High blood pressure is a key risk factor for stroke and heart disease, but it can be treated. If you have tried lifestyle changes and your blood pressure is still greater than 130/80, your healthcare provider may discuss starting you on medication to lower your blood pressure.

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There are many different names that blood pressure medications go by, and it can be confusing to know which medication is right for you. The answer depends on many factors, such as:

• Age 

• Race

• Medical history

 

Here, we’ll cover common blood pressure medications, so you can talk with your healthcare provider about the best option for you.

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Blood pressure medications for younger adults 

Angiotensin-converting enzyme (ACE) inhibitors, angiotensin-receptor blockers (ARBs), and beta blockers are recommended as first-choice medications in some younger adults with high blood pressure. They are all effective at lowering blood pressure, but differ in the ways they work. 

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ACE inhibitors

ACE inhibitors work by acting on a pathway that helps control blood pressure, fluid balance, and sodium and potassium levels in the body.

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Angiotensin II is a hormone within the pathway that increases blood pressure by causing the blood vessels to narrow. ACE inhibitors lower blood pressure by preventing the formation of angiotensin II.

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They are a first choice for some younger adults because they are inexpensive and well-tolerated. A simple way to distinguish ACE inhibitors from other blood pressure medications is to look for names that end in “il.”

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Common ACE Inhibitors include:

• Benazepril

• Captopril

• Enalapril

• Lisinopril

• Quinapril

• Ramipril

 

Dry cough, headache, and hyperkalemia (elevated potassium levels) are potential side effects of ACE inhibitors. Angioedema is a rare, potentially life-threatening reaction that causes the lips, tongue, and throat to swell, making it difficult to breathe.

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Angioedema from ACE inhibitors is more common in Black people. For this reason, some healthcare providers do not consider ACE inhibitors a first-choice medication for Black adults.

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Similarly, ACE inhibitors are not recommended for people who are pregnant because of potential health complications in newborns. So if you are considering becoming pregnant, talk with your healthcare provider about a different option. 

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Angiotensin-receptor blockers

ARBs are very similar to ACE inhibitors in that they also lower blood pressure and the risk of stroke in some people. ARBs and ACE inhibitors both lower the action of angiotensin II, but they have different potential side effects and work in slightly different ways.

 

ARBs do not typically cause dry cough as a side effect, but they may cause dizziness. As with ACE inhibitors, ARBs should not be taken if you are pregnant or are considering becoming pregnant.

 

One way to identify ARBs is that their names typically end in “an.”

 

Common ARBs include:

• Candesartan

• Losartan

• Irbesartan

• Olmesartan

• Telmisartan

• Valsartan

 

Beta blockers

Beta blockers are an option for younger patients who can’t take ACE inhibitors or ARBs. They lower blood pressure by reducing heart rate, meaning your heart doesn’t have to work as hard to pump blood.

 

Some studies show that beta blockers don’t provide the same protection against stroke risk as ACE inhibitors or ARBs. But when used in combination with other medications, they can be very effective. For the most part, names of beta blockers tend to end in “ol.”

 

Common beta blockers include:

• Atenolol

• Nebivolol

• Carvedilol

• Metoprolol

• Nadolol

• Propranolol

 

Common side effects of beta blockers include:

• Dizziness 

• Tiredness 

• Cold hands and feet

• Sexual dysfunction

 

Blood pressure medications for Black adults

In the U.S., high blood pressure is more common in Black adults than in other populations. Black people often experience high blood pressure at a younger age, and some may have a hard time getting it under control. Thiazide diuretics and calcium channel blockers are often used as first-choice medications for treating Black adults with high blood pressure. 

 

Thiazide and thiazide-like diuretics

Thiazide and thiazide-like diuretics work by increasing urination to help the kidneys get rid of extra fluid, sodium, and potassium in the body. They are often called “water pills.”

 

Most healthcare professionals will recommend taking these in the morning to prevent urinating often during the night and disrupting your sleep. They begin working within a couple of hours and the effects last for about 12 hours.

 

There are many thiazide and thiazide-like diuretics available, and they are all effective, well-tolerated, and generally inexpensive.

 

Common thiazide and thiazide-like diuretics include:

• Chlorthalidone 

• Chlorothiazide

• Hydrochlorothiazide 

• Indapamide 

• Metolazone 

 

There is some evidence that chlorthalidone may be preferred because it is longer-acting and more potent than other options. Talk with your healthcare provider about which medication is the best choice for you.

 

Calcium channel blockers

Calcium channel blockers are another option for Black adults looking to control their high blood pressure. In addition to supporting bone health, calcium is a mineral that helps the heart muscle contract.

 

Calcium channel blockers lower blood pressure by blocking calcium from entering the heart muscle, decreasing how hard your heart has to work. Names of these blood pressure medications often, but not always, end in “ine.”

 

Common calcium channel blockers include:

• Amlodipine

• Diltiazem 

• Felodipine ER

• Isradipine

• Nicardipine

• Nifedipine

• Nisoldipine

• Verapamil

 

Dizziness, headaches, and swelling in the arms and legs are some possible side effects of calcium channel blockers. Talk with your healthcare provider if you experience any of these.

 

Choosing blood pressure medications

Many drugs are available to treat high blood pressure. Choosing the right one can be tricky. Learn how to find the best one for you with your personal doctor.