|
|||||||||||
 |
Home
Q: I have high blood pressure. Do I start with one medication or a combination?Ask Our Expert about Blood Pressure Medication
Q: I have high blood pressure. Do I start with one medication or a combination?A: Most people start on one medication, often a diuretic. But many individuals may need to be treated more aggressively with a combination of drugs. Which combinations work best for high-risk patients is the subject of ongoing investigation. Q: What medications are available, and what do they do?A: There are dozens of combination medications, but most drugs for hypertension fall into four general categories:
Q: Why start with a diuretic?A: Any of these drugs might be effective as an initial therapy. But the Joint National Committee for the Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC) recommends starting with diuretics. They have relatively few side effects, they're less expensive for the patient, and about half of people with hypertension who take them are able to bring blood pressure down to a target range of at least 130/90 (or, ideally, 120/80) without needing another medication. Q: When might other drugs be added to my treatment?A: If a diuretic alone doesn't bring your blood pressure down enough, it's generally better to add a different medication than increase the dose of the diuretic. Hypertension has a lot of possible causes, and those related to blood volume-which diuretics address-may not be the only ones at work. Adding a different medication attacks the problem in a new way. Many combination treatments are already formulated together so you can take them in one pill instead of two. Q: What combinations are usually used?A: People already on a diuretic can be given an ACE inhibitor or a beta blocker as a second drug. It depends on other conditions you may have. ACE inhibitors, for example, help to protect your kidneys if you have diabetes. Different combinations allow treatment to be tailored to your individual condition, so it's important to follow your doctor's advice. Q: How do these drugs affect my risk for having a heart attack or stroke?A: It's been clearly shown that people who control blood pressure with medication are less likely to suffer heart attacks, strokes and death than people with uncontrolled blood pressure. For a lot of people, reducing risks comes from lowering blood pressure alone. But many of these drugs have biochemical actions that also help the heart directly by relaxing it or helping on some other front. Q: What are the risks of these medications?A: One risk they all share is bringing blood pressure too low, so tell your doctor if you feel side effects like dizziness. Controlling your blood pressure is like getting the right temperature in a bathtub-you might need some trial and error to find what's right for you. Other side effects depend on the medication. For example, diuretics may reduce levels of potassium in the blood, ACE inhibitors may cause kidney problems in certain patients, beta blockers can make the heart beat too slowly and calcium channel blockers may cause swelling in the legs. Q: What else can I do to lower my risks from high blood pressure?A: First, if you smoke, quit. Second, don't drink more than two alcoholic drinks a day if you're male; one if you're female. Third, exercise regularly and eat a varied, heart-healthy diet and small amounts of fat, especially saturated animal fat. Moderate, healthy lifestyle measures like these can be powerful, without the side effects of medication. This page last updated 10/15/08 05:59 PM
ARTICLE TOOLS:
|
Questions?ResourcesGet maps and directions
|
|
|||||
|
|
|
||||||
