Types of High Blood Pressure Medications

Your doctor or other health care professional will prescribe a drug that fits your specific needs based on your medical condition, and any other existing health problems you may have.

There are a number of types and classes of drugs available for managing and treating high blood pressure (hypertension). Your doctor or other health care professional will prescribe a medication that fits your specific needs based on your medical condition, and any other existing health problems you may have, for example, kidney disease, heart disease, or diabetes. Your doctor also may recommend other therapies and lifestyle changes like getting more exercise, managing stress, and eating a healthy diet.

This information will provide a list of high blood pressure medication generic and brand names, their uses (treatment, management, or prevention of health problems, how they work (mechanism of action), and common side effects.  Here are the 10 types of high blood pressure medications include:

1. Angiotensin converting enzyme (ACE) inhibitors - Angiotensin converting enzyme (ACE) inhibitors are blood pressure medications that inhibit the activity of the enzyme angiotensin converting enzyme (ACE), which is important for controlling blood pressure.
2. Angiotensin receptor blockers (ARBs) - Angiotensin II receptor blockers (ARBs) are medications used to treat elevated blood pressure or hypertension.
3. Beta-blockers - By blocking the effect of norepinephrine and epinephrine, beta blockers reduce blood pressure by dilating blood vessels and heart rate.
4. Calcium channel blockers (CCBs) - CCBs inhibit the movement of calcium into muscle cells. The reduction in calcium reduces the force of the heart's muscular pumping action (cardiac contraction) and thereby reduces blood pressure.
5. Diuretics - Diuretics are among the oldest known medications for treating high blood pressure. 
6. Alpha-blockers - Alpha-blockers relax the muscles and lower blood pressure.
7. Alpha-beta blockers - Alpha-beta blockers work the same way as alpha-blockers but also slow the heartbeat as beta-blockers do.
8. Clonidine - Clonidine (Catapres, Catpres-TTS) is an inhibitor of the nervous system in the brain.
9. Aliskiren (Tekturna) -  Aliskiren blocks the effects of renin and angiotensin so that blood pressure does not increase.
10. Minoxidil - Minoxidil is a vasodilator. Vasodilators are muscle relaxants that work directly on the muscles surrounding the arteries throughout the body.

Angiotensin converting enzyme (ACE) inhibitors are blood pressure medications that inhibit the activity of the enzyme angiotensin converting enzyme (ACE), which is important for controlling blood pressure.

Angiotensin II is a very potent chemical formed in the blood by ACE from, angiotensin I. When formed, angiotensin II causes the muscles surrounding blood vessels to contract, thus narrowing the vessels and increasing blood pressure.

ACE inhibitors are medications that inhibit the activity of ACE which decreases the production of angiotensin II. As a result, these medications cause the blood vessels to enlarge or dilate, and this reduces blood pressure. This lower blood pressure makes it easier for the heart to pump blood and can improve the function of a failing heart. In addition, the progression of kidney disease due to high blood pressure or diabetes is slowed.

Common side effects of this ACE inhibitors

• Cough
• Low blood pressure (hypotension)
• Fatigue
• Headache
• Increased blood potassium levels

This list is not does not include all side effects or adverse events for ACE inhibitors.

This class of medicine also are used for other health conditions, for example:

• Prevention and treatment of diabetes and kidney disease
• Heart failure

Examples of generic and brand names available for ACE inhibitors

• enalapril (Vasotec)
• captopril (Capoten)
• lisinopril (Zestril and Prinivil)
• benazepril (Lotensin)
• quinapril (Accupril)
• perindopril (Aceon)
• ramipril (Altace)
• trandolapril (Mavik)
• fosinopril (Monopril)
• moexipril (Univasc)

Angiotensin II receptor blockers (ARBs) are medications used to treat elevated blood pressure, or hypertension. These medications that block the action of angiotensin II by preventing angiotensin II from binding to angiotensin II receptors on the muscles surrounding blood vessels.

As a result, blood vessels enlarge (dilate), and blood pressure is reduced. Reduced blood pressure makes it easier for the heart to pump blood and can improve heart failure. In addition, the progression of kidney disease due to high blood pressure or diabetes is slowed. ARBs have effects similar to ACE inhibitors, but ACE inhibitors act by preventing the formation of angiotensin II rather than by blocking the binding of angiotensin II to muscles on blood vessels.

Common side effects of ARBs

• Cough
• Low blood pressure (Hypotension)
• Fatigue
• Headache
• Increased blood potassium levels
• Indigestion
• Diarrhea

This list is not does not include all side effects or adverse events for ARBs.

This class of medicine also are used for other health conditions, for example:

• Prevention and treatment of diabetes kidney disease
• Heart failure

Examples of generic and brand names available for ARBs

• losartan (Cozaar)
• irbesartan (Avapro)
• valsartan (Diovan)
• candesartan (Atacand)
• olmesartan (Benicar)
• telmisartan (Micardis)
• eprosartan (Teveten)
• azilsartan (Edarbi)

Beta blockers are medications that block norepinephrine and epinephrine (adrenaline) from binding to both beta 1 and beta 2 receptors on organs and muscles, including the muscles surrounding blood vessels that cause the blood vessels to narrow and the heart to beat. By blocking the effect of norepinephrine and epinephrine, beta blockers reduce blood pressure by dilating blood vessels and reducing heart rate. They also may constrict air passages because stimulation of beta receptors in the lung cause the muscles that surround the air passages to contract.

Common side effects of beta blockers

• Fatigue
• Dizziness
• Shortness of breath
• Impotence
• Low blood pressure

This list is not does not include all side effects or adverse events for beta blockers.

This class of medicine also are used for other health conditions, for example:

• Heart failure
• Chest pain (angina)
• Hyperthyroidism
• Fast heart rate
• Migraine

Examples of brand and generic names available for beta blockers

• acebutolol (Sectral)
• atenolol (Tenormin)
• betaxolol (Kerlone has been discontinued)
• bisoprolol fumarate (Zebeta)
• carteolol (Cartrol, discontinued)
• carvedilol (Coreg)
• esmolol (Brevibloc)
• labetalol (Trandate [Normodyne - discontinued])
• metoprolol (Lopressor, Toprol XL)
• nadolol (Corgard)
• nebivolol (Bystolic)
• penbutolol (Levatol has been discontinued)
• pindolol (Visken, discontinued)
• propranolol (Hemangeol, Inderal LA Inderal XL, InnoPran XL)
• timolol (Blocadren, discontinued)

Calcium is needed by all muscle cells, including those of the heart and muscles and surrounding arteries, in order for the cells to contract. CCBs inhibit the movement of calcium into muscle cells. The reduction in calcium reduces the force of the heart's muscular pumping action (cardiac contraction) and thereby reduces blood pressure. These medications also relax the muscle cells surrounding the arteries to further reduce blood pressure.

Three major types of calcium channel blockers are available. One type is the dihydropyridines, which do not slow the heart rate or cause other abnormal heart rates or rhythms (cardiac arrhythmias). They are commonly used for treating high blood pressure and are very effective in reducing blood pressure in African Americans.

Common side effects of CCBs

• Water retention in the arm and legs (peripheral edema)
• Constipation
• Shortness of breath
• Rash
• Headache

This list is not does not include all side effects or adverse events for CCBs.

• Migraine headache prevention
• Chest pain (angina)
• Abnormal heart beats
• Essential tremor
• Pheochromocytoma
• Hypertrophic subaortic stenosis
• Portal hypertension

Examples of brand and generic names available for CCBs

• amlodipine (Norvasc)
• amlodipine and atorvastatin (Caduet)
• amlodipine and benazepril (Lotrel)
• amlodipine and valsartan (Exforge)
• amlodipine and telmisartan (Twynsta)
• amlodipine and olmesartan (Azor)
• amlodipine and olmesartan and hydrochlorothiazide (Tribenzor)
• amlodipine and aliskiren (Tekamlo has been discontinued in the US)
• amlodipine and aliskiren and hydrochlorothiazide (Amturnide has been discontinued in the US)
• amlodipine and perindopril (Prestalia)
• clevidipine (Cleviprex)
• diltiazem (Cardizem)
• felodipine (Plendil has been discontinued in the US)
• isradipine (Dynacirc has been discontinued in the US)
• nifedipine (Procardia, Procardia XL, Adalat CC, Afeditab)
• nicardipine (Cardene, Cardene SR)
• nimodipine (Nimotop has been discontinued in the US)
• nisoldipine (Sular)
• verapamil (Calan)

The other two types of CCBs are referred to as the non-dihydropyridine agents. One type is verapamil (Calan, Covera, Isoptin, Verelan) and the other is diltiazem (Cardizem, Tiazac, Dilacor, and Diltia).

Diuretics are among the oldest known medications for treating high blood pressure. They work in the tiny tubes (tubules) of the kidneys to promote the removal of salt from the body. Water (fluid) also is removed along with the salt; however, the exact mechanism whereby diuretics lower blood pressure is not clearly known. The leading theory is that they directly cause the muscles surrounding blood vessels to relax. Diuretics may be used alone for high blood pressure. More frequently, however, low doses of diuretics are used in combination with other medications for high blood pressure to enhance the effect of the other medications.

Common side effects of diruetics

• Dehydration
• Low blood potassium
• Low blood pressure
• Fatigue
• Increased blood glucose
• Increased level of uric acid

This list is not does not include all side effects or adverse events for diuretics.

This class of medicine also are used for other health conditions, for example:

• Congestive heart failure
• Peripheral edema
• Pulmonary edema
• High potassium blood levels

Most commonly used diuretics to treat hypertension

• hydrochlorothiazide (Hydrodiuril)
• chlorthalidone
• The loop diuretics furosemide (Lasix), bumetanide (Bumex), and torsemide (Demadex)
• The combination of triamterene and hydrochlorothiazide (Dyazide)
• metolazone (Zaroxolyn)

The thiazide drugs are related to sulfa drugs. For those individuals who are allergic to sulfa drugs, ethacrynic acid, a loop diuretic, is a good option. Diuretics probably should not be used in pregnant women.

Muscles surrounding blood vessels have alpha receptors. Stimulation of alpha receptors, like stimulation of beta receptors, cause the muscles surrounding the arteries to contract and narrow the arteries. By blocking the alpha receptor, alpha-blockers relax the muscles and lower blood pressure.

Common side effects of alpha blockers

• Low blood pressure
• Dizziness
• Nausea
• Weakness

Examples of generic and brand names available for alpha blockers

• terazosin (Hytrin - brand name discontinued in the US)
• doxazosin (Cardura)

This list is not does not include all side effects or adverse events for alpha blockers.

Alpha blockers also are used for treating a health problem called benign prostate hyperplasia (BPH).

Alpha-beta blockers work the same way as alpha-blockers but also slow the heartbeat as beta-blockers do. As a result, less blood is pumped through the vessels, vessels dilate and blood pressure is lowered.

Common side effects of alpha blockers

• Dizziness
• Fatigue
• Slow heart rate
• Shortness of breath
• Weight gain
• Low blood pressure

This list is not does not include all side effects or adverse events for these medications.

This class of medicine also are used for other health conditions, for example:

• Heart failure
• Heart attack prevention

Examples of brand and generic names available for alpha blockers

• carvedilol (Coreg), and
• labetalol (Trandate). Normodyne is discontinued brand in the US.

Clonidine (Catapres, Catpres-TTS) is an inhibitor of the nervous system in the brain. These inhibitors of the nervous system act by binding to receptors on nerves in the brain to reduce the transmission of messages from the nerves in the brain to nerves in other areas of the body. By inhibiting transmission to nerves outside of the brain that innervate muscle cells of the heart and blood vessels, heart rate and blood pressure are reduced.

Common side effects

• Low blood pressure
• Drowsiness
• Headache
• Withdrawal symptoms

This list is not does not include all side effects or adverse events for Clonidine.

This class of medicine also are used for other health conditions, for example:

• Cancer pain
• Restless syndrome
• Tourette's syndrome
• Opioid withdrawal
• Postherpetic neuralgia
• Smoking cessation

The kidneys produce renin when they detect low blood pressure. Renin stimulates the production of angiotensin I, a protein which is converted to angiotensin II by angiotensin-converting enzyme (ACE) in the lungs. Angiotensin II is a powerful constrictor of blood vessels, and constricting blood vessels increases blood pressure. Angiotensin II also causes the secretion of an additional blood pressure elevating hormone in the adrenal glands called aldosterone, which helps the body retain sodium. Aliskiren blocks the effects of renin and angiotensin so that blood pressure does not increase.

Common side effects

• Diarrhea
• Increased blood levels of potassium
• Abnormal kidney function test results

Minoxidil is a vasodilator. Vasodilators are muscle relaxants that work directly on the muscles surrounding the arteries throughout the body. The arteries then dilate and blood pressure is reduced.

Common side effects

• Edema
• Increased heart rate
• Weight gain
• Headache

This list is not does not include all side effects or adverse events for Minoxidil.

Other uses

• Male baldness (topical foam and solution)