There are many classes of medications
for treating hypertension, together
called antihypertensives, which - by
varying means - act by lowering blood
pressure. Evidence suggests that
reduction of the blood pressure by 5-6
mmHg can decrease the risk of stroke by
40%, of coronary heart disease by
15-20%, and reduces the likelihood of
dementia, heart failure, and mortality
from vascular disease.
Commonly used drugs include:
- Beta blockers
such as metoprolol (Lopressor),
atenolol, labetalol, carvedilol
(Coreg)
- ACE inhibitors
such as lisinopril (Zestril),
quinapril, fosinopril (Monopril),
captopril, enalapril, ramipril
(Altace)
- Angiotensin
receptor blockers (ARBs): eg,
losartan (Cozaar), valsartan
(Diovan), irbesartan (Avapro)
- Calcium
channel blockers such as amlodipine
(Norvasc), verapamil
- Diuretics: eg,
chlortalidone, hydrochlorothiazide
(also called HCTZ)
- Combination products (which
usually contain HCTZ and one other
drug)
- Alpha blockers
such as terazosin, prazosin
The aim of treatment should be blood
pressure control ( less than 140/90
mmHg for most patients, and lower in
certain contexts such as diabetes or
kidney disease). Each added drug may
reduce the systolic blood pressure by
5-10 mmHg, so often multiple drugs are
necessary to achieve blood pressure
control.