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You are in: Home > Heart Information > Treatments For Heart Conditions > Drug Treatment > Drug Treatment For High Blood Pressure

Drug Treatment For High Blood Pressure

Your treatment may involve a combination of two, or more, of the following groups of drugs to lower your blood pressure:

• ACE inhibitors (Angiotensin Converting Enzyme inhibitors)
• ARBs (Angiotensin II receptor blockers): these are mainly used when ACE inhibitors are not suitable e.g. due to side effects.
• Calcium channel blockers
• Diuretics ('water' tablets): usually a 'thiazide' diuretic will be used e.g. bendrofluazide.
• Alpha blockers
• Beta blockers: latest evidence shows that, due to side effects, these should no longer be considered as routine first treatment for high blood pressure. If you have been taking beta blockers for some time your doctor may discuss reviewing your treatment. Do not stop taking them without discussing with your doctor.

The following drugs may also be prescribed to help reduce the risk of further problems with your heart:

• Antiplatelets: this is usually aspirin.
• Statins

Choosing the best combination of drugs

It is very common to need a combination of two, or more, drugs to reduce your blood pressure to the within the target range. One of the benefits of taking a combination of blood pressure lowering drugs is that you are likely to need lower doses of each drug and will have fewer side effects.

What combination you receive will depend upon your individual circumstances (particularly your age and ethnic origin). Your doctor and / or nurse may go through a number of well–recognised steps before finding the best combination for you.

The following table outlines current recommendations for choosing blood pressure lowering drugs. This is often known as the 'A / CD' approach.

	Younger than 55 years old	55 years old and older OR people of African or Caribbean origin
STEP 1	A	C or D
STEP 2	A +C or A + D	A +C or A + D
STEP 3	A + C + D	A + C + D
STEP 4	Add : further diuretic or alpha blocker or beta blocker Consider seeking specialist advice	Add : further diuretic or alpha blocker or beta blocker Consider seeking specialist advice

A = ACE inhibitor (or ARB) C = calcium channel blocker D = thiazide diuretic

(Note that if you are black of African or Caribbean descent then you should start treatment with calcium channel blockers or thiazide diuretics regardless of what age you are.)

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