Heart Health Understanding the Heart

Hypertension Q & A

How well do medications work in hypertension?
If several blood pressure measurements in your doctor's office at several different points in time have indicated that you have borderline high blood pressure, your doctor will likely work with you to modify your diet—to avoid salty and fatty foods that increase the water content of your body and your blood pressure—and to encourage you to engage in moderate aerobic activity. In cases of borderline high blood pressure (for example, 160/90), these measures alone may be enough to bring your blood pressure to within normal limits.

When these measures are insufficient to keep your high blood pressure under control, your doctor may prescribe medications. This may take the form of diuretic pills such as hydrochlorothiazide or dyazide, which have been shown to decrease blood pressure effectively and are some of the first medications that internists will prescribe for elevated blood pressures.

Beta-blockers are another type of anti-hypertensive medication that is not only extremely effective in reducing blood pressure, but have the added benefit of helping people live longer if they have had a heart attack. You may know these medications as Lopressor, or its longer acting sister, Toprol-xl, or Atenolol. There is a pharmacopoeia of other agents not only effective in reducing blood pressure, but may also be suited for your medical needs.

There are ACE-inhibitors, a class of drugs that may be more familiar to you by names such as Captopril, Lisinopril, or Zestril. If you have diabetes, these agents not only help to control your blood pressure, but to protect your kidneys from the potentially long-term harmful effects of elevated blood sugars on your renal (kidney) function. If you have had a heart attack, you may find yourself prescribed both an ACE-inhibitor and a beta-blocker, not only because they reduce your blood pressure, but because they have additional positive effects on your heart. A beta-blocker can help to decrease the risk of irregular rhythms that can occur after heart attacks. An ACE-inhibitor can help your heart recover after a heart attack, and help to keep even damaged areas of your heart soft and compliant, more like the areas of your heart that were not damaged.

If you have blood pressure that is especially difficult to control, you may be prescribed a combination of these agents, as well as other classes of medications. The presence of many effective medications for treatment of hypertension makes it especially important to work with a doctor if you have high blood pressure.

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