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High Blood Pressure (Hypertension)

What Medications Are Right For You?

Last updated on:
10/04/2012

Contributing Author: Guy Slowik FRCS

You will have to work with your doctor to figure out exactly what medication or medications are right for you, and what dosages control your blood pressure best.

What Your Doctor Will Consider When Choosing Your Medication

Not every medication is right for everyone. When choosing the best medication for you to start taking, your doctor will consider:

  • Your age
  • Your race or ethnic background
  • The severity of your high blood pressure
  • If you have any other chronic diseases such as diabetes or heart failure
  • If you are taking any other medications and remedies, including prescribed or over-the-counter drugs and herbal remedies

For example, diuretics and beta-blockers are often the first drugs used to treat high blood pressure. But a person with both high blood pressure and type 1 diabetes might fare better on an ACE inhibitor.

Some groups of people respond better to one type of drugs than to another. For example, older people and black people do not respond to beta-blockers as well as they do to diuretics.

Need To Know:

Other medications or remedies, including over-the-counter drugs and herbal remedies, may react with some types of blood pressure medication. In order to select the right medication for you, your doctor must know about any other medications or remedies you are taking.

How To Information:

What you should consider when choosing your medication

You should also have some input into choosing the right medication. Some things you might want to consider include:

  • How often will you have to take the medication? Some drugs control blood pressure over a longer period, which means that you have to take your medication less often. These drugs may also provide smoother blood pressure control.
  • How much does the medication cost? Older drugs are more likely to be available in less expensive, generic forms.
  • How will the medication impact your day-to-day life? Can you live with the drug's side effects? Sometimes side effects can be decreased (or stopped) by reducing the drug dosage. In other cases, you doctor may recommend treatment with another agent.

What If The Medication Doesn't Lower Your Blood Pressure?

After selecting the medication to begin your treatment for high blood pressure, your doctor will advise you to start taking the lowest dosage possible. This is intended to avoid side effects as well as a fall in blood pressure that happens too rapidly. If your blood pressure remains uncontrolled after one or two months of therapy, your doctor will adjust the dose upwards.

If the full dose of the drug does not effectively control your blood pressure, your doctor will:

  • Add another type of drug
  • Switch to another type of drug

Adding a second type of drug can be useful if you are not having problems with the first drug. But if you are experiencing troublesome side effects, or if the first drug isn't lowering your blood pressure, your doctor is likely to recommend that you switch to another type of drug.

If your blood pressure is still not controlled after these changes, additional medications can be added. There are a variety of mixed-class medications that can reduce the number of pills you need to take each day.

If your blood pressure is still not adequately controlled, your doctor may refer you to a cardiologist with specific expertise in treating high blood pressure.

Nice To Know:

Q. If I take medication for my high blood pressure, and the pressure falls to normal, why do I have to keep taking the medication?

A. In some cases, high blood pressure is caused by another condition. This type of hypertension is referred to as secondary hypertension. Treating the underlying condition can sometimes cure secondary hypertension.

But 90 to 95 percent of people with high blood pressure have essential hypertension, for which there is no single identifiable cause. So if you stop taking your medication after your blood pressure falls to normal levels, it's likely that your blood pressure will increase again. As smooth, persistent control of blood pressure is a goal of treating hypertension, discontinuing your medication would be undesirable.

Also, some medications (for example, beta-blockers) can cause sudden increases in heart rate and blood pressure if you suddenly stop taking them. Therefore, you should never discontinue taking your medication on your own. This should be a decision made in consultation with your doctor.

How To Information:

How to get the most out of your medications

No matter what type of drug your doctor selects for you, there are some general rules to follow in order to get the most benefit from your medication:

  • Keep taking the medication every day, even if your blood pressure begins to come down or if you feel fine.
  • Make sure you know how and when you should take the medication (for example, with or without food).
  • Do not adjust the amount of medication you take each day, either upwards or downwards. Your doctor is the only person who should adjust your dosage of blood pressure medication.
  • Keep track of any side effects that you experience and report them to your doctor. Find out what side effects are serious enough to warrant immediate medical attention.
  • Make a note on your calendar to refill the prescription before it runs out.
  • Make sure you have enough pills to take you when you travel.

Need To Know:

Remember that high blood pressure usually causes no symptoms, but it stays with you, inflicting damage on key organs if left uncontrolled.

 

 
 

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From Andrew Maynard - Chair of the University of Michigan Department of Environmental Health Sciences, with help from David Faulkner - 2013 Master of Public Health graduate.