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Blood Pressure Treatments

This information is for educational purposes only and should not replace medical advice. Always talk to your healthcare provider for medical decisions.

Most Important Things to Know:

Blood pressure medicines help protect your body from damage while you work on healthy lifestyle changes. Think of them as a shield that keeps your heart, brain, and kidneys safe while you build better health habits.

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What everyone should understand:

  1. Your blood pressure is lower because your medicines are working. This is why doctors recommend continuing your medicines - stopping them would let your blood pressure rise again.

  2. Even lowering your top blood pressure number by 5 points can help protect your body.

  3. Many people take more than one blood pressure medicine. This is normal and helps by:

    • Different medicines work on different parts of your body to lower blood pressure.​

    • Some medicines work better as a team than alone.

  4. Your doctor can help you take less medicine as your healthy changes start working.

What You'll Learn on This Page:

Learn how blood pressure medicines protect your body while you make healthy changes

Find out about common blood pressure medicines and how they work

See where we got this information and find trusted sources

How Blood Pressure Medicines Help You Stay Healthy

Even Lowering Systolic Blood Pressure By 5 mmHg Helps Protect You

Even lowering the top number (systolic) blood pressure by 5 mmHg may make stroke, heart problems, and kidney damage less likely.

Example: My blood pressure - 135/80

                  I lower it to 130/80 

Click on the Buttons Below to Learn More

Overview

How Medicines Work

Blood pressure medicines stop the changes that make blood pressure high:

  • How narrow your blood vessels (arteries) are

  • The amount of fluid in your body

  • Blocks chemicals that can hurt your heart

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Many people are on more than one medicine. More than one medicine:

  • Stop different causes of high blood pressure

  • Can work better than taking more of one medicine​

Lifestyle Changes Are Still Important

Your blood pressure medicines work hard to keep your numbers in a healthy range. When you make lifestyle changes and take medicine:

  • Your medicines may work better.

  • You might need less medicine over time.

  • You'll feel better overall.

  • You lower your risk of heart problems.

Treatment
How It Works
Common Side Effects
Solutions for Side Effects
Monitoring

Lifestyle Only

Works in many ways:

  • Your blood vessels are more relaxed

  • Your heart is healthier and doesn't have to work as hard

  • Your kidneys are healthier

Depending on how long changes take:

  1. Longer period with high blood pressure

  2. Continued or increased risk of brain, heart, and kidney damage

  • Taking a blood pressure lowering medication

  • Blood tests (monitor for damage to your body)

  • Daily blood pressure

  • Lifestyle changes that you make​

ACE Inhibitors

  • Removes extra water

  • Relaxes blood vessels

  • Protects the heart

  • Dry cough

  • Lightheadedness

  • Kidney problems

  • ​Take at night (check with your doctor)

  • Stand up slowly

  • Drink enough water (check how much with your doctor)

  • Talk to your doctor- might change medicine or dose

  • Blood tests

  • Daily blood pressure

ARBs

Similar to ACE inhibitors

  • Dry cough (less than ACEi)

  • Lightheadedness

  • Kidney problems

Same as ACE Inhibitors​

  • Blood tests

  • Daily blood pressure

Water Pills (Diuretics)

Removes extra water

  • Low potassium

  • More bathroom trips

  • Dry mouth

  • Blood tests

  • Daily blood pressure

  • Eat less salt

  • Take in the morning (ask your doctor)

  • Sip water 

  • Talk to your doctor- might change medicine or dose

Calcium Channel Blockers

Relaxes blood vessels

  • Headache

  • Ankle swelling

  • Flushing

  • Constipation

  • Gum problems

  • Elevate feet

  • Stay active

  • Eat more fiber

  • Floss

  • Talk to your doctor- might change medicine or dose

  • Blood tests

  • Daily blood pressure

Lifestyle Only

Benefits When Combined With Good Medical Care

  • Lowers blood pressure naturally

  • Better overall health

    • More energy​

    • Feel healthier and fitter

Challenges

  • Takes longer to see results

  • Results vary based on:

    • Your genes​

    • Age

    • Other health conditions

    • How high your blood pressure is

  • Requires consistent long-term commitment

  • May not lower blood pressure enough

Risks of Lifestyle-Only Approach

  • Longer time with high blood pressure

  • Continued risk of health problems:

    • Brain: stroke risk​

    • Heart: heart attack risk

    • Kidneys: chronic kidney disease risk

  • Harder to reverse damage once it happens

  • May miss the window for prevention​

Some people will have a harder time lowering blood pressure through lifestyle alone. This isn't a failure—it's about your body's needs. Work with your doctor to find the right combination of lifestyle changes and medicine for you.

ACE Inhibitors

Most end in "-pril"

(lisinopril, ramipril, enalapril, perindopril, benazepril, captopril, quinapril)

How ACE Inhibitors Help

  • Help get rid of extra fluid in your body 

  • Relaxes your blood vessels

  • Protects your heart from damage

  • Can help protect your kidneys

Possible Side Effects

  • Dry cough that doesn't bring up mucus

  • Feeling dizzy, especially when standing up

  • Changes in how your kidneys are working

What You Can Do About Side Effects

If you get a cough:​

  • ​Tell your doctor—they can switch you to a different type (ARB).

  • The cough usually goes away with changing the medication.

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If you feel dizzy:

  • Tell your doctor—they might suggest changing the dose.

  • Stand up slowly.

  • Make sure to drink enough water.

  • Ask your doctor about taking the medication at night instead of in the morning.

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For kidney changes:

  • Regular blood tests help catch any changes early.

  • Changing the medicine will fix most changes.

Get Emergency Help If You Have:

Signs of Allergic Reaction:​

  • Swelling of the face, lips, or tongue

  • Trouble breathing

  • Really bad stomach pain, diarrhea, or throwing up

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Signs of Pancreas Problems:

  • Really bad stomach pain

  • Feeling sick to your stomach

  • Have trouble eating​

ARBs

Most end in "-sartan"

(losartan, olmesartan, candesartan, valsartan, irbesartan, telmisartan, azilsartan medoxomil)

How ARBs Help

  • Works like ACE inhibitors but in a slightly different way

  • Relaxes your blood vessels

  • Protects your heart from damage

  • Can help protect your kidneys

  • Often used when people can't take ACE inhibitors

Possible Side Effects

  • Feeling dizzy, especially when standing up

  • Less likely to cause cough than ACE inhibitors

  • Changes in kidney function tests

What You Can Do About Side Effects

If you feel dizzy:

  • Tell your doctor—they might suggest changing the dose.

  • Stand up slowly.

  • Make sure to drink enough water.

  • Ask your doctor about taking the medication at night instead of in the morning.

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For kidney changes:

  • Regular blood tests help catch any changes early.

  • Most changes can be managed by changing the medicine.

  • Usually, your kidneys return to normal with medication adjustment.

Calcium Channel Blockers

Most end in "-dipine"

(Amlodipine, felopidine, nifedipine, nisoldipine, nimodipine, isradipine, nicardipine, levamlodipine, clevidpine)

(Calcium channel blockers not ending in "-dipine": verapamil, diltiazem)

How Calcium Channel Blockers Help

  • Relaxes your blood vessels

  • Some help heart rhythm

  • Some are safe during pregnancy

Possible Side Effects

  • Swelling in ankles

  • Headache

  • Feeling flushed or warm

  • Some people get constipated

  • Can cause gum problems (gingival hyperplasia)

What You Can Do About Side Effects

For ankle swelling:

  • Elevate feet when resting

  • Stay active by walking

  • Tell your doctor, they might suggest:

    • Changing your dose​

    • Switching to a different kind of calcium channel blocker

    • Adding an ACE inhibitor or ARB to stop the swelling

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For headache/flushing:

  • Tell your doctor, they:

    • Might suggest changing the dose

    • Can let you know if it might get better with time

    • Can tell you if taking it at a different time of day might help

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Constipation:​

  • Eat more fiber-rich foods

  • Stay active by walking

  • Ask your doctor about diet changes that might help

  • Talk to your doctor - they might suggest changing the dose or trying a different medicine

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Gum problems (gingival hyperplasia):

  • Brush teeth at least twice daily

  • Floss at least once a day

  • See your dentist regularly

  • Tell your dentist about this medicine

  • Tell your doctor - they may suggest a different medication

Diuretics (Water Pills)

Usually a thiazide diuretic

(Hydrochlorothizide, chlorthalidone, iindapamide, metolazone, bendroflumethiazide, chlorothiazide)

How Water Pills Help

  • Removes extra water and salt from your body

  • Lowers the amount of fluid your heart has to pump

  • Often works well with other blood pressure medicines

  • Some types safe in pregnancy

Possible Side Effects

  • More trips to the bathroom

  • Changes in blood tests (potassium and other minerals)

  • Changes in blood sugar

  • Feeling thirsty

  • Some people have trouble sleeping

What You Can Do About Side Effects

For bathroom trips:

  • Take the medicine in the morning

  • Plan activities where you'll have bathroom access

  • Eat less salt - Can help the medicine work better. This means your doctor may be able to lower your dose over time.

  • Talk to your doctor - They can suggest ways to help or another medicine

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For blood test changes:

  • Regular blood tests catch changes early

  • Your doctor might suggest supplements â€‹

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Changes in blood sugar:​

  • Regular blood tests help catch changes early

  • Your doctor can help adjust or change your medicine​

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Feeling thirsty/dehydrated:

  • Sip water throughout the day

  • Ask your doctor how much water is right for you

  • Tell your doctor if you're having trouble drinking enough water

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Sleep problems:

  • Take medicine in the morning

  • Keep a regular sleep schedule

  • Talk to your doctor - They might suggest a different medication or timing

Written by: 

Aaron Vrolijk, MD

See Our Review Process

Last Updated: January 16, 2025

Resources We Used
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Disclaimer: The information provided on this site is intended for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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