The good news is, we have a wonderful, large armamentarium of medications now that lower blood pressure. We do know, however, that if one has hypertension, it will require an average of 2.7 medications to get that blood pressure to normal. And that surprises a lot of people. A lot of people will be started on a blood pressure medication, go back and follow up with their physician maybe a few weeks or months later and find out that that one medicine alone isn’t enough, and then another medication is introduced. And I think sometimes patients perceive that that’s a failure on their part or on their health care provider’s fault, when at the outset we know that it may indeed require several medications.
When several medications are used, each of those medications can be then used in smaller doses, which helps to minimize the side effects.
A very important group of medications to lower blood pressure are diuretics, and these are medications that lower blood pressure by kind of lowering the circulating fluid volume in the body. These are very important, and in many cases, when there’s more than one medicine needed, a diuretic will be one of those.
A second important group of medications are the beta blockers. These are particularly important in a group of patients that have already suffered from a heart attack. They’re very important players in our toolbox against hypertension.
We also have what we call the calcium channel blockers, a group of medicines that actually work on the arterial wall to relax the wall and drop the blood pressure.
We have a group of medications called the angiotensin converting enzyme inhibitors -- a big name -- the ACE inhibitors that lower blood pressure.
And we also have the angiotensin receptor blockers, or the ARBs group. So those are kind of the main groups of medications that lower blood pressure.
And what your particular health care provider may choose to use in your case can be dictated by several different things, whether or not you have diabetes, whether you’ve already had a heart attack or heart disease. Sometimes whether you’re a man or a woman, what age you are, what race you are. So all these things kind of play in. But we do know that the actual lowering of the blood pressure, no matter what agent, has profound impact on the development of heart attack, on the prevention of stroke, as well as the prevention of heart failure.