What is the best blood pressure medication with the least side effects

• Other BP Drugs
  • What Are Other Types of High Blood Pressure Drugs?
• Side Effects
  • What Are Side Effects of the 4 Best Blood Pressure Drugs?
• Guide
  • What Are the 4 Best Blood Pressure Drugs? Topic Guide

The four best types of blood pressure drugs that are considered the first choices to lower blood pressure include thiazide diuretics, ACE (angiotensin-converting enzyme) inhibitors, angiotensin receptor blockers (ARBs), and calcium channel blockers.

Blood pressure drugs (antihypertensives) are prescription medications used to lower high blood pressure (hypertension). 

There several classes of high blood pressure medications. The best blood pressure drug depends on a person’s overall health and other health conditions. The guidelines for high blood pressure from the American College of Cardiology and the American Heart Association recommend four types of blood pressure drugs as the first choices to lower blood pressure, including: 

1) Thiazide diuretics

• Used to help the body get rid of excess sodium (salt) and water and help control blood pressure
• Often used in combination with other prescription medications
• Examples include: 
  • Chlorthalidone (Hygroton)
  • Chlorothiazide (Diuril)
  • Hydrochlorothiazide (Esidrix, Hydrodiuril, Microzide)
  • Indapamide (Lozol)
  • Metolazone (Mykrox, Zaroxolyn)

2) ACE (angiotensin-converting enzyme) inhibitors

• These medicines help the body produce less angiotensin, which helps blood vessels relax and open up, which lowers blood pressure
• Examples include: 
  • Benazepril (Lotensin)
  • Captopril (Capoten)
  • Enalapril maleate (Vasotec)
  • Fosinopril sodium (Monopril)
  • Lisinopril (Prinvil, Zestril)
  • Moexipril (Univasc)
  • Perindopril (Aceon)
  • Quinapril hydrochloride (Accupril)
  • Ramipril (Altace)
  • Trandolapril (Mavik)

3) Angiotensin receptor blockers (ARBs)

• These drugs block the effects of angiotensin, so the angiotensin cannot constrict blood vessels, which helps blood vessels stay open so blood pressure is reduced
• Examples include: 
  • Candesartan (Atacand)
  • Eprosartan mesylate (Teveten)
  • Irbesartan (Avapro)
  • Losartan (Cozaar)
  • Telmisartan (Micardis)
  • Valsartan (Diovan)

4) Calcium channel blockers

• Prevents calcium from entering smooth muscle cells of the heart and arteries so the heart’s contraction is not as forceful
• This helps relax and open narrowed blood vessels, reduce heart rate, and lower blood pressure
• Examples include: 
  • Amlodipine (Lotrel, Norvasc)
  • Bepridil (Vasocor)
  • Diltiazem hydrochloride (Cardizem CD, Cardizem SR, Dilacor XR, Tiazac)
  • Felodipine (Plendil)
  • Isradipine (dynacirc, dynacirc CR)
  • Nicardipine (Cardene SR)
  • Nifedipine (Adalat CC, Procardia XL)
  • Nisoldipine (Sular)
  • Verapamil hydrochloride (Calan SR, Covera HS, Isoptin SR, Verelan)

What Are Other Types of High Blood Pressure Drugs?

Other classes of high blood pressure medications include: 

• Beta-blockers
  • These drugs reduce heart rate, the heart’s workload, and the heart’s output of blood to lower blood pressure
• Alpha blockers
  • These medicines reduce the resistance in the arteries, relaxing the muscle tone of the vascular walls
• Alpha-2 receptor agonists
  • These reduce blood pressure by decreasing the activity of the sympathetic (adrenaline-producing) action of the involuntary nervous system
• Combined alpha and beta-blockers
  • Used as an intravenous (IV) drip for patients experiencing in hypertensive crisis
  • May be prescribed for outpatient use if a patient is at risk for heart failure
• Central agonists
  • These drugs help decrease the ability of blood vessel to tense up or contract
• Peripheral adrenergic inhibitors
  • These medications lower blood pressure by blocking neurotransmitters in the brain so they don’t receive the “message” to constrict
  • Rarely used unless other medications don’t help
• Vasodilators
  • Causes the muscle in the walls of blood vessels to relax, allowing the vessel to widen which allows blood to flow through better

QUESTION

What Are Side Effects of the 4 Best Blood Pressure Drugs?

Common side effects of blood pressure medications vary depending on the drug class. Side effects of the four common blood pressure drugs may include: 

• Thiazide diuretics
  • Potassium loss
    • Weakness
    • Leg cramps 
    • Tiredness
  • Impotence 
  • Increased blood sugar levels in diabetics
  • Attacks of gout after prolonged treatment (uncommon)
• ACE (angiotensin-converting enzyme) inhibitors
  • Skin rash
  • Loss of taste
  • Chronic dry, hacking cough
  • Kidney damage (rare)
  • Women taking ACE inhibitors for high blood pressure should not become pregnant while on this class of drugs because it can be dangerous to both mother and baby during pregnancy
• Angiotensin receptor blockers (ARBs)
  • Occasional dizziness
  • ARBs should not be used during pregnancy because they can cause injury or death to a developing fetus
• Calcium channel blockers
  • Headache
  • Dizziness
  • Palpitations
  • Swollen ankles
  • Constipation

From

Heart Health Resources

Reviewed on 6/10/2022

References

Image Source: iStock Images

https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/types-of-blood-pressure-medications

https://www.goodrx.com/conditions/hypertension/outdated-blood-pressure-medications-current-best-treatments