Choosing meds

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Choosing blood pressure medicines

Choosing blood pressure medicines


Research shows that some types of blood pressure medicines work better in different types of people.

How effective a blood pressure medicine will be for you can depend on your:

  • age
  • ethnic origin
  • medical problems (such as kidney disease or angina)
  • medical history, for example which blood pressure medicines you have tried in the past.

Of course, everyone is different. Some medicines will work better for others than they do for you. Your doctor and nurse will usually go through a number of steps to find the right blood pressure medicines for you. See the diagram below.


 

Younger than
55 years old

55 years and older
or black* people of any age

Step 1

A

ACE inhibitor
or Angiotensin receptor blocker
if side-effects

 

C or D

Calcium-channel blocker or Thiazide Diuretic

 

Step 2

A + C or A + D

A + C or A + D

 

Step 3

A + C + D

  A + C + D

 

Step 4

Add one of the following or consider seeking specialist advice:

Further diuretic therapy or Alpha-blocker or Beta-blocker

Add one of the following or consider seeking specialist advice:

Further diuretic therapy or Alpha-blocker or Beta-blocker

  

* Black means a person of African or Caribbean descent who is not mixed race or Asian


Step 1

The first blood pressure medicine you will take will depend on your age and ethnic origin.

  • If you are under 55 and do not have African-Caribbean origins, you will probably start with an ACE inhibitor or an angiotensin receptor blocker.
  • If you are 55 or older, or have African or Caribbean origins (but you are not mixed race), you will probably start with a calcium-channel blocker or thiazide diuretic.

Step 2

You may find that one medicine on its own is not enough. Your doctor will then add a blood pressure medicine from another group. This means that:

  • if you are already taking an ACE inhibitor or angiotensin receptor blocker, you will also have to take a calcium-channel blocker or a thiazide diuretic; 
  • if you are already taking a calcium-channel blocker or a thiazide diuretic, you will also have to take an ACE inhibitor.

Step 3

If you have to take three medicines, you will take an ACE inhibitor (or an angiotensin receptor blocker) and a calcium channel blocker and a thiazide diuretic.

Step 4

Sometimes three types of blood pressure medicine together are still not enough to fully control a person’s blood pressure. Your doctor may give you another medicine or they may refer you to a specialist.




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