Online Reporter
Dr Tendai Zuze
Health Matters
HIGH blood pressure is a very common condition and many people live with it for years without feeling sick.
Despite this, uncontrolled blood pressure quietly damages the heart, brain, kidneys, and other organs.
Blood pressure medicines are therefore very important because they prevent strokes, heart attacks, kidney failure, and early death (if there is such a thing). For the vast majority of people, the benefits of these medicines are much greater than any side effects they may cause.
It is also important to understand that not everyone experiences side effects. When side effects do occur, they are usually mild and often improve as the body adjusts to the medicine.
Some side effects depend on the dose, meaning higher doses may cause more problems, and some can add up when several blood pressure medicines are used together.
If side effects become troublesome, the medicine can usually safely be reduced, changed, or stopped by a healthcare professional. Patients should never stop blood pressure treatment on their own.
Water tablets, also called diuretics, are commonly used and include medicines such as hydrochlorothiazide (HCT), indapamide, and urazide. These medicines work by helping the body remove extra salt and water. Because of this, people may pass urine more often, especially at the beginning of treatment.
Some people feel thirsty, tired, dizzy when standing up, or experience muscle cramps.
These effects are often related to the dose and may improve with time. In some cases, diuretics can lower potassium levels or worsen gout, which is why occasional blood tests may be required. Taking these medicines in the morning usually reduces problems with night-time urination.
Calcium channel blockers, such as amlodipine and nifedipine, work by relaxing blood vessels.
A common side effect is swelling of the feet or ankles, which can worry patients, but is not usually dangerous.
Headaches, facial flushing, dizziness, or a fast heartbeat may also occur, especially when starting treatment or at higher doses. Ankle swelling is related to dose and often improves when the dose is reduced or when the medicine is changed.
Beta blockers, including atenolol, slow the heart rate and reduce the workload on the heart. Some people feel tired, dizzy, or notice cold hands and feet. A slow heartbeat can also occur.
Less commonly, beta blockers may affect sleep, worsen asthma symptoms, or cause erectile problems in men. These medicines should not be stopped suddenly, as this can be harmful, and many of the side effects improve after the first few weeks of use.
ACE inhibitors, such as captopril aand enalapril, are widely used because they protect both the heart and kidneys.
A well-known side effect is a dry, persistent cough. While this cough is not dangerous, it can be irritating. Dizziness or tiredness may occur when starting the medicine, especially if blood pressure drops quickly.
Very rarely, ACE inhibitors can cause swelling of the lips, face, or tongue, which is a medical emergency and requires immediate attention. If the cough is troublesome, the medicine can be changed to a different class.
ARBs, such as losartan, work in a similar way to ACE inhibitors, but usually do not cause a cough. They are generally very well tolerated. Some people may experience dizziness, headache, or tiredness, particularly when starting treatment. In certain patients, potassium levels may rise, so blood tests are sometimes needed.
There are other blood pressure medicines and combination tablets that contain two or more medicines in one pill. These are often used to improve blood pressure control while keeping doses lower, which helps reduce side effects.
If a person suspects that a blood pressure medicine is causing side effects, the most important step is not to stop the medicine. Symptoms should be noted, including when they started, and the patient should return to their doctor or clinic. The healthcare provider can then decide whether to adjust the dose, change the medicine, alter the timing of the dose, or request blood tests. In most cases, there is a suitable alternative that controls blood pressure with fewer side effects.
Blood pressure medicines are life-saving treatments. Serious side effects are uncommon, and most problems are mild and manageable.
Treatment can almost always be adjusted to suit the individual patient. Living with uncontrolled high blood pressure is far more dangerous than taking these medicines. When concerns arise, early discussion with a healthcare provider leads to safe and effective solutions.
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