Deciding whether to treat high blood pressure with medicine and choosing the best medicine are based mainly on:

• How high your blood pressure is.
• Whether you have signs that high blood pressure has caused organ damage, such as an enlarged heart or early damage to your arteries, kidneys, or eyes.
• Whether you have other medical conditions, such as coronary artery disease, diabetes, or kidney or lung disease or risk factors for heart disease, such as diabetes or high cholesterol.
• Whether you think you can succeed at making lifestyle changes.

Doctors usually prescribe a single, low-dose medicine first. If blood pressure is not controlled, your doctor may change the dosage or try a different medicine or combination of medicines. It is common to try several medicines before blood pressure is successfully controlled. Many people need more than one medicine to get the best results.

High Blood Pressure: Should I Take Medicine?

Medicine choices

Medicine choices include:

• Diuretics.
• ACE inhibitors.
• Angiotensin II receptor blockers (ARBs).
• Beta-blockers.
• Calcium channel blockers.
• Direct renin inhibitors.
• Other medicines for high blood pressure, including alpha-blockers and vasodilators.

All of these medicines are effective for lowering the risk of heart attack and stroke.

Work with your doctor to find the right medicine or combination of medicines that have the fewest side effects and work well for you. And be sure to take your medicines regularly as prescribed.

High Blood Pressure: Taking Medicines Properly

Taking Medicines as Prescribed

Dealing With Medicine Side Effects and Interactions

You may have regular blood tests to monitor how the medicine is working in your body. Your doctor will likely let you know when you need to have the tests.

What to think about

• The medicine your doctor chooses may be based on other health problems you have. For example, doctors often prescribe ACE inhibitors for people who have diabetes or heart failure.
• Some people who get a cough while taking ACE inhibitors do well with ARBs, which usually don't cause a cough.
• Check with your doctor before you take any nonsteroidal anti-inflammatory drugs (NSAIDs)—for example, aspirin or ibuprofen—with high blood pressure medicines. NSAIDs may raise blood pressure and keep your blood pressure medicines from working well.