Guide to High Blood Pressure Medications
Angiotensin-Converting Enzyme (ACE) Inhibitors
These are often preferred by healthcare providers for people with diabetes because the medication has fewer side effects, does not affect blood sugar levels and provides additional kidney protection. ACE inhibitors expand blood vessels and decrease resistance, which lets blood flow more easily and makes the heart's work easier or more efficient. ACE inhibitors are used to treat symptoms of heart failure and to lower blood pressure. Your healthcare provider may perform blood tests to make sure there are no effects on your potassium levels or kidneys.
Side Effects:
- Dry cough
- Rash or itching
- Allergy-like symptoms
- Allergic reaction with generalized swelling (angioedema)
- Excess potassium in the body (hyperkalemia), especially in people with kidney failure
Commonly prescribed ACE inhibitors include:
- Benazepril (Lotensin)
- Captopril (Capoten)
- Enalapril (Vasotec)
- Fosinopril (Monopril)
- Lisinopril (Prinivil, Zestril)
- Moexipril (Univasc)
- Perindopril (Aceon)
- Quinapril (Accupril)
- Ramipril (Altace)
- Trandolapril (Mavik)
Diuretics
Diuretics lower blood pressure by causing the body to rid itself of excess fluids and sodium through urination. If diuretics alone don't bring the desired effects, they may be combined with other blood pressure medications. In people with diabetes, diuretic drugs may increase the blood sugar level. A change in drug, diet, insulin or oral antidiabetic dosage corrects this in most cases. Your doctor can change your treatment. Most of the time the degree of increase in blood sugar isn't much.
Some of these drugs may decrease your body's supply of a mineral called potassium. Eating foods containing potassium may help prevent significant potassium loss. You can prevent potassium loss by taking a liquid or tablet that has potassium along with the diuretic, if your doctor recommends it.
Side Effects:
- Fatigue
- Leg cramping
- Decreased potassium levels
Some commonly prescribed diuretics include:
- Amiloride (Midamor)
- Bumetanide (Bumex)
- Chlorothiazide (Diuril)
- Chlorthalidone (Hygroton)
- Furosemide (Lasix)
- Hydrochlorothiazide (Esidrix, Hydrodiuril)
- Indapamide (Lozol)
- Spironolactone (Aldactone)
Beta Blockers
Beta blockers decrease the heart rate and cardiac output, which lowers blood pressure. They're also used with therapy for cardiac arrhythmias and in treating angina pectoris.
For people with diabetes, beta blockers may hide some of the warning signs of low blood sugar. When you take a beta blocker, your heart rate may not increase in response to a low blood sugar level. You will need to check your blood sugar levels carefully after you start taking a beta blocker. If you have low blood sugar often, your doctor may want to change the dosages of your diabetes medicine.
Side effects:
- Insomnia
- Cold hands and feet
- Fatigue
- Depression
- Slow heartbeat
- Symptoms of asthma
Some commonly prescribed medications include:
- Atenolol (Tenormin)
- Betaxolol (Kerlone)
- Bisoprolol/hydrochlorothiazide (Ziac)
- Bisoprolol (Zebeta)
- Carteolol (Cartrol)
- InsoAcebutolol (Sectral)
- Metoprolol (Lopressor, Toprol XL)
- Nadolol (Corgard)
- Propranolol (Inderal)
- Sotalol (Betapace)
- Timolol (Blocadren)
Angiotensin-2 Receptor Antagonists
Angiotensin-2 (AT-2) receptor antagonists have been shown to produce effects similar to those produced by ACE inhibitors. They may be better tolerated because they produce less cough. Rather than lowering levels of angiotensin II (as ACE inhibitors do), angiotensin II receptor blockers prevent this chemical from having any effects on the heart and blood vessels. This keeps blood pressure from rising.
For people with diabetes, this medication is often preferred because of the extra protection for the kidneys.
Side effects:
- Dizziness/Lightheadedness
- Decreased kidney function
- Increased potassium levels
Some common products in this category include:
- Candesartan (Atacand)
- Eprosartan (Teveten)
- Irbesartan (Avapro)
- Losartan (Cozaar)
- Telmisartan (Micardis)
- Valsartan (Diovan)
Calcium Channel Blockers
Calcium channel blockers, also known as "calcium antagonists," interrupt the movement of calcium into heart and vessel cells. Besides being used to treat high blood pressure, they're also used to treat angina (chest pain) and/or some arrhythmias (abnormal heart rhythms).
Side effects:
- Constipation
- Headache
- Rapid heartbeat
- Rash
- Drowsiness
- Nausea
- Swelling in the feet and legs
Some commonly prescribed calcium channel blockers include:
- Amlodipine (Norvasc, Lotrel)
- Bepridil (Vascor)
- Diltiazem (Cardizem, Tiazac)
- Felodipine (Plendil)
- Nifedipine (Adalat, Procardia)
- Nimodipine (Nimotop)
- Nisoldipine (Sular)
- Verapamil (Calan, Isoptin, Verelan)
Above content provided by The American Heart Association in partnership with Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.
Posted January 2009
