How Blood Pressure Medicine Works

If your blood pressure numbers are consistently high, the doctor may have recommended blood pressure medication or maybe you’re taking one already. This may leave you wondering, how does blood pressure medicine work?

Blood pressure medicine works differently depending on which medication. Blood pressure medicines work by doing the following:

  • Decreases the amount of water and salt in the body.
  • Relaxes blood vessels.
  • Makes the heart beat with less force.
  • Blocks nerve activity which can constrict blood vessels.

This blog post will inform you of the various different types of medications and how they help decrease blood pressure. In addition, I’ll list the different medications by names so you can find out how each one specifically works on your body.

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Disclaimer: Some links in this article are affiliate links which means I may earn a small commission at no extra cost to you.

How Blood Pressure Medications Work

The following are 11 categories of blood pressure medications and what they do to lower blood pressure 1.

1. ACE Inhibitors

How do ACE inhibitors work?

ACE inhibitors work by limiting or blocking the angiotensin-converting enzyme which has a narrowing effect on the blood vessels. Blocking the enzyme keeps the blood vessels relaxed and more open which keeps blood pressure lower.

ACE inhibitors is the abbreviation for angiotensin-converting enzyme inhibitors 2. The angiotensin-converting enzyme is responsible for hormones that help control blood pressure.

What are some ACE inhibitor medications? The following are ACE Inhibitor medications:

  • Captopril (Capoten)
  • Lisinopril (Prinivil, Zestril)
  • Benazepril (Lotensin)
  • Ramipril (Altace)
  • Enalapril (Vasotec)
  • Moexipril (Univasc)
  • Fosinopril (Monopril)
  • Perindopril (Aceon)
  • Quinapril (Accupril)
  • Trandolapril (Mavik)

Ace inhibitors can cause coughing in some people. Find out which other blood pressure medicines do the same in my blog post, Blood Pressure Medications That Cause Coughing.

2. Diuretics

How do diuretics work? Diuretics increases the amount of urine the body produces. This causes the body to lose excess water and sodium. Blood volume decreases which leads to lower blood pressure.

Diuretics are often called water pills and they’re typically the first kind of blood pressure medication a doctor prescribes 3.

What are some diuretics medications? The following are diuretics medications:

  • Metolazone (Mykrox, Zaroxolyn)
  • Bumetanide (Bumex)
  • Amiloride (Midamor)
  • Indapamide (Lozol)
  • Triamterene (Dyrenium)
  • Chlorthalidone (Hygroton)
  • Chlorothiazide (Diuril)
  • Furosemide (Lasix)
  • Hydrochlorothiazide (Hydrodiuril, Esidrix, Microzide)
  • Spironolactone (Aldactone)

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3. Beta-blockers

How do beta-blockers work?

Beta-blockers blocks the action of certain hormones in the nervous system. This slows down the heart rate and decreases the strength of each heartbeat. This decreases the force of the blood pumped through the blood vessels. In addition, beta-blockers obstruct the production of adriotensin ll which helps to relax and open up the blood vessels.

One of the hormones beta-blockers block is adrenaline. Adrenaline prepares the body for exertion by increasing the heart rate and constricting blood vessels 4.

What are some Beat-blockers medications? The following are Beta-blockers medications:

  • Nadolol (Corgard)
  • Timolol (Blocadren)
  • Sotalol (Betapace)
  • Atenolol (Tenormin)
  • Acebutolol (Sectral)
  • Bisoprolol (Zebeta)
  • Betaxolol (Kerlone)
  • Propranolol (Inderal)
  • Pindolol (Visken)
  • Nebivolol (Bystolic)
  • Penbutolol (Levatol)
  • Metoprolol (Toprol XL, Lopressor)
  • Carteolol (Cartrol)

4. Calcium Channel Blockers

How do calcium channel blockers work? Calcium channel blockers relax the muscles surrounding the blood vessels keeping them more open. In addition, they decrease the heart rate and strength of each heartbeat which pumps the blood with less force through the blood vessels.

Calcium channel blockers accomplish this by blocking calcium into certain muscle cells, so it’s more difficult for electronic signals to pass. They are also called CCBs or calcium antagonists 5.

What are some calcium channel blockers medications? The following are calcium channel blockers medications:

  • Amlodipine (Norvasc)
  • Verapamil (Covera, Isoptin, Calan, Verelan)
  • Isradipine (DynaCirc)
  • Bepridil (Vasocor)
  • Diltiazem (Cardizem, Tiazac, Dilacor)
  • Felodipine (Plendil)
  • Nicardipine (Cardene)
  • Nifedipine (Adatta, Procardia)
  • Nisoldipine (Sular)

5. Angiotensin ll Receptor Blockers

How do angiotensin ll receptor blockers work?

Angiotensin ll blockers block the action of angiotensin ll by preventing it from binding to angiotensin ll receptors on the muscles surrounding blood vessels. This allows the blood vessels to open up lowering blood pressure.

Angiotensin ll receptors, also called ARBs, work similar to ACE inhibitors that prevent the formation of angiotensin ll instead of blocking the binding of it to the muscles surrounding the blood vessels 6.

What are some angiotensin ll receptor blockers medications? The following are angiotensin ll receptor blockers medications:

  • Candesartan (Atacand)
  • Eprosartan (Teveten)
  • Losartan (Cozaar)
  • Irbesartan (Avapro)
  • Valsartan (Diovan)
  • Telmisartan (Micardis)

6. Vasodilators

How do vasodilators work? Vasodilators relax the muscles in the blood vessels walls. This keeps the blood vessels open allowing the blood to flow through easier.

What are some vasodilators medications? The following are vasodilators medications:

  • Hydralazine (Apresoline)
  • Minoxidil (Loniten)

7. Central Agonists

How do central agonists work? Central agonists stop the brain from sending signals to speed up the heart and narrow blood vessels. This keeps the blood vessels open and the pressure in the blood vessels lower.

What are some central agonists medications? The following are central agonists medications:

  • Guanabenz (Wytensin)
  • Clonidine (Catapres)
  • Guanfacine (Tenex)
  • Methyldopa (Aldomet)

8. Direct Renin Inhibitors

How do direct renin inhibitors work? Direct renin inhibitors stop the enzyme renin from stimulating angiotensin ll formation. This keeps the blood vessels open and reduces blood volume. 

What are some direct renin inhibitors medications?

  • Aliskiren (Tekturna)

9. Peripheral Adrenergic Blockers

How do peripheral adrenergic blockers work? Peripheral adrenergic blockers block neurotransmitters in the brain from sending messages to the smooth muscles of the blood vessels to constrict. This keeps the blood vessels dilated and keeps blood pressure lower.

What are some peripheral adrenergic blockers medications? The following are peripheral adrenergic blockers medications:

  • Guanadrel (Hylorel)
  • Guanethidine Monosulfate (Ismelin)
  • Reserpine (Serpasil)

10. Alpha Blockers

How do alpha blockers work? Alpha blockers reduce the blood vessel’s resistance and relax the muscles of the blood vessel walls.

What are some alpha blockers medications? The following are alpha blockers medications:

  • Doxazosin Mesylate (Cardura)
  • Prazosin Hydrochloride (Minipress)
  • Terazosin Hydrochloride (Hytrin)

11. Alpha-2 Receptor Agonists

How do alpha-2 receptor agonists work? Alpha-2 receptor agonists decrease the activity of the sympathetic portion of the involuntary nervous system. This keeps the heart rate lower and prevents the blood vessels from constricting.

What are some alpha-2 receptor agonists? The following are alpha-2 receptor agonists:

  • Methyldopa

Combined Blood Pressure Medications

How do combined blood pressure medications work? If one blood pressure medication is not effective, a second medication may be combined with the first one. Many people obtain better blood pressure control with a combination treatment. 

Sometimes one blood pressure medication is not effective at lowering blood pressure for an individual. Therefore, it may take a few different tries with other drugs until one is found effective.

However, sometimes one drug alone won’t lower blood pressure enough 7. That’s when a second drug may be added as a combination treatment to control the blood pressure 8. The optimal treatment is a combination with the best blood pressure control with the fewest side effects.

What are some combined blood pressure medications? The following are combined blood pressure medications:

  • Combined alpha and beta-blockers

Carvedilol (Coreg)

Labetalol Hydrochloride (Normodyne, Trandate)

  • Combined diuretics

Amiloride Hydrochloride + Hydrochlorothiazide (Moduretic)

Spironolactone + Hydrochlorothiazide (Aldactazide)

Triamterene + Hydrochlorothiazide (Dyazide, Maxzide)

  • Combined Beta-blocker and diuretics

Hydrochlorothiazide + Bisoprolol (Ziac)

BP Tip: It’s possible to lower BP naturally by changing how you breathe. There’s a device approved by the FDA and The American Heart Association. It guides your breathing a few minutes a day which has been proven to lower BP. You can check it out in the manufacturer’s website by clicking here.

Wrapping Up Blood Pressure Medication

If you have any concerns about your medication or treatment, don’t hesitate to talk to your physician or pharmacist. Concerns or fears are normal. Educating yourself about medication and how they work is a way for you to take control and be a part of your blood pressure program 9.

Follow all recommendations of your physician, especially when it comes to how over-the-counter medications may interact with blood pressure medication 10.

Disclaimer: The medications listed in this article are for information and reference only. Blood Pressure Explained does not endorse or recommend any specific medication. It’s important to consult with your physician and pharmacist about any medication you may be taking as they are the best sources of information. Never stop taking medication or change your dose without consulting with the prescribing physician.

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Article Resources: Blood Pressure Explained follows strict guidelines to ensure our content is the highest journalistic standard. It's our mission to provide the reader with accurate, honest and unbiased guidance. Our content relies on medical associations, research institutions, government agencies and study resources. Learn more by reading our editorial policy.
  1. The American Heart Association: Types of Blood Pressure Medications[]
  2. CDC: Blood Pressure Medications[]
  3. National Center for Biotechnology Information: Diuretics in primary hypertension – reloaded[]
  4. National Center for Biotechnology Information: Beta Blockers[]
  5. National Center for Biotechnology Information: Calcium Channel Blockers[]
  6. National Center for Biotechnology Information: Angiotensin ll Receptor Blockers (ARB) []
  7. National Center for Biotechnology Information: Alpha Blockers[]
  8. National Center for Biotechnology Information: Combination therapy in the treatment of hypertension[]
  9. The American Heart Association: Managing High Blood Pressure Medications[]
  10. The American Heart Association: What You Should Know About High Blood Pressure and Medications[]

Kevin Garce

Kevin Garce is a Certified Health Coach who encourages people by informing them on blood pressure topics important to them. His years of research and knowledge inspire people to achieve their goals. Read more here About Me

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