MEDICATIONS: DRUGS THAT HELP LOWER BLOOD PRESSURE: ANTIHYPERTENSIVES

Antihypertensives are drugs that help lower blood pressure. Blood pressure measures the force with which blood moves through the blood vessels. While blood pressure normally varies throughout the day, rising during exercise and falling during sleep, in some people the blood pressure stays high all the time. Some cases of high blood pressure (hypertension) can be treated with lifestyle changes — losing weight, lowering salt intake, exercising more, stopping smoking — but in most cases, hypertension is treated with medication to help control the condition. There are five classes of medication used to treat hypertension.

Diuretics

These drugs work by making it difficult for the kidneys to retain water and salt. By increasing the amount of urine, the amount of fluid in the bloodstream is reduced, which reduces pressure on the artery walls of the blood vessels. Examples of diuretics include bumetanide (Bumex), chlorothiazide (Diuril), chlorthalidone (Hygroton), furosemide (Lasix), hydrochlorothiazide (Esidrix, HydroDIURIL), metolazone (Zaroxolyn), and spironolactone (Aldactone).

Beta Blockers

Beta blockers reduce high blood pressure by slowing the force and speed of the action of the heart, including the rate at which it contracts. The medication may also reduce blood pressure by directly affecting the central nervous system, altering the body's response to certain nerve impulses. Examples of beta blockers are atenolol (Tenormin), bisoprolol (Zebeta), carvedilol (Coreg), metoprolol (Lopressor), and propranolol (Inderal). Some beta blockers can cause drowsiness and possibly impair a person's ability to drive.

ACE Inhibitors

Angiotensin-converting enzyme (ACE) inhibitors lower blood pressure by blocking production of angiotensin II, a chemical the body produces to raise blood pressure. Normally, angiotensin maintains blood pressure by tightening the arteries and causing the retention of sodium (salt) and water.

ACE inhibitors reduce blood pressure very quickly. Examples include benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik).

Angiotensin II Receptor Antagonists

Angiotensin II receptor antagonists lower blood pressure by blocking angiotensin from binding to receptor sites in the smooth muscles of the blood vessels. This stops the angiotensin from tightening the arteries and raising the blood pressure. Examples include candesartan (Atacand), irbesartan (Avapro), losartan potassium (Cozaar), and valsartan (Diovan).

Calcium Channel Blockers

Calcium channel blockers reduce blood pressure by dilating the arteries, thereby reducing resistance to blood flow. They include amlodipine (Norvasc), bepridil (Vascor), diltiazem (Cardizem, Dilacor XR, Tiazac), felodipine (Plendil), isradipine (DynaCirc), nicardipine (Cardene), nimodipine (Nimotop), nisoldipine (Sular), and verapamil (Calan, Covera-HS, Isoptin, Verelan)

Other Drugs That Can Lower Blood Pressure

Several drugs relax the muscles in the walls of the arteries or veins, thus reducing blood pressure. These drugs are sometimes considered to be nerve blockers. They include clonidine (Catapres), guanfacine (Tenex), hydralazine (Apresoline), methyldopa (Aldomet), minoxidil (Loniten), and prazosin (Minipress).

A few drugs combine a calcium channel blocker with an ACE inhibitor in a single pill. The doctor decides which combination works best for various symptoms.

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