Many people with hypertension have other health conditions, and they may require additional or different classes of blood pressure drugs to effectively control blood pressure and help manage other health issues. In fact, blood pressure medications are effective in the treatment and prevention of a wide variety of diseases—from heart attacks and strokes to kidney disease.

For example, if you have angina (chest pain), you'll probably be prescribed a beta blocker or calcium channel blocker to manage hypertension because these drugs also help relieve chest pain. If you have suffered a heart attack, you'll typically be prescribed an ACE inhibitor, beta blocker and potassium-sparing diuretic like spironolactone or eplerenone to lower blood pressure and help prevent another attack. If you have severe heart failure, you might find yourself taking a combination of an ACE inhibitor, beta-blocker, ARB, spironolactone or eplerenone and a loop diuretic. If you've had a stroke, taking a thiazide diuretic and an ACE inhibitor may not only lower blood pressure but also reduce future strokes.

What if you have diabetes or kidney disease? You will likely need at least three blood pressure medications to reach your blood pressure goal (typically, 130/80 mm Hg). The best drugs are those that also lower the risk of diabetes complications and slow the progression of kidney disease. For example, ACE inhibitors and ARBs prevent kidney disease. In addition, thiazide diuretics, beta blockers, ACE inhibitors, ARBs and calcium channel blockers help reduce the risk of stroke and heart attack in people with diabetes. If you have kidney disease, a loop diuretic will be prescribed instead of a thiazide diuretic.

Publication Review By: Lawrence Appel, M.D., and Rafael H. Llinas, M.D.

Published: 16 Jul 2013

Last Modified: 16 Jul 2013