Examining Options for Treating High Blood Pressure

Hypertension medications examined in recent review

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) High blood pressure is a relatively common condition that can increase the risk of heart attack and stroke. A recent review examined the different drug treatment options.

In this review, the researchers looked at the four main types of medications for people with chronic high blood pressure.

These researchers found that strictly following a long-term medication regimen was one of the most important issues in managing high blood pressure.

"Follow your doctor's instructions for taking prescription medications."

Michel Burnier of the Service of Nephrology and Hypertension, Centre Hospitalier Universitaire Vaudois, and his colleagues wrote this review on treating high blood pressure.

High blood pressure, or hypertension, forces the heart to work harder to push blood through the blood vessels.

People with high blood pressure have a higher risk of having a stroke, heart attack and kidney disease, as well as several other health problems.

Doctors often advise patients with high blood pressure to make lifestyle changes, like a healthier diet and physical activity, to help lower blood pressure. However, in some cases, medications may be necessary to bring blood pressure down.

There are four main types of medications that treat high blood pressure:

  • Diuretics, which rid the body of extra water
  • Renin-angiotensin system (RAS) blockers, which affect hormones that regulate blood pressure and water balance in the body
  • Calcium channel blockers, which prevent calcium from entering muscle cells along the walls of the arteries
  • Beta-blockers, which lower blood pressure by lessening the effect of stress hormones on the heart. Beta-blockers are not used as frequently as the other types of medications.

This review focused on several questions about treatment for high blood pressure, using previous clinical studies to answer them.

Specifically, the researchers addressed a comparison of ACE inhibitors or angiotensin II receptor blockers, two types of RAS blockers.

The authors of this review cited previous research that examined 26 trials testing ACE inhibitors and angiotensin II receptor blockers. As both of these medications were linked to reduced risks of heart attacks and strokes, the authors of this review concluded that both medications were effective and offered significant benefits to patients with high blood pressure.

The researchers also looked at evidence on the effectiveness of third-generation calcium channel blockers in protecting against peripheral edema. Peripheral edema is the swelling of tissues, usually in the legs, due to excess fluids.

The researchers examined studies showing that the third-generation medications significantly reduced cases of peripheral edema. In one study, third-generation calcium channel blockers reduced instances of peripheral edema by 50 percent.

The researchers also evaluated trials on two types of diuretics — hydrochlorothiazide and chlorthalidone. According to the authors of the review, previous clinical trials did not provide evidence for making a specific recommendation for one type of diuretic over the other.

The authors of this review also addressed the future of drug therapy for patients with high blood pressure. They claimed that very few new medications are being investigated outside the existing classes of medications.

They also suggested that, regardless of patients' treatment plan, adherence and long-term persistence were essential parts of preventing outcomes like heart attack or stroke.

The review was published in the European Heart Journal on November 11.

The authors declared no conflicts of interest and did not disclose any funding sources.

Review Date: 
December 2, 2013
Last Updated:
December 3, 2013