Blood pressure tablets

There are a number of drugs used to treat blood pressure. Sometimes these may be used alone, in other cases they may be used in a combination of 2 or 3 tablets. The main focus for doctors is to use whatever works best to control your blood pressure. The lower the better.

Blood pressure medications, like any others, only work if taken as prescribed by your doctor. Just because you feel well, doesn't mean that you should stop taking your medication. Generally, high blood pressure has no symptoms. Controlling blood pressure is a very important part of heart disease prevention.

Lifestyle measures are also important in order to reduce blood pressure. These include cutting out all added salt in your food, reducing alcohol intake to a sensible level, and taking regular exercise.

Medication groups include ACE inhibitors, diuretics, calcium channel blockers, beta-blockers, angiotension receptor blockers (ARBs) and a few others.

ACE inhibitors

ACE inhibitors work by reducing chemicals made in the kidneys like angiotensin, which can cause increased blood pressure. Therefore, they reduce blood pressure and have a protective effect in heart failure.

Side effects are not particularly common with this group, but can be a nuisance for some people. They include a persistent dry cough or sore throat, unexpectedly low blood pressure resulting in dizziness (particularly possible after the first dose), and raised potassium levels.

They are often used in combination with water tablets (diuretics) and calcium blockers.

Thiazides (diuretics)

Thiazides work on the kidney, and are a weak type of diuretic. That means that people taking them go to the toilet more often, but usually this is only at the start.

They are taken once a day in the morning. As with other water tablets, there is a small tendency to lose salts like sodium and potassium on thiazides, so they are often given in a combination with a small potassium supplement (there will then be a ‘K' in the name).

They are often used with an ACE inhibitor, and in that case the potassium supplement is probably not necessary, as ACE inhibitors tend to accumulate potassium.

There are many ACE/thiazide combinations (usually ending in 'zide) - two for the price of one.

Calcium blockers

These are popular medicines. Some have been around for many years, while there are also some newer versions.

These medicines reduce blood pressure mainly by opening up arteries, making it easier for the heart to pump blood around the body. This makes them useful in treating angina as well as blood pressure; it also causes most of the side effects, like facial flushing, headaches and sometimes swollen ankles.

Unlike thiazides, results can be improved by increasing the dose, so it is common to increase them gradually until the desired blood pressure target is achieved.

Calcium blockers are often given in combination with an ACE inhibitor, and sometimes with a diuretic as well.

Beta-blockers

Beta-blockers have commonly been used to control blood pressure in the past. However they are now not considered to be as effective as the other treatments for reducing blood pressure, and so are no longer the first choice of treatment for high blood pressure.

Your doctor may still give you a beta-blocker in some cases; for instance, if you have problems with the other types of medications or if you also need a beta-blocker to control angina. Beta-blockers work by slowing and relaxing the heart, and are therefore particularly useful in people who have suffered a heart attack, because they help to prevent another attack.

Side effects are not especially common. They include a slow heart rate, (for example a pulse below 60 beats per minute); wheezy chest in people with asthma; and worsening of poor circulation, psoriasis or heart failure (circulation is an important concern for some people with diabetes). Fatigue, sleep problems and rashes are less common side effects. Beta-blockers should not be used in those with heart rhythm problems, asthma or established circulation problems.

The generic or chemical name (in small letters on the box) for beta-blockers usually ends in -olol.