Blood pressure medications explained

High blood pressure, also known as hypertension, is common in Australia with an estimated 7.2 million adults living with the condition.¹ Because there are often no symptoms, high blood pressure often goes undiagnosed. Known as the silent killer, high blood pressure increases our risk of stroke and heart attack.

Starting blood pressure medication can help prevent serious illness and even death.³

“Your GP will usually recommend medication when lifestyle changes alone haven't brought your blood pressure down, or when your overall risk of heart disease is high enough that waiting isn't the safer option,” says Bupa GP, Dr Janice Tan.

If your blood pressure is 140/90mmHg or higher, you have high blood pressure.⁴

“High blood pressure usually has no symptoms, but over the years it damages your heart, brain, kidneys and eyes. Medication lowers your risk of heart attack, stroke and kidney disease,” says Dr Tan.

If you have high blood pressure, it's important to get treatment to prevent serious illness and even death.⁵

Medication prescribed to help treat high blood pressure in Australia are called antihypertensives.⁶

“They all work to lower blood pressure, but do so through different routes,” says Dr Tan.

Different types of blood pressure medication include:

ACE inhibitors and ARBS: Both types of medication work to widen your arteries, making it easier for your heart to pump blood around your body.

Calcium channel blockers: These stop calcium from entering your heart muscle, which widens the arteries and relieves stress on the heart.

Diuretics: Also known as fluid tablets, this medication makes you urinate more and rid your body of excess fluid, which can cause pressure in your blood vessels and heart.

Beta blockers: Blocking the effects of adrenaline, this medication can help slow the heart rate and relieve artery stress.⁷

“Many people end up on a low dose of 2 medicines rather than a high dose of one. This often works better and causes fewer side effects,” says Dr Tan.

Several factors will influence what type of blood pressure medication your doctor recommends, says Dr Tan.

“Your other health conditions matter most. For example, ACE inhibitors are often preferred if you have diabetes or kidney disease, while some medicines are avoided in pregnancy.

“Your age, kidney function, other medications, previous side effects and even how your body responded to a medicine in the past all shape the choice.”

All types of medication can cause side effects, but not everyone will experience them.⁶

“Most people have few or no side effects, and many settle within a couple of weeks,” says Dr Tan. “Don't stop a medicine on your own if something bothers you. There are plenty of alternatives, so tell your GP, and they can adjust the dose or switch you to something that suits you better.”

Side effects from ACE inhibitors and ARBs can include:

• Headaches
• Dizziness
• High potassium levels in the blood.

Side effects from calcium channel blockers can include:

• Nausea
• Headache
• Dizziness
• Flushing
• Fluid retention.

Side effects from diuretics can include:

• Dizziness
• Weakness
• Muscle cramps
• Thirst
• Need to urinate more often.

Side effects from beta blockers can include:⁷

• Cold hands or feet
• Dizziness
• Extreme fatigue
• Weight gain.

“Some people will need to stay on blood pressure medication for life because the medication controls high blood pressure rather than curing it. Stopping usually means your blood pressure climbs back up,” says Dr Tan.

Others may be able to stop taking medication, but should only do so under the strict care and guidance of their prescribing doctor. It can be harmful to stop taking medication suddenly, so always talk to your doctor before making any changes.

Lifestyle medicine can also help to lower blood pressure and reduce your risk of heart attack and stroke.

Lose excess weight.

While your doctor can advise on what is a healthy weight for you, almost any excess weight loss could help to lower you blood pressure. Blood pressure is measured in millimetres of mercury (mm Hg). On average, blood pressure may decrease by about 1 mm Hg for each kilogram of weight lost.⁸

Regular exercise

Doing 30 minutes of moderate intensity exercise every day could help to lower your blood pressure by 5-8 mm Hg.⁸ Speak to your doctor before starting any new exercise to make sure it’s safe for you.

Reduce the amount of salt in your diet

Limiting sodium to 1500mg a day can help lower blood pressure by 5-6 mm Hg.⁸ Avoid adding salt to food, read food labels and look for low-sodium varieties of food and drink and eat less processed food that tends to be higher in sodium.

Reduce alcohol consumption

As well as increasing blood pressure, alcohol can negatively impact how blood pressure medication works.8 If you do choose to drink alcohol, limit the amount and have more alcohol-free days each week than drinking days.