List of Blood Pressure Medications

Here's a list of blood pressure medications prescribed to lower high blood pressure (hypertension). No single drug works the same or "best" for everyone.

The wide range of high blood pressure medications to choose from also means that, as long as you and your healthcare provider are patient and persistent, it is highly likely you'll find an effective and well-tolerated treatment regimen.

This article discusses different types of blood pressure medications, their side effects, and when they're prescribed.

Common Blood Pressure Medications

While there are many different types of medications for hypertension, there are four major categories of drugs that are frequently prescribed:

• Angiotensin-converting enzyme (ACE) inhibitors
• Angiotensin receptor blockers (ARBs)
• Calcium channel blockers
• Thiazide diuretics

Sometimes combination therapy (more than one medication) is needed.

Combination therapy would involve taking two antihypertensive medications, each from a different drug category.

Generally speaking, drugs from each of these classes tend to work equally well in controlling hypertension.

That said, individuals may respond quite differently.

Healthcare providers have no way of predicting this ahead of time, so patients must settle for an educated trial-and-error approach.

For example, individuals with hypertension who also have diabetes or chronic kidney disease with albuminuria (when a person's urine contains high levels of the protein albumin) are generally prescribed an ACE inhibitor or an ARB (if an ACE inhibitor is not tolerated).

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Classes of Blood Pressure Medications

Listing every high blood pressure medication here is impossible, but the following list provides a comprehensive overview of available options.

Each drug's brand name(s) is listed first, followed by the generic name.

Diuretics

Diuretics ("water pills") increase the amount of sodium and water excreted into the urine by the kidneys.

Diuretics are thought to lower blood pressure mainly by reducing fluid volume in the blood vessels.

Thiazide diuretics

• Thalidone, also sold as Tenoretic and Clorpres (chlorthalidone)
• Microzide and Esidrix (hydrochlorothiazide)
• Lozol (indapamide)
• Zaroxolyn, also sold as Mykrox (metolazone)

Potassium-sparing diuretics

• Midamor (amiloride hydrochloride)
• Aldactone (spironolactone)
• Dyrenium (triamterene)
• Inspra (eplerenone)
  

Loop diuretics

• Lasix (furosemide)
  
• Torsemide
• Bumex (bumetanide)
• Edecrin (ethacrynic acid)
  

Carbonic anhydrase inhibitors

• Diamox (acetazolamide)
  

Aldosterone receptor antagonists

• Catapres (clonidine)
• Cardura (doxazosin)
• Wytensin (guanabenz)
• Tenex (guanfacine)
• Apresoline (hydralazine hydrochloride)
• Aldomet (methyldopa)
• Minipress (prazosin)
• Hytrin (terazosin)

Possible side effects of diuretics include:

• Frequent urination
• Lightheadedness
• Fatigue
• Bowel changes
• Hypokalemia (common with thiazide diuretics)
• Erectile dysfunction

Angiotensin-Converting Enzyme (ACE) Inhibitors

The angiotensin-converting enzyme (ACE) inhibitors can lower blood pressure by dilating the arteries.

Popular ACE inhibitors include:

• Fosinopril
• Lotensin (benazepril)
• Captopril
• Vasotec, also sold as Vaseretic (enalapril)
  
• Zestril (lisinopril)
• Perindopril
• Quinapril
• Altace (ramipril)
• Trandolapril
  

Side effects may include:

• Dizziness
• Chronic cough
• Loss of sense of taste
• Hyperkalemia 

Angiotensin II Receptor Blockers (ARBs)

The angiotensin II receptor blockers (ARBs) also reduce blood pressure by dilating the arteries.

ARBs are generally superior to ACE inhibitors due to better efficacy and fewer adverse effects.

Options include:

• Edarbi (azilsartan)
• Atacand (candesartan)
• Teveten (eprosartan)
• Avapro (irbesartan)
• Cozaar (losartan)
• Benicar (olmesartan)
• Micardis (telmisartan)
• Diovan (valsartan)
  

Side effects may include:

• Dizziness
• Allergic reaction
• Hyperkalemia
• Kidney damage

Beta-Blockers

Beta-blockers are no longer considered a first-line, single-drug therapy for hypertension unless a patient has ischemic heart disease, heart failure, or arrhythmias.

These drugs block the effect of adrenaline on the cardiovascular system, slow the heart rate, and reduce stress on the heart and the arteries.

Some beta-blockers include:

• Acebutolol
• Tenormin (atenolol)
• Kerlone (betaxolol)
• Zebeta, also sold as Ziac (bisoprolol)
• Cartrol (carteolol)
• Lopressor, also sold as Toprol (metoprolol)
• Corgard (nadolol)
• Toprol-XL (metoprolol succinate)
• Bystolic (nebivolol)
• Levatol (penbutolol)
• Visken (pindolol)
• Inderal, Inderal LA (propranolol)
• Blocadren (timolol)

Side effects may include:

• Worsening of dyspnea in people with chronic obstructive pulmonary disease (COPD) or asthma
• Sexual dysfunction
• Fatigue
• Depression
• Worsening of symptoms in people with peripheral artery disease

Calcium Channel Blockers

Calcium channel blockers can reduce blood pressure by dilating the arteries and, in some cases, reducing the force of the heart's contractions.

Examples of calcium channel blockers include:

• Norvasc (amlodipine)
• Cardizem, also sold as Tiazac (diltiazem)
• Plendil (felodipine)
• DynaCirc (isradipine)
• Cardene (nicardipine)
• Procardia XL, also sold as Adalat CC, (nifedipine)
• Sular (nisoldipine)
• Verelan, also sold as Covera HS, and Isoptin SR, (verapamil)
  

Side effects may include:

• Constipation
• Swelling of the legs
• Headache
• Dizziness

Alpha blockers

Alpha-blockers help reduce blood pressure by relaxing the muscle tone of blood vessel walls.

Examples of alpha-blockers include:

• Cardura (doxazosin)
• Minipress (prazosin)
• Hytrin (terazosin hydrochloride)

Side effects include:

• Fast heart rate
• Dizziness
• Low blood pressure
• Weakness

Vasodilators

Vasodilators help relax the muscle tone of the vascular walls, allowing the vessels to widen so that blood can flow through better.

Examples of vasodilators include:

• Apresoline (hydralazine)
• Loniten (minoxidil)

Side effects may include:

• Headache
• Constipation
• Swelling in the lower legs
• Fast heart rate
• Excess hair growth (only with minoxidil)
  

Alpha-2-receptor agonists

These drugs stimulate alpha-2 adrenergic receptors in the central nervous system, which decreases sympathetic nervous system activity.

This causes a drop in blood pressure and heart rate.

Examples of alpha-2-receptor agonists include:

• Aldomet (methyldopa)
• Catapres, also sold as Duraclon, Kapvay, and Nexiclon XR (clonidine)
  
• Intuniv, also sold as Tenex, (guanfacine)

Side effects may include:

• Dry mouth fatigue
• Headache
• Sexual dysfunction
• Drowsiness or dizziness (only with methyldopa)
  

Direct renin inhibitors

Direct renin inhibitors reduce blood pressure by inhibiting renin activity, which normally triggers blood vessels to constrict.

Aliskiren is the only direct renin inhibitor available.

Side effects may include:

• Diarrhea
• Stomach pain
• Headache
• Dizziness

Combination Drugs for Hypertension

Research has found that combining blood pressure medications has a significantly more significant effect (about five times greater) on lowering a person's blood pressure than simply doubling the dose of a single medication.

The best scientific evidence (from the ACCOMPLISH trial) suggests that clinical outcomes (including the risk of stroke, heart attack, and cardiovascular death) are most improved with combination therapy when a long-acting calcium channel blocker is used with an ACE inhibitor or an ARB.

Thus, most healthcare providers will try this combination first.

That said, there are many single-pill combinations (single tablets that contain two or more medications). They include:

• Moduretic (amiloride and hydrochlorothiazide)
• Lotrel (amlodipine and benazepril)
• Tenoretic (atenolol and chlorthalidone)
• Lotensin HCT (benazepril and hydrochlorothiazide)
• Ziac (bisoprolol and hydrochlorothiazide)
• Vaseretic (enalapril and hydrochlorothiazide)
• Lexxel (felodipine and enalapril)
• Apresazide (hydralazine and hydrochlorothiazide)
• Prinzide, also sold as Zestoretic (lisinopril and hydrochlorothiazide)
• Hyzaar (losartan and hydrochlorothiazide)
• Aldoril (methyldopa and hydrochlorothiazide)
• Lopressor HCT (metoprolol and hydrochlorothiazide)
• Corzide (nadolol and bendroflumethiazide)
• Inderide (propranolol and hydrochlorothiazide)
• Aldactazide (spironolactone and hydrochlorothiazide)
• Dyazide, also sold as Maxide (triamterene and hydrochlorothiazide)
• Tarka (verapamil extended-release and trandolapril)

Suppose the blood pressure remains elevated with combination therapy using a calcium channel blocker plus an ACE inhibitor or ARB drug.

In that case, a thiazide drug will usually be added as a third drug.

If this combination fails to control the blood pressure, a fourth drug (usually spironolactone, a non-thiazide diuretic) may be added.

When Are Blood Pressure Medications Prescribed?

The American College of Cardiology and the American Heart Association define and stage hypertension as follows:

The extent of your high blood pressure, as indicated by these criteria, helps dictate which treatment course may be best for you.

Blood pressure (BP) is measured in millimeters of mercury (mmHg).

If there is a difference between the systolic pressure (top number) and diastolic blood pressure (bottom number), the higher one determines the stage.

Most treatment goals involve achieving blood pressure less than 120/80 mmHg.

The first step to treating high blood pressure involves making lifestyle changes that have been shown to reduce blood pressure.

This includes eating a heart-healthy diet, losing weight (if needed), exercising regularly, etc.

These changes may be done alone, or they may be used in combination with one or more high-blood pressure medications.

Deciding whether or not to start medication for your high blood pressure requires a discussion with your healthcare provider. In some cases, the decision is clear-cut.

For example, medication is strongly advised if a patient has hypertension and another medical condition, like type 2 diabetes mellitus.

Summary

Standard classes of hypertension drugs include diuretics, ACE inhibitors, ARBs, calcium channel blockers, and beta-blockers.

With so many treatment options, you should expect your healthcare provider to find a therapeutic regimen that will significantly decrease your risk of a bad outcome from hypertension—without disrupting your everyday life.

However, any of the drugs used to treat hypertension have the potential to cause side effects. If you are experiencing any troublesome side effects, talk to your practitioner about finding a treatment regimen you can tolerate better.