Medication

If lifestyle changes are not effective in keeping your blood pressure down, your doctor may need to prescribe blood pressure medications. There are several different types and a doctor may try different medications until the one that works for you is found.

It is common for patients with high blood pressure to take several medications at once because some medications can work well in combination. As research continues medications are emerging that work by several mechanisms and can therefore provide a number benefits without the need to take a lot of pills.

Types of blood pressure medication that are available include:
Diuretics	These are the oldest known drugs for the treatment of hypertension. They work by eliminating excess water and salt from the body by increasing their transport from the blood into the urine by the kidneys. This lowers the volume of blood in your system and hence lowers the pressure. Diuretics are often found in combination with other hypertension medications such as Angiotensin II inhibitors.
Beta blockers	These drugs counteract the effects of stimulatory hormones and subsequently reduce the heart rate and the heart's output of blood. Reducing the heart rate and blood output contributes to lower blood pressure.
Angiotensin Receptor Blockers (ARBs)	Angiotensin is a molecule involved in the process of constriction of arteries. Normally it is healthy for arteries to constrict as it can help push blood along through the system. But high blood pressure can be caused by over-constricted or narrowed vessels. ARBs stop angiotensin from binding to the vessel walls and therefore interfere with the constriction process, relaxing the arteries and reducing pressure.
Angiotensin converting enzyme (ACE) inhibitors	These drugs work by essentially the same method as ARBs but target a different step of the process. ACE inhibitors can sometimes have side effects that are not present with ARBs.
Calcium channel blockers	These drugs work by relaxing the blood vessels and reducing the force of the heart rate.
Vasodilators	These drugs cause the vessel walls to dilate, thus relaxing their walls and lowering blood pressure.
Central nervous system agents	These drugs stop the brain sending messages for blood vessels to constrict.

High blood pressure is a key risk factor in the development of cardiovascular related diseases. But as we have seen there are other factors, such as diabetes (abnormal blood sugar levels) and dyslipidemia (abnormal blood lipid levels).

There are currently several different approaches to managing cardiovascular disease, including:

• Reducing blood pressure
• Modifying the levels of certain types of lipids (fat molecules) in the blood
• Reducing the amount of glucose in the blood
• Preventing blood from clotting

There are also medications that aim to reduce the risk of cardiovascular disease before it occurs. Patients who already have a history of cardiovascular disease, and are therefore at an increased risk, also benefit from these medications through reduced risk of further disease. Some medications have focused on reducing the risk of one aspect of cardiovascular disease, such as heart failure. Recently, medications have emerged which take a more ‘whole body’ approach to cardiovascular treatment. These medications are attempting to address the multiple risk factors together, including high blood pressure, to fight the risk of disease from all angles.