Beta blockers are just one choice to treat high blood pressure

Q. I heard that taking beta blockers for high blood pressure is not a good idea. I take a beta blocker, so should I ask my doctor to take me off it?

One study found that beta blockers may increase the risk of having a heart attack or stroke if you are using them to treat high blood pressure alone.

Beta blockers also treat other conditions such as heart failure. If you are taking a beta blocker, discuss it with your doctor. Warning: Don’t stop taking the drug on your own.

More than half of Americans over age 60 have high blood pressure. Many people with high blood pressure need more than one medication to treat it. So, I’ve received many questions about blood-pressure drugs.

There’s a lot of confusion about these medications because there are so many of them and they work in a variety of ways. Today’s column is devoted to clearing up some of the confusion.

Beta blockers

Beta blockers make your heart beat more slowly and with less force. Your heart pumps less blood, and your pressure goes down.

The following are the brand names for common beta blockers: Sectral, Tenormin, Kerlone, Zebeta, Cartrol, Tandate, Lopressor, Toprol XL, Corgard, Levatol, Visken, Inderal, Betapace and Blocadren.

Angiotensin-converting enzyme (ACE) inhibitors

ACE inhibitors keep your body from making angiotensin II, a hormone that normally causes blood vessels to narrow. ACE inhibitors expand blood vessels so your blood pressure goes down.

The following are common ACE inhibitors: Lotensin, Capoten, Vasotec, Monopril, Prinivil, Zestril, Univasc, Aceon, Accupril, Altace and Mavik.

Angiotensin II receptor blockers (ARBs)

ARBs are like ACE inhibitors because they protect against angiotensin II. ARBs don’t lower levels of the hormone; they prevent this chemical from affecting the heart and blood vessels.

The following are common ARBs: Atacand, Teveten, Avapro, Cozaar, Benicar, Micardis and Diovan.

Calcium channel blockers

These drugs block calcium from entering the muscle cells of the heart and blood vessels. This relaxes blood vessels and lowers blood pressure.

The following are common calcium channel blockers: Norvasc, Cardizem, Dilacor XR, Tiazac, Plendil, DynaCirc CR, Cardene, Adalat CC, Procardia, Nimotop, Sular, Calan, Covera HS, Isoptin and Verelan.

Diuretics

Diuretics, also known as “water pills,” help the kidneys flush extra water and salt from your body and decrease blood volume to lower pressure.

The following are common diuretics: Midamor, Bumex, Diuril, Hygroton, Thalitone, Lasix, Esidrix, Hydrodiuril, Saluron, Lozol, Enduron, Zaroxolyn, Aldactone, Demadex and Dyrenium.

Vasodilators

Vasodilators open blood vessels by directly relaxing the muscles in the vessel walls.

Common vasodilators are Apresoline and Loniten.

Alpha blockers

Alpha blockers, also called alpha-adrenergic antagonists, reduce nerve impulses that tighten blood vessels; this permits blood to flow more freely.

Common alpha blockers are: Cardura, Minipress, Minizide, Hytrin, Flomax and Uroxatral.

Alpha-beta blockers

These drugs work two ways: they reduce nerve impulses to blood vessels and slow the heartbeat.

Common alpha-beta blockers are Coreg and Normodyne.

Central-acting agents

Central-acting agents work by preventing your brain from sending signals to your nervous system to speed up your heart rate and narrow your blood vessels.

The following are examples: Catapres, Clorpres, Combipres, Wytensin, Tenex, Aldomet, Aldochlor and Aldoril.

Combination drugs

There are a variety of preparations that combine medications. For example, Cozaar, which is an ARB, is combined with a diuretic to form Hyzaar.

The following are other popular combination drugs:

Lexxel, Lotrel, Tarka, Tenoretic, Ziac, Corzide, Inderide, Timolide, Lotensin, Vaseretic, Prinzide, Zestoretic, Uniretic, Accuretic, Avalide and Diovan HCT.

Renin inhibitors

Renin inhibitors are a relatively new type of blood pressure drug. As the name indicates, they inhibit renin, which is an enzyme secreted by the kidneys that is involved in the release of angiotensin.

Tekturna is a renin inhibitor.