Information last reviewed: May 2026 — for educational purposes only.
Hypertension affects nearly half of adults in the United States and is a major modifiable risk factor for heart attack, stroke, heart failure, and chronic kidney disease. A wide range of antihypertensive drug classes is available, each with distinct mechanisms, benefits for specific patient profiles, and adverse effect considerations. Treatment choice is guided by comorbidities — for example, ACE inhibitors or ARBs are preferred in diabetic nephropathy, beta-blockers in heart failure with reduced ejection fraction, and calcium channel blockers in isolated systolic hypertension in older adults.
Blood Pressure Drug Classes
- ACE Inhibitors — block angiotensin-converting enzyme, preventing conversion of angiotensin I to angiotensin II; reduce blood pressure and protect kidneys; class-effect dry cough in 10–20% of patients
- ARBs (Angiotensin Receptor Blockers) — block AT1 receptors; similar benefits to ACE inhibitors but no cough; preferred in ACE inhibitor-intolerant patients
- Beta-Blockers — reduce heart rate and cardiac output; essential in heart failure, post-MI, and angina; non-selective forms mask hypoglycaemia in diabetics
- Calcium Channel Blockers (CCBs) — dihydropyridine (amlodipine) and non-dihydropyridine (diltiazem, verapamil) subtypes; dihydropyridines preferred for blood pressure; non-dihydropyridines also used for rate control in atrial fibrillation
- Alpha-1 Blockers — relax vascular smooth muscle; also used for BPH; risk of first-dose orthostatic hypotension
- Central Alpha-2 Agonists — clonidine reduces sympathetic outflow from the CNS
Blood Pressure Medications at Lucas Clinic
- Clonidine 0.1–0.3 mg Tablets — central alpha-2 agonist; also ADHD, PTSD nightmares, withdrawal; rebound hypertension risk
- Cozaar (Losartan) 25–100 mg Tablets — ARB; no cough; renoprotective in diabetic nephropathy; mild uricosuric effect
- Diltiazem 30–360 mg Tablets/Capsules — non-dihydropyridine CCB; also A-fib rate control; CYP3A4 inhibitor
- Doxazosin 1–8 mg Tablets — alpha-1 blocker; also BPH; first-dose orthostatic hypotension
- Inderal (Propranolol) 10–80 mg Tablets — non-selective beta-blocker; also tremor, migraine prevention, anxiety
- Lisinopril 2.5–40 mg Tablets — ACE inhibitor; most prescribed ACE inhibitor in the US; dry cough common
- Lopressor/Toprol-XL (Metoprolol) Tablets — cardioselective beta-1 blocker; Toprol-XL approved for heart failure
- Norvasc (Amlodipine) 2.5–10 mg Tablets — dihydropyridine CCB; very long half-life; ankle oedema common
- Prazosin 1–5 mg Capsules — alpha-1 blocker; also PTSD nightmares (off-label); first-dose syncope
Disclaimer: This page is for general informational purposes only and does not constitute medical advice. Always consult a licensed healthcare professional before taking any medication. See our full disclaimer.