Just the other day a patient and I were discussing the fact that when he went to see his medical doctor for an annual exam they told him he had borderline high blood pressure and was prescribed some drug . No mention of diet or exercise were discussed.
How many millions of people go through the exact same thing?
Here are the four types of high blood pressure drugs doctors commonly prescribe describing how they work and their side effects.
Angiotensin-Converting Enzyme (ACE) Inhibitors
These are often preferred for people with diabetes, because this prescription drug has fewer side effects, does not affect blood sugar levels and provides additional kidney protection. ACE inhibitors expand blood vessels and decrease resistance, which lets blood flow more easily and makes the heart’s work easier or more efficient. ACE inhibitors are used to treat symptoms of heart failure and to lower blood pressure. Your medical doctor should perform periodic blood tests to make sure there are no effects on your potassium levels or kidneys.
- Dry cough
- Rash or itching
- Allergy-like symptoms
- Allergic reaction with generalized swelling (angioedema)
- Excess potassium in the body (hyperkalemia), especially in people with kidney failure.
- Benazepril (Lotensin)*
- Enalapril (Vasotec)*
- Fosinopril (Monopril)*
- Lisinopril (Prinivil, Zestril)*
- Moexipril (Univasc)*
- Perindopril (Aceon)*
- Quinapril (Accupril)*
- Ramipril (Altace)*
- Trandolapril (Mavik)*
Diuretics lower blood pressure by causing the body to rid itself of excess fluids and sodium through urination. If diuretics alone don’t bring the desired effects, they may be combined with other blood pressure medications. In people with diabetes, diuretic drugs may increase the blood sugar level.
Some of these drugs may decrease your body’s supply of potassium.
- Leg cramping
- Decreased potassium levels
- Amiloride (Midamor)*
- Bumetanide (Bumex)*
- Chlorothiazide (Diuril)*
- Chlorthalidone (Hygroton)*
- Furosemide (Lasix)*
- Hydrochlorothiazide (Esidrix, Hydrodiuril)*
- Indapamide (Lozol)*
- Spironolactone (Aldactone)*
Beta blockers decrease the heart rate and cardiac output, which lowers blood pressure. They’re also used with therapy for cardiac arrhythmias and in treating angina pectoris.
For people with diabetes, beta blockers may hide some of the warning signs of low blood sugar. When you take a beta blocker, your heart rate may not increase in response to a low blood sugar level. You will need to check your blood sugar levels carefully after you start taking a beta blocker. If you have low blood sugar often, your doctor may want to change the dosages of your diabetes medicine.
- Cold hands and feet
- Slow heartbeat
- Symptoms of asthma
- Atenolol (Tenormin)*
- Betaxolol (Kerlone)*
- Bisoprolol/hydrochlorothiazide (Ziac)*
- Bisoprolol (Zebeta)*
- Carteolol (Cartrol)*
- InsoAcebutolol (Sectral)*
- Metoprolol (Lopressor, Toprol XL)*
- Nadolol (Corgard)*
- Propranolol (Inderal)*
- Sotalol (Betapace)*
- Timolol (Blocadren)*
Angiotensin-2 (AT-2) receptor antagonists have been shown to produce effects similar to those produced by ACE inhibitors. They may be better tolerated because they produce less cough. Rather than lowering levels of angiotensin II (as ACE inhibitors do), angiotensin II receptor blockers prevent this chemical from having any effects on the heart and blood vessels. This keeps blood pressure from rising.
For people with diabetes, this medication is often preferred because of the extra protection for the kidneys.
- Decreased kidney function
- Increased potassium levels
- Candesartan (Atacand)*
- Eprosartan (Teveten)*
- Irbesartan (Avapro)*
- Losartan (Cozaar)*
- Telmisartan (Micardis)*
- Valsartan (Diovan)*
Calcium channel blockers, also known as “calcium antagonists,” interrupt the movement of calcium into heart and vessel cells. Besides being used to treat high blood pressure, they’re also used to treat angina (chest pain) and/or some arrhythmias (abnormal heart rhythms).
- Rapid heartbeat
- Swelling in the feet and legs
- Amlodipine (Norvasc, Lotrel)*
- Bepridil (Vascor)*
- Diltiazem (Cardizem, Tiazac)*
- Felodipine (Plendil)*
- Nifedipine (Adalat, Procardia)*
- Nimodipine (Nimotop)*
- Nisoldipine (Sular)*
- Verapamil (Calan, Isoptin, Verelan)*