Common Medications for High Blood Pressure Explained

One of the first vital signs checked upon entering a doctor’s office is blood pressure. With the rise of the use of electronic, self-inflating cuffs, many are now able to take their own blood pressure at home. Many American adults, 45.4% to be exact, fall into the category of having high blood pressure. Also known as hypertension, a high blood pressure is defined by the American College of Cardiology and the American Heart Association as being above 130/80 mmHg. Hypertension is a risk factor contributing to heart attacks, so managing it is critical for heart health. While monitoring your own blood pressure is an important step in keeping it under control, if your doctor does diagnose you with hypertension, they are likely to prescribe you medication to help. If you ever wondered what exactly your anti-hypertensive medication was doing and how it works, read on to find out. 

Diuretics

One way to decrease blood pressure is to decrease the total volume of blood in the body. I’m not suggesting blood sucking leeches, I’m talking about diuretics. By pulling the water out of your body and excreting it through urine, the volume of fluid within your blood vessels decreases. With less fluid to exert an outward force (called hydrostatic pressure) in the vascular system, your blood pressure decreases.

ACE Inhibitors and ARBS

While the use of diuretics to decrease blood pressure intuitively makes sense, the first line treatments are a bit more complex. Enter: Angiotensin-converting enzyme (ACE) inhibitors and Angiotensin II receptor blockers (ARBs). You might already notice the word “angiotensin” in each of the drug class names. Angiotensin is a precursor protein that gets converted into the active metabolite angiotensin II by, you guessed it, angiotensin-converting enzyme. So what exactly does angiotensin II do? It functions to constrict the blood vessels in the body, and especially in the kidney. By reducing the angiotensin II produced in your body or by blocking the receptor it binds to, the blood vessels will relax allowing them to stretch more and lead to lower blood pressures.

Beta Blockers

Beta blockers work by slowing down your heart rate. When your heart has a chance to slow down, the amount of blood pumped out (known as stroke volume) decreases allowing the pressure being exerted on the arteries to decrease. 

Calcium Channel Blockers

Calcium Channel Blockers (CCBs) decrease cardiac contractility, or how strongly the heart beats with each pump. Because the heart pumps out less blood with each squeeze, it puts less pressure on the arteries. 

Pregnancy Safe Antihypertensives

Although ACE inhibitors and ARBs are the best tools in arsenal when it comes to fighting hypertension, these drugs are absolutely NOT to be used during pregnancy! These drug classes are teratogenic, meaning they cause abnormal development of the embryo or fetus. Some of the deformities in this case include abnormal kidney development, low blood pressure, and lung underdevelopment. Alternative drugs that are pregnancy safe include hydralazine, labetalol, nifedipine, and methyldopa. 

Lifestyle Modification

In addition to medication, lifestyle modification plays an important role in regulating blood pressure. Regular exercise along with eating plenty of fiber can mitigate the risk of hypertension. The American Heart Association suggests adults get at least 150 minutes of moderate intensity exercise each week, and at least 60 minutes per day for children ages 6-17.