blood pressure center

What Are the 4 Best Blood Pressure Drugs?

Reviewed on 6/10/2022
Elderly woman speaking with her doctor about blood pressure medication
The four best types of blood pressure drugs that are considered the first choices to lower blood pressure include thiazide diuretics, ACE (angiotensin-converting enzyme) inhibitors, angiotensin receptor blockers (ARBs), and calcium channel blockers.

Blood pressure drugs (antihypertensives) are prescription medications used to lower high blood pressure (hypertension). 

There several classes of high blood pressure medications. The best blood pressure drug depends on a person’s overall health and other health conditions. The guidelines for high blood pressure from the American College of Cardiology and the American Heart Association recommend four types of blood pressure drugs as the first choices to lower blood pressure, including: 

1) Thiazide diuretics

2) ACE (angiotensin-converting enzyme) inhibitors

3) Angiotensin receptor blockers (ARBs)

4) Calcium channel blockers

What Are Other Types of High Blood Pressure Drugs?

Other classes of high blood pressure medications include: 

  • Beta-blockers
    • These drugs reduce heart rate, the heart’s workload, and the heart’s output of blood to lower blood pressure
  • Alpha blockers
    • These medicines reduce the resistance in the arteries, relaxing the muscle tone of the vascular walls
  • Alpha-2 receptor agonists
    • These reduce blood pressure by decreasing the activity of the sympathetic (adrenaline-producing) action of the involuntary nervous system
  • Combined alpha and beta-blockers
    • Used as an intravenous (IV) drip for patients experiencing in hypertensive crisis
    • May be prescribed for outpatient use if a patient is at risk for heart failure
  • Central agonists
    • These drugs help decrease the ability of blood vessel to tense up or contract
  • Peripheral adrenergic inhibitors
    • These medications lower blood pressure by blocking neurotransmitters in the brain so they don’t receive the “message” to constrict
    • Rarely used unless other medications don’t help
  • Vasodilators
    • Causes the muscle in the walls of blood vessels to relax, allowing the vessel to widen which allows blood to flow through better

What Are Side Effects of the 4 Best Blood Pressure Drugs?

Common side effects of blood pressure medications vary depending on the drug class. Side effects of the four common blood pressure drugs may include: 

  • Thiazide diuretics
    • Potassium loss
      • Weakness
      • Leg cramps 
      • Tiredness
    • Impotence 
    • Increased blood sugar levels in diabetics
    • Attacks of gout after prolonged treatment (uncommon)
  • ACE (angiotensin-converting enzyme) inhibitors
    • Skin rash
    • Loss of taste
    • Chronic dry, hacking cough
    • Kidney damage (rare)
    • Women taking ACE inhibitors for high blood pressure should not become pregnant while on this class of drugs because it can be dangerous to both mother and baby during pregnancy
  • Angiotensin receptor blockers (ARBs)
    • Occasional dizziness
    • ARBs should not be used during pregnancy because they can cause injury or death to a developing fetus
  • Calcium channel blockers

From WebMD Logo

Heart Health Resources
Featured Centers
Health Solutions From Our Sponsors
Reviewed on 6/10/2022
References
Image Source: iStock Images

https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/types-of-blood-pressure-medications

https://www.goodrx.com/conditions/hypertension/outdated-blood-pressure-medications-current-best-treatments