Medication for High Blood Pressure

NYU Langone doctors often prescribe diuretics to improve kidney function in people with high blood pressure. Healthy kidneys filter blood to remove waste and make urine. When the arteries near the kidneys are narrowed, it is more difficult for the kidneys to excrete sodium from the body, which raises blood pressure levels. Diuretics help with eliminating sodium and water from the body in order to lower blood pressure. 

NYU Langone doctors often prescribe a medication from a class of diuretics called thiazides. Side effects may include increased urination and possible dehydration. Your doctor can advise you on how to stay properly hydrated throughout the day while you take this medication.

Angiotensin-converting enzyme (ACE) inhibitors help block the body’s production of a hormone that narrows blood vessels. This hormone can also accelerate cardiac damage and fibrosis, or hardening, of the heart muscle and blood vessels.

Blocking this hormone enables the vessels to dilate, or widen. This reduces the work required of the heart, increases blood flow, and lowers blood pressure. Side effects may include dizziness and coughing.

Like ACE inhibitors, angiotensin II receptor blockers help prevent blood vessels from narrowing, reducing the heart’s workload. They are closely related to ACE inhibitors, but are less likely to cause side effects such as coughing.

Calcium channel blockers slow the absorption of calcium in the heart muscles and the walls of the blood vessels, allowing them to relax and leaving more room for blood to flow. Some of these medications can also slow heart rate.

Beta blockers inhibit the effects of the hormone adrenaline on the heart and blood vessels. This can cause the heart to beat more slowly and less vigorously.

For best results, beta blockers are almost always prescribed with other blood pressure medications. Side effects can include mild depression, fatigue, and sexual dysfunction, which your doctor can help you to manage.

Your physician chooses the appropriate medications for you based on other medical conditions you may have, such as diabetes, kidney disease, and heart disease. If high blood pressure does not improve after taking a combination of these medications, NYU Langone specialists may prescribe other medications.

These may include alpha blockers, which lessen the effects of chemicals in the body that narrow blood vessels, or alpha–beta blockers, which slow the heart rate to reduce the amount of blood pumped through blood vessels. Medications called central-acting agents relax the nervous system to prevent an increase in heart rate and narrowing of the blood vessels. Vasodilators prevent arteries from narrowing. 

NYU Langone doctors may also recommend a low daily dose of aspirin to increase blood flow and reduce the risk of heart attack and stroke. Because there is an increased risk of bleeding with aspirin, your physician helps you weigh the risks and benefits before deciding on this approach.

High levels of LDL, or “bad,” cholesterol can lead to a full or partial blockage of arteries, a leading risk factor for high blood pressure. If you have unhealthy cholesterol levels, your NYU Langone physician may recommend medications, including statins and cholesterol absorption inhibitors, as part of your treatment plan for hypertension.

Because diabetes increases the risk of blockages in the arteries, people with uncontrolled diabetes often have secondary hypertension. Proper management of diabetes may help lower blood pressure. NYU Langone doctors are experts in managing type 2 diabetes, and may prescribe diabetes medications, including insulin, as part of your treatment plan.