Feeling frustrated or worried that your blood pressure medication does not work? You are not alone. High blood pressure can be stubborn. There are practical steps you can take. This guide will help you understand your options. It will also show you how to work with your doctor to get your blood pressure under control.
Understanding Blood Pressure Medications
Blood pressure medicines come in different types. Each type works in a unique way to lower blood pressure. Here are the common categories of blood pressure medications:
- ACE Inhibitors (e.g., lisinopril, enalapril): These drugs relax blood vessels by blocking a chemical that causes narrowing. This helps lower pressure.
- ARBs (e.g., losartan, valsartan): They block the action of a body chemical that tightens blood vessels. This keeps vessels open.
- Calcium Channel Blockers (e.g., amlodipine, diltiazem): They prevent calcium from entering heart and vessel cells, allowing the arteries to relax and widen.
- Beta Blockers (e.g., metoprolol, atenolol): They make the heart beat slower and with less force. This reduces blood pressure.
- Diuretics or “Water Pills” (e.g., hydrochlorothiazide, furosemide): They help your body remove extra salt and water. This lowers the fluid in your blood vessels, reducing pressure.
- Other Medications: In some cases, other drugs like renin inhibitors (e.g., aliskiren), alpha blockers (e.g., doxazosin), or aldosterone antagonists (e.g., spironolactone) may be used. These are usually added if common medicines are not enough or if there are special conditions.
What to do when your blood pressure medication does not work? It’s important to know that treating high blood pressure often requires more than one medication. Two or more blood pressure medicines often work better together than one alone. Each medicine targets a different mechanism. Your doctor may combine an ACE inhibitor with a diuretic, or a calcium blocker with a beta blocker, for example.
Always take your blood pressure medicine as directed. Skipping pills or stopping on your own can cause your blood pressure to rise quickly. If one medicine isn’t working well, don’t give up – there are many options and combinations your doctor can try. It can take time to find the best medicine or combination for you.
If You Are Newly Diagnosed
Being newly diagnosed with high blood pressure can be overwhelming. Starting medication is a big step. If your first medication doesn’t seem to be working right away, here’s what to keep in mind:
- Give It Time: Blood pressure medications may take a few days to a few weeks to show full effect.
- Follow Up with Your Doctor: Regular follow-ups are crucial. Your doctor may adjust the dose or switch medications based on how you respond.
- Track Your Blood Pressure at Home: Home monitoring helps spot trends. Measure at the same time each day and bring your log to appointments.
- Stick to the Plan: Take your medication consistently. Missing doses can make it seem like the medicine isn’t working. (Harvard Health)
- Lifestyle Matters from Day One: Reduce salt, exercise, and avoid excessive alcohol. These boost medication effectiveness. (See more on this below.)
Don’t be discouraged. Doctors often adjust treatment early on. Trial-and-error is normal. With time, you’ll find what works best.
If You Have Been on Treatment for a Long Time
If you’ve been managing high blood pressure for years, you might be surprised to see your readings creep up. This is not unusual. Blood pressure can change over time.
- Reassess Your Routine: Weight gain, stress, aging, and diet can all reduce your medication’s effect.
- Check Your Medications (All of Them): Some medications or supplements can raise blood pressure or interfere with BP drugs. (Harvard Health, AHA)
- Evaluate Your Adherence: Be honest with yourself about missed or irregular doses. (Harvard Health)
- Talk to Your Doctor About Adjustments: You may need a higher dose or another medication. Adding a second or third drug is common. (URMC Newsroom)
- Check for Secondary Causes: Issues like kidney problems or sleep apnea may resist standard treatments. (Harvard Health, URMC Newsroom)
- Know When to See a Specialist: If you’re on three medications (including a diuretic) and still not at goal, you may have resistant hypertension. A specialist can offer advanced options. (Hypertension Treatment)
- Never Lose Hope: New options are always emerging. Most people can get their blood pressure under control with the right approach. (URMC Newsroom)
