Tailoring your treatment
There are several different types of medication for high blood pressure. Your age, ethnicity and family history can affect how they work. Other medications can also affect how they work. Your doctor will work with you to make sure your prescription is tailored to your needs.
You might need to try different doses or take more than one type, depending how you respond. Blood pressure medications can be more effective in combination. But if you are taking four different types and your blood pressure remains high, you may be referred to see a specialist.
Getting started with your medication
It can sometimes take a while to adjust to taking a long-term medication. You will have regular blood pressure checks, and you may be able to monitor your blood pressure at home.
Your pharmacist can give you support with taking medicines, such as practical tips for taking tablets and advice about side effects.
In England, you can can also ask your pharmacist about the New Medicines Service (NMS), which offers support with new medication.
How long will I be on medication?
The aim of the medication is to lower your blood pressure and keep it stable over many years. Some people may be advised to continue taking medication for high blood pressure for the rest of their lives.
Alongside treatment, you should have advice and support with healthy lifestyle changes. With support from a GP or pharmacist, some people may eventually be able to reduce or stop their medication.
I didn’t realise I was living with high blood pressure. It’s likely I’ll now be on medication long-term. The stroke has made me reflect and change a lot of my lifestyle habits.
Ian, stroke survivor
Side effects and drug interactions
Like all medications, some people may get side effects from blood pressure medications, although others will not get any. Do not stop taking your medication without speaking to a health professional. Always check with your GP or pharmacist before taking new types of medication, including any over-the-counter treatments and supplements.
Always read the patient information leaflet that comes with your medication, and talk to your GP or pharmacist if you have any questions about how to take your medication.
Blood pressure medication types
This information explains what the different types of medication are, who can take them, how to take them and possible side effects.
This guide can only give general information. You should always get individual advice about your own health and any treatment you may need from a medical professional such as a GP or pharmacist. Do not stop taking any prescribed medication without talking to your GP or pharmacist first. They can give you advice on any side effects or difficulties with taking your medication.
The main groups of blood pressure medication are:
ACE inhibitors work by relaxing your blood vessels. Examples of ACE inhibitors include enalapril, lisinopril, perindopril and ramipril.
Who can and cannot take it?
They are often used with people aged under 55, who are not of Black African or Black Caribbean origin. But they can still be an option for other people.
They can be used in combination with some other blood pressure medications, but if you’re taking them with diuretics, you need regular checks on your kidney function.
How to take it
It's important to take your medication exactly as your doctor has told you. They are usually taken as a tablet once a day. You’ll have a blood test soon after starting ACE inhibitors, to check kidney function.
They are more effective if you eat less salt. Using potassium-based salt substitutes can raise blood potassium levels, so check with your GP or pharmacist before using them.
Common side effects
The most common side effect is a persistent dry cough. Other side effects can include dizziness, tiredness, rash, headaches and changes to your sense of taste.
Like ACE inhibitors, these work on the hormone angiotensin-2 by blocking its effects. Examples include candesartan, irbesartan, losartan, valsartan and olmesartan.
Who can and cannot take it?
These drugs are usually used instead of an ACE inhibitor if you’re not able to tolerate one. The two types of medication should not be used together.
They are mainly used with people under 55, who are not of Black African or Black Caribbean origin. But they can still be an option for other people.
They can help to protect your kidneys if you have diabetes or kidney disease.
How to take it
It's important to take your medication exactly as your doctor has told you. They are usually taken as a tablet once a day. Try to take it at the same time every day.
Common side effects
Possible side effects are usually mild and include dizziness, headaches or cold-like symptoms.
They stop calcium from entering the muscle cells in your heart and blood vessels. This relaxes your arteries and lowers your blood pressure. Examples of calcium channel blockers include amlodipine, felodipine and nifedipine, as well as the less commonly used diltiazem and verapamil.
Who can and cannot take it?
These medications are particularly effective in people aged over 55, or in Black African and Black Caribbean people of any age.
How to take it
It's important to take your medication exactly as your doctor has told you. They are usually taken as a tablet once a day.
Avoid drinking grapefruit juice while taking some types of calcium channel blockers as it can increase the amount of medication in your bloodstream. This can make your blood pressure drop suddenly and increase your risk of side effects. Ask your GP or pharmacist for advice.
Common side effects
Possible side effects include swollen ankles, ankle or foot pain, constipation, skin rashes, a flushed face, headaches, dizziness and tiredness.
Thiazide-like diuretics are the diuretics most commonly used to treat high blood pressure. Diuretics are also known as water pills because they work by flushing out excess water and salt from the body through urine.
Examples include indapamide and bendroflumethiazide.
Who can and cannot take it?
Diuretics are often used with people over 55, and people of Black African and Black Caribbean origins. They can also be an option for other people, and they may be used if calcium channel blockers cause side effects.
How to take it
It's important to take your medication exactly as your doctor has told you. They are usually taken as a tablet once a day. It can be helpful to take them in the morning, as taking them in the evening can mean you need a wee during the night.
You may need to have regular blood tests after you start treatment to check potassium levels and blood sugar.
Common side effects
Possible side effects include needing to wee more often, thirst, dizziness, weakness, feeling lethargic or sick, muscle cramps and skin rash.
Beta-blockers
Beta-blockers work by making your heart beat more slowly and with less force, which reduces your blood pressure. They are usually only recommended if other treatments have not worked, because they are less effective than other treatments on their own. It’s important you do not suddenly stop taking this type of medication without seeking medical advice first.
Examples of beta-blockers include labetalol, atenolol and bisoprolol.
Possible side effects include cold fingers and toes, nausea, tiredness and sleep problems. It can make asthma worse or affect your breathing if you have heart failure.
Other medication groups
Other medications that may be used to control blood pressure include doxazosin and terazosin (which belong to a group called alpha-blockers), and clonidine and methyldopa (which belong to a group called centrally acting antihypertensive drugs). Another type of diuretic called spironolactone can also be used at low doses. These medications are only usually recommended if other treatments have not worked.
Whether you need encouragement on making lifestyle changes or information on treatment, our Stroke Support Helpline is here to help with any aspect of stroke.
Call us on 0303 3033 100, from a textphone 18001 0303 3033 100 or email helpline@stroke.org.uk