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Harvard Commentaries
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School

Better Blood Pressure: Medications

June 02, 2014

High Blood Pressure
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Better Blood Pressure: Medications
Better Blood Pressure: Medications
If lifestyle changes alone do not lower your high blood pressure, your doctor will want you to try medications.
InteliHealth Medical Content

Reviewed by the Faculty of Harvard Medical School

Better Blood Pressure Through Medications
If lifestyle changes alone do not lower your blood pressure to a healthy level, your doctor will want you to try medications. Many things determine what drug you'll be prescribed, including your age, racial and genetic background, presence or absence of damage to your kidneys and other organs, the risk of side effects, and the presence of other diseases.

No single medicine is ideal for all people. Drugs differ in the way they lower blood pressure and, depending on each person's characteristics, in their potential for unwanted side effects. If the first drug or drug dose you try does not work, your doctor will change the dose or the drug. This is not unusual, so don't be discouraged. It's hard to predict who will respond to particular medicines. Work with your doctor until you find the right medicines for you.

If your blood pressure is severely elevated, you may need to be hospitalized and given intravenous medicine while your blood pressure, heart rhythm and rate are monitored.

For People Over 60

Doctors once believed that it was of no benefit to treat high blood pressure in people over age 60, and that treatment might even be harmful. The theory was that older people needed a higher blood pressure because their arteries were stiffer. Some doctors feared that lowering the blood pressure to levels that were normal in younger people might cause strokes or kidney failure.

A wealth of research now shows that people over 60 get just as much benefit, if not more, from having their high blood pressure treated. Proper treatment reduces the risk of major diseases in people over 60:

  • Risk of stroke reduced by 35 percent
  • Risk of coronary heart disease reduced by 20 percent
  • Risk of premature death from blood-vessel disease reduced by 20 percent
For African-Americans

African-Americans generally respond best to blood- pressure medicines in one of three groups: diuretics, calcium channel blockers, and combination alpha and beta-blockers. Beta-blockers and ACE inhibitors are somewhat less powerful in African-Americans unless combined with diuretics.


Reduce Your Pill Bill
Some of the most effective blood pressure drugs are quite inexpensive. Learn how you can contain costs, while still using effective medicines.


Master Your Medications
Because high blood pressure medication generally needs to be taken indefinitely, cost, convenience and tolerance are extremely important in deciding on the best treatment regimen for you. Blood pressure medications are grouped into different categories, or classes, which work in different ways. Learn all about the different drug classes and drugs in our chart.



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