A guide to high blood pressure medications today

There are tons of medications out there to help treat high blood pressure. Beyond changing your diet and lifestyle, medication may be necessary. Ask your doctor about these medications:

In the world of treatment of hypertension, the idea is to reach a fairly stable blood pressure of less than 140/90 millimetres of mercury (mmHg) — or if you have diabetes or kidney disease, less than 130/80 mmHg. Today, doctors have a plethora of pharmaceuticals to get you there, most in four main drug categories, plus two new antihypertensive classes.

• Long considered the first step in any medical management of hypertension, diuretics, which help your body get rid of excess fluid and sodium, fell out of favour in the 1990s as newer drugs were introduced.
• A newer study showed that diuretics were more likely than calcium channel blockers and ACE inhibitors to prevent heart failure and strokes, especially among African-Canadians.
• If you're taking blood pressure medication but aren't taking a thiazide-type diuretic, talk to your doctor about adding such a drug to your regimen.
• Although that latest study evaluated only thiazide diuretics, other classes of diuretics include loop diuretics, such as Lasix, and potassium-sparing diuretics, such as amiloride (Midamor).

• This class of drugs, which includes such popular prescription drugs as atenolol (Tenormin), metoprolol (Lopressor), and propranolol (Inderal), work by slowing your heartbeat, thus relaxing blood vessels.

• Angiotensin-converting enzyme inhibitors work by blocking the action of a chemical called angiotensin II, which is responsible for narrowing blood vessels and raising blood pressure.

• Although these drugs are prescribed for hypertension, there is no clear evidence that they reduce either death or complications from cardiovascular disease.
• They work by relaxing the tone of the muscles in blood vessels so they dilate better.
• Generally, you shouldn't be taking a calcium channel blocker for hypertension unless all other classes of medication — diuretics, ACE inhibitors, and beta-blockers — have failed to control your pressure.

• The drugs in this newer class of antihypertensives work somewhat like ACE inhibitors but don't lead to the accumulation of the enzyme bradykinin, which can cause coughing.
• Expect your doctor to consider an ARB if you are unable to tolerate an ACE inhibitor.

• The first approved drug in this new class is named eplerenone (Inspra).
• It is used primarily in people with heart failure or as an additional medication to treat hypertension that doesn't improve with other medications.
• One study found that Inspra was as effective as a popular calcium channel blocker in treating systolic hypertension.

Now you know the differences between some of the highest-prescribed blood pressure drugs. With all of these different types of blood pressure medication available, it is important to consult your doctor and plan a medical strategy that is best for you.