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Published on April 17, 2017

Finding the Right Blood Pressure Medication Shouldn’t Raise Your Blood Pressure

The number of blood pressure medication advertisements, while annoying, actually corresponds with the number of folks who need those medications.

Unfortunately, only half of the approximately 70 million American adults with hypertension (high blood pressure) are managing their condition.

Why the disconnect?

For one, the array of medications available can be quite confusing and overwhelming.

Here to help is Joseph Kummer, MD, Bryan Heart cardiologist, who shares information about your medication options.

The Journey to Better Blood Pressure

As a general rule, you want your blood pressure to be less than 140/90. How you get there varies.

“The best medication is for any one individual is kind of a moving target, because there are some that are better for certain patients and ones that are better for others,” explains Dr. Kummer. You must look at the whole picture, as it depends upon factors such as how high your blood pressure is, your heart health and your kidney health.

Beta Blockers: Great for a Weak Heart

Beta blockers are quite universally used. They’re good at lowering blood pressure, but they do cause side effects in some patients.

How do they work?

Beta blockers tell the heart to beat a little bit slower. “When you slow the heart rate, the heart pumps a little bit less blood overall, and that lowers the pressure in the arteries,” says Dr. Kummer. Since beta blockers relax the heart, they can be beneficial for an individual with a weak heart.

ACE Inhibitors: Drug Names End in “PRIL”

“ACE inhibitors work very well,” says Dr. Kummer. “They’re typically very, very well tolerated.” These drugs are designed to keep the kidneys from pulling quite as much fluid in the body. ACE inhibitors also work on relaxing the arteries themselves to bring down blood pressure.

Angiotensin-Receptor Blockers

This class of drugs is very similar to ACE inhibitors. “These are still fairly affordable, as are the ACE inhibitors for the most part,” says Dr. Kummer. “They work similarly to the ACE inhibitors and are considered to be first-line agents for high blood pressure.”

Diuretics: You Will Pee!

A lot of individuals take diuretics to address HBP, which are simply medications that make you pee more. Urinating more frequently gets rid of more fluid throughout the body and, in particular, within the arteries. Dr. Kummer says these drugs are also well tolerated and work effectively in lowering blood pressure.

Calcium-Channel Blockers: Drug Names End in “PINE”

Calcium-channel blockers work mostly just by relaxing the arteries themselves. It’s more of a direct action on the arteries that cause them to relax. These drugs don’t have many side effects and are usually very well tolerated.

First Steps

If you have a high blood pressure reading, your doctor will want to see you again in a few weeks. If it’s still above 140/90, they’ll often start with medication.

Again, the question of the hour is this…which medication?

“We usually like to hold off using beta blockers, unless there is some other direct reason, for instance, if you’ve had a heart attack previously,” explains Dr. Kummer.

The vast majority of people need at least two medications to effectively control blood pressure. Combination pills are an option, which of course is easier than taking two pills but often more costly.

“One thing that really can help is getting a blood pressure cuff to check your levels at home, especially if there are times when it seems a bit high but other times looks great,” says Dr. Kummer. This can help identify certain triggers.

Limit Salt

“The real mechanism of how the ACE inhibitors and the angiotensin-receptor blockers work, and even the diuretics, is to ultimately keep the kidneys from pulling more salt into the body,” says Dr. Kummer. If you don’t consume as much salt, your body won’t have to work as hard to get rid of it, and your blood pressure won’t be as high.

Processed foods contain a ton of salt. Learn to read labels. “You’re going to get some improvement, but it’s not going to be dramatic,” advises Dr. Kummer. “Some patients can get by just by limiting salt intake in order to lower their blood pressure to an acceptable level, but ultimately, most are still going to need medication.”

The Long Haul

“Making the changes in your diet, exercising more, limiting your salt intake – those approaches are all going to help. Nonetheless, it’s still quite likely that many individuals will need to be on medications for quite some time…perhaps the rest of their lives,” explains Dr. Kummer. “That being said, if you do all those things the right way, you probably won’t need to be on as many medications.”

For more information, you can go to bryanheart.com.


To listen to an interview with Joseph Kummer, MD, Bryan Heart cardiologist, follow this link: Blood Pressure Medications 101

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