Medications

Many people also need medication to help lower their blood pressure.

Blood pressure medicines work in different ways. For this reason, it’s fairly common for people to take two or more blood pressure lowering medicines.

It can take some time to find the right combination of medicine, so be patient and talk with your care team about any questions or concerns.

When Should Medicines Be Started?

According to expert guidelines, medication should be started if your blood pressure is:

• Equal to or higher than 140 over 90 mm Hg (stage 2 hypertension) on average
• Blood pressure is above 130 over 80 mm Hg and if you 
• Have existing heart disease or a history of stroke
• Have diabetes, chronic kidney disease, or are likely to develop cardiovascular disease over the short-term (that means they have a higher chance of having a heart attack or stroke than the health care provider and patient might feel comfortable with)

If your blood pressure is in this range and you have a low risk of developing heart problems or stroke, it’s reasonable to focus on making purposeful lifestyle changes for 3 to 6 months. If at the end of that time your blood pressure still remains high, you should start on medications too.

Common medications used to treat high blood pressure include:

• Thiazide-type diuretics
• Angiotensin-converting enzyme (ACE) inhibitors
• Angiotensin receptor blockers (ARBs)
• Calcium channel blockers
• Other medications, such as mineralocortcoid antagonists (MRAs), other types of diuretics (loop or potassium sparing), beta blockers, among others

For people with stage 2 hypertension, starting on a single pill that includes two first-line blood pressure lowering drugs is preferred over taking separate pills to try to bring down blood pressure quicker.

It's important to:

• Take your medications exactly as prescribed
• Report any side effects
• Do not stop taking prescribed medication without talking with your care team
• Know what to do if you miss a dose – there are once daily or combination pills that can make remembering easier
• Share and review a complete list of all the medications you take, including over-the-counter drugs and supplements

Remember to review your treatment plan, blood pressure readings and target blood pressure numbers at each health visit.