Why is it so that virtually all blood pressure medications have side effects? Are there BP medications with no side effects? Medications are designed to target specific physiological processes to achieve therapeutic effects.
However, because the body’s systems are interconnected, drugs can also influence other processes, leading to unintended reactions known as side effects. For instance, a medication intended to relax blood vessels might also affect kidney function or electrolyte balance.
Also, not everyone experiences side effects in the same way. Factors such as genetics, age, diet, existing health conditions, and other medications can influence how a person reacts to a drug. For example, some individuals may develop a persistent cough when taking certain blood pressure medications, while others do not.
Blood Pressure Medications With Low Incidence of Side Effects
Below is an overview of common blood pressure medication classes, examples of drugs within each class known for low incidence of side effects.
Angiotensin-Converting Enzyme (ACE) Inhibitors
Captopril
In clinical trials involving approximately 7,000 patients, only about 1% developed proteinuria (presence of excess proteins in urine). Other renal-related side effects, such as renal insufficiency and renal failure, were reported in approximately 0.1% to 0.2% of patients. Drugs.com
Enalapril
In patients with hypertension, dizziness was reported in only 4.3% of cases, while cough occurred in only 1.3%. Drugs.com
Lisinopril
In patients with hypertension, dizziness was reported in only 3.5% of cases, and cough occurred in 2.5%. Wikipedia
Ramipril
In U.S. placebo-controlled trials, cough was reported in 1.0% of patients, dizziness in 0.5%, and impotence in 0.4%. Drugs.com
Perindopril
In patients treated for hypertension, the most common adverse events were cough, dizziness, and back pain, each occurring in ≥5% of patients. Drugs.com
Angiotensin II Receptor Blockers (ARBs)
Losartan
In clinical trials, dizziness was reported in approximately 3% of patients. This equates to about 30 individuals out of every 1,000 experiencing this side effect.
Valsartan
Headache and dizziness were observed in 2% and 1% of patients, respectively. This means that out of 1,000 patients, 20 may experience headaches and 10 may feel dizzy.
Olmesartan
The rate of withdrawals due to adverse reactions was 2.4%. This suggests that approximately 24 out of 1,000 patients discontinued the medication due to side effects. Drugs.com
Candesartan
In placebo-controlled trials, 2.4% of patients discontinued therapy due to adverse events. Drugs.com
Beta-Blockers
Carvedilol
Adverse events such as flu syndrome and depression were reported with a frequency greater than 1% but less than or equal to 3%. Drugs.com
Calcium Channel Blockers (CCBs)
Nifedipine
Peripheral edema (swelling) occurred in about 4% of patients at doses less than 60 mg per day. Drugs.com
Diuretics
Hydrochlorothiazide
At a 12.5 mg daily dose, adverse events were comparable to placebo. However, rare cases of noncardiogenic pulmonary edema have been reported, with approximately 40 cases documented, predominantly in women at a mean dose of 38.7 mg. This suggests that such severe reactions occur in less than 0.01% of patients, or fewer than 1 in 10,000 individuals. Drugs.com
Indapamide
Gastrointestinal side effects such as dyspepsia, constipation, diarrhea, flatulence, and dry mouth occur in less than 5% of patients. Nervous system side effects, including dizziness and headache, are reported in about 5% of patients. Drugs.com
Eplerenone
Treatment discontinuation due to adverse events occurred in 4.4% of patients, indicating that 44 out of 1,000 patients halted treatment due to side effects. Drugs.com
Alpha-Blockers
Prazosin
The incidence of syncope (fainting) is approximately 1% in patients given an initial dose of 2 mg or greater. Drugs.com
