Medications To Lower Blood Pressure

Can High Blood Pressure Affect Pregnancy

High blood pressure complicates about 10% of all pregnancies. There are several different types of high blood pressure during pregnancy and they range from mild to serious. The forms of high blood pressure during pregnancy include:

Chronic hypertension: High blood pressure which is present before pregnancy.

Gestational hypertension: High blood pressure in the latter part of pregnancy.

Preeclampsia: This is a dangerous condition that typically develops in the latter half of pregnancy and results in hypertension, protein in the urine and generalized swelling in the pregnant person. It can affect other organs in the body and cause seizures .

Chronic hypertension with superimposed preeclampsia: Pregnant people who have chronic hypertension are at increased risk for developing preeclampsia.

Your provider will check your blood pressure regularly during prenatal appointments, but if you have concerns about your blood pressure, be sure to talk with your provider.

High Blood Pressure In Older People

The target blood pressure reading for the over-80s is below 150/90 mmHg when it’s measured in the clinic or surgery, and below 145/85 mmHg for home readings.

While there are definite benefits from taking medicines to reduce blood pressure if you’re under the age of 80, it’s less clear it’s useful if you’re over 80.

It’s now thought that if you reach 80 while you’re taking medicine for high blood pressure, it’s fine to continue treatment provided it’s still helping you and is not causing side effects.

If you’re diagnosed with high blood pressure and you’re aged over 80, your doctor will also consider your other health risk factors when deciding whether to give you treatment for the high blood pressure.

Page last reviewed: 23 October 2019 Next review due: 23 October 2022

Are Blood Pressure Medications Right For You

When youre first diagnosed with high blood pressure you might not need to take medications. Your doctor or nurse might suggest you make healthy changes to your lifestyle first, which could be enough to lower your blood pressure to a healthy level, but if thats not enough on its own, they may suggest you take medications as well.

The role of blood pressure medicines is to lower your risk of heart disease, stroke, and other health problems. So, whether you would benefit from them depends not only on your blood pressure, but on your overall health and risk of disease. Your doctor will consider a number of things, including:

• your age, ethnicity, family history and lifestyle
• any which raise your risk of heart attack or stroke, such as high cholesterol, being overweight, diabetes, kidney problems and diseases of the blood vessels such as coronary heart disease
• if members of your family have high blood pressure, strokes or heart attacks, or have done in the past
• any other illnesses you may have and medications youre taking, and any side effects

How high does your blood pressure need to be before starting medications?Your doctor will consider your when deciding whether to prescribe medications.

Your doctor will want to bring your blood pressure down to a target level, for example around 140/90mmHg.

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Try Meditation Or Deep Breathing

While these two behaviors could also fall under stress reduction techniques, meditation and deep breathing deserve specific mention.

Both meditation and deep breathing may activate the parasympathetic nervous system. This system is engaged when the body relaxes, slowing the heart rate, and lowering blood pressure.

Theres quite a bit of research in this area, with studies showing that different styles of meditation appear to have benefits for lowering blood pressure .

Deep breathing techniques can also be quite effective.

In one study, participants were asked to either take six deep breaths over the course of 30 seconds or simply sit still for 30 seconds. Those who took breaths lowered their blood pressure more than those who just sat .

Try guided meditation or deep breathing. Heres a video to get you started.

Bottom line: Both meditation and deep breathing can activate the parasympathetic nervous system, which helps slow your heart rate and lower blood pressure.

How Do Doctors Know If The High Blood Pressure Medication Is Working

After starting treatment, your doctor will regularly monitor your blood pressure. It may be necessary for them to adjust the dosage, change drugs, or add a second drug to control your blood pressure.

Your doctor can choose a second drug from any of the first-line classes. In some cases, they may need to consider another antihypertensive class, such as a beta-blocker.

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Which Medications Can Lower Blood Pressure

There are several classes of drugs designed to reduce blood pressure . The following are the most commonly used antihypertensives:

• Calcium channel blockers

All of these medications can prevent long-term effects of high blood pressure. The suitability of a medication will depend on various factors. It is best to talk to your doctor about which of the medications is suitable for you. The most important issue is whether you have any other medical conditions.

How Is Resistant Hypertension Diagnosed

• Full history and physical exam, which includes letting your doctor know about all medications and supplements, whether they are prescription, over-the-counter, herbal or recreational. Its important to mention if you skip doses of daily medicines.
• True measurement of your blood pressure using correct technique and calibrated equipment.
• Home blood pressure measurement during the day and 24-hour ambulatory blood pressure monitoring to record your blood pressure throughout a regular day. It may be used if your physician suspects your blood pressure readings in the office dont tell the whole story.
• Tests for secondary conditions, which may include special blood work and imaging studies. Identifying and treating these conditions may eliminate hypertension or at least make it more treatable.
• Tests for organ damage caused by hypertension, which may include:
• Electrocardiogram to measure your hearts size and rhythm
• Echocardiogram to measure your hearts size and function
• Fundoscopic eye exam to check for damaged blood vessels inside the eye these tiny blood vessels come in from the brain and are a unique opportunity for your doctor to judge the health of similar blood vessels in your brain, heart and kidneys
• Urinalysis to check for kidney damage
• Other blood tests

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Tips On How To Take Your Blood Pressure Medicine

• Take your medicine regularly. Get into a routine and take your pills at the same time every day, to help you remember to take them. Try using a pillbox marked with the days of the week and fill it at the beginning of each week to make it easier to remember.
• Don’t let your supply run out. Get your prescription before you run out and make sure you have enough for weekends, public holidays and when you are away on holiday.
• If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose. Do not take 2 doses to make up for the dose you missed.
• Don’t stop taking your blood pressure medicine suddenly. If you feel unwell or have any side effects, tell your healthcare provider.
• Check with your healthcare provider before starting any new medicines or supplements. Blood pressure medicines can interact with other medicines and herbal supplements.
• Be careful taking anti-inflammatories while you are on blood pressure medicines. This includes ibuprofen and diclofenac .

Avoid taking these medicines together
AVOID anti-inflammatories if you are taking ACE inhibitors AND diuretics, OR ARBs AND diuretics. Taking them together can damage your kidneys. Read more about anti-inflammatories and blood pressure medicines.

What Questions Should I Ask My Provider

• Are there supplements or non-prescription medicines that I shouldnt take?
• Can I keep taking these medicines if I get pregnant?
• What kinds of exercise should I do?

A note from Cleveland Clinic

If you dont treat high blood pressure, it can put you at risk for developing serious illnesses later in life such as heart attack, kidney failure and stroke. But if you follow your providers instructions, you can control your blood pressure. Be sure to take any medicines your provider ordered as instructed. Keep taking them even if your blood pressure numbers begin to fall into the normal range. Living a healthy lifestyle by eating healthy foods, watching your weight and getting regular exercise is also a great way to help control your blood pressure.

Last reviewed by a Cleveland Clinic medical professional on 09/21/2021.

References

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How Is High Blood Pressure Diagnosed

It is not uncommon for your blood pressure to go high occasionally however, it is persistently high blood pressure that is a concern. For this reason, if a doctor or nurse takes your blood pressure and it is high but you dont have any risk factors or symptoms, then at least two other separate measurements should be taken before you are diagnosed with high blood pressure.

Before getting your blood pressure taken you should avoid the following for at least an hour before the measurement:

• Strenuous exercise
• Stressful situations.

Sit down for at least five minutes before the reading is taken and dont talk while it is being measured.

Other tests may be ordered if your doctor concludes you have high blood pressure. These may include blood tests, an electrocardiogram, and sometimes a chest x-ray.

Top 10 High Blood Pressure Medications

Drugs that treat high blood pressure are known as antihypertensives. Blood pressure medications work by:

• reducing the amount of water and salt in your body
• causing the blood vessels to relax to keep them from narrowing
• hampering nerve activity that causes blood vessels to restrict
• lowering your heart rate and helping it beat with less force

There are several classes of antihypertensive medications, and each class includes several drug options. Your doctor will work with you to find the best treatment plan.

The following list provides the top 10 blood pressure medications by prescriptions written. The list includes a brief description of each drug, including its class, how to take it, and what it treats. The next section provides more information on drug classes.

The most common high blood pressure medications by total prescriptions written include:

Lisinopril : This medication is an angiotensin-converting enzyme inhibitor. It is a drug that you usually take once per day. Most people find once-daily dosing to be convenient and easy to remember. Lisinopril is also a treatment option for heart failure.

Metoprolol : This medication is a beta-blocker. It comes in an immediate-release form and an extended-release form. It also helps lower the risk of repeat heart attacks and helps treat angina and congestive heart failure.

Amlodipine : This medication is a calcium channel blocker. People usually take it once per day. Amlodipine is also a treatment option for angina.

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What Is High Blood Pressure

Blood pressure is the measurement of the pressure or force of blood pushing against blood vessel walls. When you have hypertension , it means the pressure against the blood vessel walls in your body is consistently too high. High blood pressure is often called the silent killer because you may not be aware that anything is wrong, but the damage is still occurring within your body.

Your blood pressure reading has two numbers. The top number is the systolic blood pressure, which measures the pressure on the blood vessel walls when your heart beats or contracts. The bottom number is the diastolic blood pressure, which measures the pressure on your blood vessels between beats when your heart is relaxing.

For example, a blood pressure of 110/70 is within the normal range, but a blood pressure of 135/85 is stage 1 hypertension, and so on .

Category

• Vascular dementia.

So Which Is The Best Medicine Or Combination Of Medicines

The one or ones chosen may depend on factors such as:

• Whether you have other medical problems.
• Your ethnic origin.
• Whether you take other medication.
• Possible side-effects.

• Beta-blockers and calcium-channel blockers can also treat angina.
• ACE inhibitors also treat heart failure.
• Some medicines are not suitable if you are pregnant.
• Some medicines are thought to be better if you have diabetes.
• Some medicines tend to work better than others in people of Afro-Caribbean origin.

If you do not have any other medical problems that warrant a particular medicine then current UK guidelines give the following recommendations as to usual medicines that should be used. These recommendations are based on treatments and combinations of treatments that are likely to give the best control of the blood pressure with the least risk of side-effects or problems.

Treatment is guided by the A/C, A+C, A+C+D approach, where:

• A = ACE inhibitor or ARB.
• C = calcium-channel blocker.

The suggested stepwise approach is as follows:

However, individuals can vary. Sometimes, if one medicine does not work so well or causes side-effects, a switch to a different class of medicine may work well.

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Should You Exercise When Your Blood Pressure Is High

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When To See A Doctor

High blood pressure is a serious condition that can lead to stroke, heart attack, and even death if left untreated. While there is a lot you can do at home to help lower your systolic blood pressure, it’s important to follow all treatment recommendations from your healthcare provider.

If you experience severe headache, blurred vision, drooping on one side of the face, weakness on one side of the body, chest pain, or other concerning symptoms, seek medical attention immediately.

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What Happened To Older Patients Whose Blood Pressure Medications Were Reduced

The OPTIMISE trial provided preliminary evidence that some older adults may be able to reduce the number of blood pressure medications they take, without causing a large increase in blood pressure. For the trial, researchers randomized 569 patients age 80 or older, with systolic blood pressure lower than 150 mm Hg, to either remain on their current blood pressure medications, or to remove at least one blood pressure medication according to a prespecified protocol. The study subjects were followed for 12 weeks to assess blood pressure response.

Researchers found that both the people who remained on their previous blood pressure medications and those who reduced the number of medications had similar control of blood pressure at the end of the study. While the mean increase in systolic blood pressure for the group that reduced medications was 3.4 mm Hg higher than the control group, the number of patients who had systolic blood pressure below the goal of 150 mm Hg at the end of the study was not significantly different between groups. Approximately two-thirds of patients were able to remain off the medication at the end of the study.

It is important to note that OPTIMISE is relatively a small study, and the investigators did not examine long-term outcomes such as heart attack, heart failure, or stroke for this study , so we dont know what the long-term effect of deprescribing would be.

Choosing The Right Blood Pressure Medicine For You

Your healthcare provider will go through a number of steps with you to find the right blood pressure medicine for you. The choice will depend on your:

• health conditions
• medical history, such as which blood pressure medicines you have tried in the past.

Since everyone is different, some medicines work better for others than they will for you. Often 2 or 3 medicines are needed and it may take time to find the right combination and dosage.

Below are the most common groups of medicines that can be used to lower blood pressure.

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Medication For High Blood Pressure

High blood pressure, or hypertension, means that your heart is working hard to pump blood through narrowed or blocked arteries and veins. NYU Langone physicians frequently prescribe medication, in addition to recommending lifestyle changes, to help people lower blood pressure.

For the best results, most people require a combination of two or three medications. To determine which medications are right for you, your doctor takes into account your age and overall heart health, as well as your kidney function.

Many medications for high blood pressure can cause a feeling of lightheadedness or dizziness. Your doctor works with you to find a medication plan that relieves your symptoms with minimal side effects.