High blood pressure contributes to many deaths from heart disease and other conditions, yet fewer than half of all Americans with hypertension have the condition under control. High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may be damaged, as well as the blood vessels of the brain and kidneys, resulting in stroke, heart failure, kidney failure or heart attack. Individuals with mild hypertension and no heart disease may be able to control their blood pressure with lifestyle changes such as not smoking, exercising and eating a healthy diet. For more severe cases, drug treatment is usually necessary. Often, a combination of two or more drugs is used to treat hypertension.

Antihypertensive Medications

Diuretics, ("water pills") which rid the body of excess water and salt.  

Angiotensin Converting Enzyme (ACE) Inhibitors

ACE Inhibitors dilate (open wider) the blood vessels so blood can flow through more easily. These drugs act by blocking formation of angiotensin, a hormone that causes tightening of arteries and sodium retention (too much salt in the body). ACE inhibitors can be used alone or in combination with a diuretic or other drugs.

Common ACE inhibitors are:

• Benazepril (Lotensin®)
• Captopril (Capoten®)
• Enalapril (Vasotec®)
• Lisinopril (Zestril®, Prinivil®)
• Quinapril (Accupril®)
• Ramipril (Altace®)
• Trandolapril (Mavik®

When patients cannot take ACE inhibitors, other vasodilators (medications that dilate, or widen, the blood vessels) may be prescribed, often in combination with a diuretic. These include: Angiotensin Receptor Blockers (ARBs), also called angiotensin II receptor antagonists. These drugs have benefits similar to ACE inhibitors, but may have fewer side effects. losartan (Cozaar®) candesartan (Atacand®) telmisartan (Micardis®) eprosartan valsartan (Diovan®).

Alpha-Adrenergic Blockers (or alpha blockers) also were developed to avoid some of the associated side effects of ACE inhibitors, such as swelling and cough. They also are prescribed for prostate problems.

• Doxazocin (Cardura®)
• Terazocin (Hytrin®)
• Prazosin (Minipress)

Hydralazine (Apresoline®) Nitrates primarily are used for relief of angina (chest pain caused by a reduced flow of blood to the heart), but they also relax smooth muscle and widen blood vessels. They are used to lower systolic blood pressure. Calcium channel blockers also are vasodilators.

Ones frequently used to treat hypertension are:

• Amlodipine (Norvasc®, Lotrel®)
• Felodipine (Plendil®)
• Nifedipine (Procardia®)
• Phenylalkamine (Verapamil®)
• Benzothiazapine (Diltiazem®)

Beta-blockers

Beta-blockers affect the force and frequency of the heartbeat and reduce workload and pressure on the heart and blood vessels. They are currently used with, or instead of, diuretics as a first-line therapy for high blood pressure. Beta-blockers may also be used to help control rapid arrhythmias.