When it comes to reducing high blood pressure, I consider diet, exercise, nutritional supplements, stress reduction, detoxification, and earthing to be first-line treatment. I’ve seen tremendous results from these natural approaches. However, I also use pharmacological drugs when needed.
For example, I would recommend drugs if your blood pressure is dangerously high and immediate action must be taken, or when lifestyle modifications and supplements have failed to reduce your blood pressure. Another case where pharmocological drugs are necessary is when you have high blood pressure and insufficient kidney function.
If you are currently taking a commonly precribed blood pressure medication—or if you and your doctor are considering these types of drugs as a high blood pressure treatment option—you should be aware of how they work within the body and what types of blood pressure medication side effects you may experience.
For instance, a brand new study published in the American Heart Association’s journal Hypertension has found that certain high blood pressure drugs can have a negative impact on mood disorders, including depression and bipolar disorder. The researchers divided study participants into four groups based on the single drug they had been prescribed to treat their high blood pressure. In the end, the researchers found that those participants prescribed beta blockers and calcium-channel blockers were at a twofold increased risk of hospitalization for mood disorders, compared with those on angiotensin inhibitors.
The following descriptions of the four types of most commonly prescribed high blood pressure drugs provide additional side effects as well as health benefits that all need to be considered by you and your doctor when weighing your treatment options.
Get more of Dr. Sinatra's advice on Healthy Blood Pressure
Four Common Prescription Drugs to Reduce Blood Pressure
1. ACE (angiotensin-converting enzyme) inhibitors suppress a powerful enzyme that causes arterial walls to constrict and cause high blood pressure. This keeps arterial walls relaxed, reducing blood pressure and decreasing the work that the heart has to do. There are a number of commonly prescribed ACE inhibitors on the market, including Captopril (Capoten), Ramipril (Altace), Enalapril (Vasotec), Benazepril (Lotensin), Fosinopril (Monopril), Quinapril (Accupril).
ACE inhibitor side effects include chronic cough (the most common and distressing symptom), headache, nausea, vomiting, reduced sexual function, liver damage, chest pain, and fatigue. Because ACE inhibitors can reduce kidney function and raise potassium levels, I always check my patients’ renal function and potassium level before prescribing an ACE inhibitor for reducing high blood pressure. You should also make sure your doctor knows if you have a history of kidney disease, collagen vascular disease or diabetes, and whether you take potassium supplements.
2. Beta blockers block the beta limb of the autonomic nervous system (ANS), which is responsible for raising alertness, heart rate, and blood pressure in flight-or-fight situations. Beta blockers blunt this exaggerated physiological response to stress, reducing high blood pressure. Some of the more commonly prescribed beta blockers include propranolol (Inderal), metoprolol (Lopressor, Toprol) and atenolol (Tenormin).
Some of the side effects of beta blockers are impotence, sleep disturbance and fatigue, dizziness, depression and anxiety, bronchial spasm (especially in asthmatics and COPD patients), and gastrointestinal problems. However, I like beta blockers, and I often prescribe them because they are among the safest of all cardiac drugs. They are effective in reducing high blood pressure and controlling atrial fibrillation, and research has shown that beta blockers can help reduce the risk of sudden cardiac death following a heart attack.
You should never stop beta blockers on your own or abruptly. Sudden discontinuation of these drugs can precipitate angina, high blood pressure or even heart attack. In addition, beta blockers should be used with caution in the elderly, pregnant women, and those with renal and thyroid disease, and should never be used by those with asthma or active lung disease.
3. Calcium-channel blockers, like beta blockers, improve blood flow and improve vascular tone through narrowed vessels. Some calcium-channel blockers reduce blood pressure by encouraging smooth-muscle relaxation in the inner lining of your blood vessels—preventing spasms and helping them dilate.
A few commonly prescribed calcium-channel blockers include Verapamil (Isoptin, Calan SR, and Verelan), Amlodipine (Norvasc), Felodipine (Plendil), sustained-release nifedipine (Procardia XL).
A few side effects of calcium-channel blockers include ankle swelling, constipation, fatigue, headache, bleeding gums, and heart palpitations. Considerable controversy has arisen regarding an increase in mortality in some patients treated with short-acting calcium-channel blockers, so check with your doctor to make sure you are on long-acting, second- or third-generation calcium-channel blockers. In addition, use caution when you combine calcium-channel blockers with digoxin for the treatment of congestive heart failure and atrial fibrillation. Some calcium-channel blockers side effects include an increase in the digoxin in your blood to dangerous levels, which can cause nausea, vomiting, loss of appetite, or “heart block,” a serious condition whereby your heart rate can slow dangerously.
4. Diuretics have an excellent track record as medications for reducing high blood pressure, as well as congestive heart failure. These agents reduce blood pressure indirectly by increasing urine output, which clears excess fluid from the body and lungs. Diuretics also help relax artery walls, thereby reduce blood pressure.
There are a few different types of diuretics, including loop diuretics (like furosemide and torsemide), thiazide diuretics (like HCTZ and indapamide), and potassium-sparing diuretics. Loop and thiazide diuretics have side effects like muscle pain and cramps, excessive thirst, low blood potassium, and nausea. Potassium-sparing diuretics have side effects like impotence, fever, headache, and drowsiness.
While these drugs do a good job of reducing blood pressure by increasing urine production, this action also promotes excretion of more than the normal amount of sodium, potassium and magnesium, which is not good for optimal body chemistry. Another frequent complication associated with all diuretics, particularly thiazide diuretics, is an increase is blood sugar and blood uric acid. Unfortunately, some patients even develop full-blown gout when they take thiazide diuretics.
Although doctors usually can’t determine which patients will develop sugar elevations or gout, it’s a good idea to inform your physician if you have a history of diabetes or gout before taking these medications for high blood pressure.
Avoid Nutrient Depletion While Medicating to Reduce Blood Pressure
These blood pressure medications side effects include the risk of depleting important nutrients, like zinc, magnesium, and CoQ10. Consequently, you need to make sure that your supplementation program includes these nutrients, or modify your diet to feature foods that are high in these nutrients. I recommend the foods below if you are taking certain drugs, so your body will still be balanced as you reduce your blood pressure with medications.
|Nutrient||Medications That Deplete Nutrient||Food Source for Nutrient|
|Zinc||ACE Inhibitors, Calcium-Channel Blockers, Diuretics||oysters, beef shank, chicken legs, pork tenderloin, yogurt, baked beans, cashews, pecans, Swiss cheese and milk|
|Vitamin B6||ACE Inhibitors, Calcium-Channel Blockers, Diuretics||potatoes, bananas, garbanzo beans, chicken breast, oatmeal, pork loin, mackerel, snapper, wheat germ and walnuts|
|Magnesium||ACE Inhibitors, Calcium-Channel Blockers||avocado, wheat germ, almonds, shredded wheat cereal, pumpkin seeds, cashews, spinach, potatoes, soybeans and peanuts|
|Phosphorous||ACE Inhibitors||yogurt, lentils, wild salmon, skim milk, halibut, beef, turkey, chicken, cheese and peanuts|
|Potassium||ACE Inhibitors, Calcium-Channel Blockers, Diuretics||figs, avocado, papaya, bananas, dates, bulgur, skim milk, guava, cantaloupe and fresh-squeezed orange juice|
|CoQ10||ACE Inhibitors, Beta Blockers, Calcium-Channel Blockers, Diuretics||beef, chicken, trout, salmon, and broccoli|
|Melatonin||Beta Blockers||bananas, barley, ginger, rice and corn|
|Folic Acid||Calcium-Channel Blockers||beef liver, fortified breakfast cereals, spinach, great northern beans, asparagus, wheat germ, fresh squeezed orange juice, turnip greens, vegetarian baked beans and broccoli|
|Vitamin B1||Diuretics||sunflower seeds, fresh squeezed orange juice, bulgur, spinach noodles, pine nuts, hickory nuts, yellow corn and potatoes|
|Calcium||Diuretics||nonfat milk, lowfat yogurt, figs, Swiss cheese, salmon, spinach, tofu, broccoli, almonds and papaya|
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