What Would You Like To Know
About Blood Pressure Medication?

How about a concise overview of the main types of blood pressure medication, written in plain English?

  • What they do
  • How they do it
  • Do they really work?
  • Do they really prolong life?

How Do We Know?

Much of the statistics and information about blood pressure medication that we have today were obtained from some very large scientific studies:

  • ALLHAT:  Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. 42,000 subjects, l994 to 2002, National Institutes of Health, National Heart, Lung, and Blood Institute.

  • JNC 7  Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.

  • Framingham Heart Study  5,200 subjects, 1948 to present, NHLBI as above.

  • US Preventive Services Task Force.

  • Numerous smaller but reliable studies by researchers including the Heart Outcomes Prevention Evaluation (HOPE) and the second Australian National Blood Pressure trial (ANBP2). Some of the Australian study's conclusions differed from ALLHAT's.

The First-line Blood Pressure Medication

Five classes of medication have been demonstrated to reduce mortality and other complications of hypertension:

Diuretics:Thiazide type. We all know what these do. They lower blood pressure by reducing the volume of fluid in the blood vessels. See Normal Blood Pressure

ACE Inhibitors: Angiotensin-converting enzyme inhibitors. Retard the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. See Normal Blood Pressure

ARBs: Angiotensin receptor blockers. Work similarly to ACE inhibitors but at a different site so that their effects are additive.

Beta blockers: Block the effects of epinephrine (adrenaline). Decrease the release of renin and decrease cardiac output. Other actions on the sympathetic nervous system.

CCBs: Calcium channel blockers. Long-acting dihydropyridines. Block the passage of Calcium in the cell wall causing potent vasodilation and thus decreasing total peripheral resistance. See Normal Blood Pressure

Second-line agents: If your problem is not managed by the above blood pressure medication you need a lot more than this website can offer so a listing is all that is required. They are the Alpha-I blockers, the aldosterone-receptor blockers, the centrally acting agents, and the direct vasodilators.

Doctor’s Practical Guide:

The Benefits of Blood Pressure Medication:

Clinical trials have demonstrated reductions of incidence in stroke of 35% to 40%, reduction in myocardial infarction (heart attack) of 20% to 25%, and more than 50% reduction in occurrence of heart failure. The greater the blood pressure lowering the greater the reduction in these morbid events.

In Stage one hypertensive people with additional cardiovascular risk factors a sustained reduction of 12 mm Hg over 10 years would prevent one death out of eleven.

In people with cardiovascular disease or target organ damage already present the same reduction would prevent one death in nine.

In the general population an overall 5 mm reduction could lower stroke mortality by 14%, coronary heart disease mortality by 9% and overall mortality by 7%.

It is quite obvious that the decision to take high blood pressure medications need not be soul wrenching. By all means try to lower your BP by life-style changes but when this fails we do have these proven agents. It beats the alternative.

Eliminate false elevations, know your true blood pressure, and partner with your doctor in the management of your blood pressure. Learn to take it yourself at How To Take Blood Pressure

A word of warning: I see on TV infomercials and on the internet advertisements for products, herbs, concoctions of various sorts, and apparatuses that are purported to lower your blood pressure along with preventing cancer, doubling your strength, eliminating arthritis, etc, etc. Do not fall for this stuff, it is bogus. Enough said?

More information about the classes of medication is on this page Blood Pressure Medications


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