High blood pressure (hypertension) is a common condition that increases the risk for heart disease, stroke, and kidney complications. Many people with diabetes also experience hypertension, making effective management especially important.
If a healthcare provider has recommended medication, it’s natural to have questions like:
What do these medications actually do?
Are there side effects to watch for?
How do I know which one is right for me?
Here’s a straightforward guide to the most commonly prescribed blood pressure medications and how they work.
1. ACE Inhibitors
(e.g., Lisinopril, Enalapril)
How they work:
These medications prevent production of a hormone (angiotensin II) that tightens blood vessels, helping them relax. This lowers blood pressure and reduces strain on the heart.
Why they’re prescribed:
They offer kidney protection and are especially beneficial for people with diabetes or early-stage kidney disease. This is often prescribed to patients living with diabetes, even in the absence of hypertension, for cardiac and renal protection.
Potential side effects include:
Dry cough, lip/facial swelling (angioedema), dizziness, or elevated potassium levels (typically monitored through labs).
2. Angiotensin II Receptor Blockers (ARBs)
(e.g., Losartan, Valsartan)
How they work:
ARBs are similar to ACE Inhibitors, and they work by blocking the effects of angiotensin II.
Why they’re prescribed:
They provide similar heart and kidney protection and are often used when ACE inhibitors aren’t well tolerated. They are less likely to cause a dry cough or angioedema.
Potential side effects include:
Dizziness, fatigue, or headache. Dry cough and angioedema are also potential side effects, but at a lesser rate than with ACE Inhibitors.
3. Calcium Channel Blockers
(e.g., Amlodipine, Diltiazem)
How they work:
They prevent calcium from entering the muscle cells in the heart and blood vessels, helping them relax and widen.
Why they’re prescribed:
They help lower blood pressure and may also reduce chest pain and control heart rate. In addition to hypertension, this class can also be used to treat Raynaud's phenomenon.
Potential side effects include:
Ankle swelling, flushing, or headache.
4. Diuretics
(e.g., Hydrochlorothiazide, Chlorthalidone)
How they work:
Often called “water pills,” they help the kidneys remove excess salt and water, reducing blood volume and pressure.
Why they’re prescribed:
Historically used as a first-line treatment or in combination with other medications, they reduce fluid volume, thus lowering blood pressure.
Potential side effects include:
Increased urination, low potassium levels, or dehydration (monitored by lab work).
5. Beta-Blockers
(e.g., Metoprolol, Atenolol)
How they work:
They slow the heart rate and reduce the force of contractions by relaxing the blood vessels and blocking the effects of epinephrine and norepinephrine, thus lowering blood pressure.
Why they’re prescribed:
Often used in people with other heart conditions, such as arrhythmias or a history of heart attack. They are also commonly used to treat other issues, such as tremors and anxiety.
Potential side effects include:
Fatigue, cold hands or feet, or a slower heartbeat.
💡 What Else Should You Know?
Medication choice depends on overall health, medical history, and lifestyle factors.
Multiple medications may be needed for effective control.
Never stop or adjust your medication without medical guidance.
Lifestyle changes, like improved nutrition, regular movement, and stress reduction, may amplify the benefits of medication.
📉 How Do You Know It’s Working?
The best way to track blood pressure progress is with regular at-home monitoring, not just the occasional reading at the doctor’s office.
Get a home blood pressure cuff and measure your blood pressure daily, especially first thing in the morning and again before bedtime.
Keep a log or use a digital system that shares data with your provider.
Consistent at-home readings help identify patterns and adjust treatment more effectively.
Work with a care team that can remotely view and respond to your readings in real-time.
📅 Interested in a personalized hypertension medication review? Reach7 Diabetes Studios offers expert consultations to help clarify your treatment plan and support blood pressure goals. Some members even receive a connected blood pressure cuff that allows your provider to closely monitor your progress.
Author
Leanna Andrews, NP
Medical specialist passionate about evidence-based medicine, nutrition, and healthy living. I cut through the noise to bring clear, reliable insights that empower everyday readers to help them Live Better & Thrive Longer.
