Hypertension medications: what to expect and how to use them

High blood pressure is usually treated with medicines, not just diet and exercise. Picking the right drug depends on your age, other health problems, and side effects you can tolerate. This page explains the common drug classes in plain language and gives simple, practical tips for starting and staying on treatment.

Main drug classes and what to expect

Here are the medicines doctors reach for most often. I name a typical drug for each class so you know what people mean when it comes up.

ACE inhibitors (example: lisinopril) — Lower pressure by relaxing blood vessels. Watch for a dry cough, dizziness, and rare but serious swelling of the face or throat (angioedema). Avoid if you are pregnant or planning pregnancy.

ARBs (example: losartan) — Work like ACE inhibitors but usually without the cough. Same pregnancy warning applies.

Calcium channel blockers (example: amlodipine) — Relax artery muscles. Common side effects are swelling in the ankles and flushing.

Diuretics (example: hydrochlorothiazide) — Help the body get rid of extra salt and water. They can lower potassium or sodium and may increase uric acid or blood sugar for some people.

Beta-blockers (example: metoprolol) — Slow the heart and lower pressure. They can cause fatigue, cold hands, or affect blood sugar control in diabetes.

Other options include alpha-blockers and vasodilators for specific situations. Your doctor will choose based on how low your target BP should be and other medical issues.

How to use medications safely

Start slow: many people begin with one drug and a low dose. Expect your doctor to retest your blood pressure and may change doses every 2–6 weeks until it’s controlled. For ACE/ARB or diuretics, labs to check kidney function and electrolytes are usually done within 1–4 weeks after starting or changing the dose.

Stick to a routine: take pills at the same time daily. Missing doses makes control harder and raises risks. If cost is an issue, ask about generics — they’re effective and cheaper.

Know common interactions: NSAIDs (like ibuprofen) can blunt blood pressure meds, and potassium supplements or salt substitutes can raise potassium dangerously with ACE/ARB or some diuretics. Grapefruit juice affects certain drugs, so mention it when you ask your doctor or pharmacist.

When to call your doctor: fainting, very fast heartbeat, new severe cough, swelling of face or throat, or signs of very low blood pressure (lightheadedness that doesn’t pass). Also check with your provider before stopping a med — sudden stopping can cause trouble.

Finally, combine meds with lifestyle: cutting salt, staying active, losing a little weight, and limiting alcohol make medicines work better. If you have questions about side effects, pregnancy, or buying medicines online, talk to your healthcare provider or a licensed pharmacist — they can help you pick a safe option.