiotensin-converting enzyme. ACE inhibitors work by reducing the amount of angiotensin II your body produces. 

Women who take ACE inhibitors should not become pregnant while on this type of drug. ACE inhibitors can be dangerous to both mother and baby during pregnancy. If you think you are pregnant while you are on ACE inhibitors, talk to your doctor because you may be at risk of severe kidney failure, hyperkalemia (excess potassium), and fetal death. Side effects not exclusive to women include skin rashes, dry coughs, loss of taste, and possible kidney damage. [3]

Angiotensin II receptor blockers (ARBs) like Cozaar (losartan) and Diovan (valsartan) are similar to ACE inhibitors in that they also reduce blood pressure by keeping blood vessels open. ARBs do not let your blood vessels narrow by blocking the receptors of angiotensin II. This class of HBP medication may cause dizziness. Like ACE inhibitors, you should not take ARBs during pregnancy because it increases the risk of injury or death to the fetus. [3]

Calcium channel blockers work exactly as their name suggests. Muscles need calcium to move and calcium channel blockers limit the calcium entering the smooth muscle cells of your heart and arteries. When this happens, your heart will beat with less force and your blood vessels will relax, lowering your blood pressure. [1] Some side effects of calcium channel blockers include dizziness, headache, constipation, irregular heartbeat, and swollen ankles. [3]

Alpha-blockers help blood flow by blocking a process that causes your blood vessels to narrow. Sometimes when catecholamines bind to alpha receptors, your blood vessels will narrow. [1] Alpha-blockers can have side effects like dizziness and a drop in blood pressure from standing up. [3]

a diorama of the arteries in a heart

Beta-blockers block the effects of the hormone epinephrine (adrenaline), your blood pressure lowers when your heart beats slower. [2] Beta-blockers can be effective in reducing your heart’s workload. Note that taking this type of medication can result in asthma, erectile dysfunction, fatigue, depression, insomnia, or cold hands and feet. [3]

Alpha-2 receptor agonists have infrequent side effects for pregnant women. This antihypertensive is commonly the first to be considered if you are pregnant. Alpha-2 receptor agonists work by decreasing the activity of the part of your involuntary nervous system that produces adrenaline. Some people may experience drowsiness or dizziness when taking this class of drugs. [3]

Central agonistsor central-acting agents, stop your brain from telling your nervous system to increase your heart rate and narrow your blood vessels. [4] Central agonists may lower your blood pressure too much, leading to weakness or fainting. Impotence, fever, anemia, mouth dryness, or drowsiness may also occur. If you experience these side effects, talk to your doctor before stopping. If you suddenly stop taking your blood pressure medications, it can be dangerous and cause your blood pressure to rise too quickly. [3] 

Vasodilatorsor blood vessel dilators, relax your blood vessels’ muscle walls and allow blood to flow more freely. Under this category, Loniten (minoxidil) is usually for HBP patients who also suffer from kidney failure. This drug may cause weight gain or excessive hair growth. Hydralazine is another common vasodilator. Some side effects may include headaches, swelling around the eyes, heart palpitations, or joint aches. However, these symptoms are typically mild and disappear after a couple of weeks. [3]

a close-up of different pills

How Do You Choose the Right Medications?

Choosing the right medication for your HBP depends on factors like pregnancy, health conditions, age, family history, and race. For example, diuretics may work better than ACE inhibitors for African Americans and older people. [4] Side effects are also important to consider when deciding on HBP medications. Ask your doctor if the benefits outweigh the risks for each potential treatment plan. 

If taking diuretics makes you potassium-deficient and tired all the time, your doctor may recommend a potassium-sparing diuretic like Aldactone (spironolactone). This type doesn’t reduce your potassium levels. [3] There are many ways to treat HBP. Your doctor may even recommend combinations of certain drugs to increase effectiveness. Always talk to your doctor first before starting any HBP medications to make sure your treatment plan is tailored to your needs and health conditions. 

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis, or treatment.