Heart and Blood Pressure Medications

Heart and blood pressure medications are commonly prescribed in primary care to manage hypertension, regulate heart rate, and support heart function. Many of these treatments are preventative, meaning their benefit is measured in reduced long-term risk rather than immediate symptom relief.

Treatment decisions are individualised. They are based on blood pressure readings, symptoms, co-existing conditions, kidney function, age, and overall cardiovascular risk.

This page explains the main classes of heart and blood pressure medications used in general practice, how they work, and what monitoring is usually required.

These articles are intended as educational sources, not diagnostic nor taking place of a proper medical assessment. If you need help, please book an appointment with one of our GP’s.

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Why treating blood pressure matters

High blood pressure often causes no noticeable symptoms. However, over time it increases strain on blood vessels and the heart, raising the risk of:

stroke
heart attack
heart failure
kidney damage

Medication is often recommended to reduce this long-term strain. Treatment is typically based on repeated readings rather than a single measurement.

Learn more here: Hypertension

Main Classes of Blood Pressure Medications

In primary care, several medication classes are used to lower blood pressure. The choice depends on clinical context rather than a single “best” drug.

ACE Inhibitors

ACE inhibitors act on the renin–angiotensin system, a hormone pathway that regulates blood pressure and fluid balance. By relaxing blood vessels, they reduce pressure within the circulation and decrease workload on the heart.

They are commonly used in:

hypertension
heart failure
certain kidney conditions
people with diabetes and raised blood pressure

They are often considered where long-term organ protection is important.

Monitoring considerations may include:

kidney function
potassium levels
blood pressure response

A persistent dry cough can occur in some individuals, and alternative medications may be used if this develops.

Common examples include ramipril, lisinopril, and enalapril, although the most appropriate choice depends on individual factors.

ARBs (Angiotensin Receptor Blockers)

ARBs work on the same hormonal pathway as ACE inhibitors but through a slightly different mechanism. They also relax blood vessels and lower blood pressure.

They are often used when:

an ACE inhibitor is not tolerated
similar organ-protective benefits are desired

Monitoring requirements are broadly similar to ACE inhibitors, including kidney function and potassium levels.

Common examples include losartan, candesartan, and valsartan.

Calcium Channel Blockers

Calcium channel blockers relax the muscles in the walls of arteries, helping them widen and reduce resistance to blood flow.

They are commonly used in:

hypertension
angina
some heart rhythm conditions

They may be particularly useful in certain age groups or where vascular stiffness contributes to raised blood pressure.

Common issues reviewed include:

ankle swelling
flushing
headache
changes in heart rate (depending on the type)

Common examples include amlodipine and diltiazem, depending on the clinical indication.

Thiazide-Type Diuretics

Often referred to as “water tablets,” these medicines help the body remove excess salt and fluid through the kidneys, reducing blood volume and blood pressure.

They are used in:

hypertension
some cases of fluid retention

They can be particularly effective when combined with other blood pressure medications.

Monitoring may include:

electrolyte levels
kidney function
blood pressure response

Examples include indapamide and bendroflumethiazide.

Beta Blockers

Beta blockers reduce heart rate and decrease the force of contraction, lowering the heart’s workload. Their role in blood pressure management varies depending on individual circumstances.

They are commonly used for:

certain arrhythmias
angina
post-cardiac event management
selected cases of hypertension

They may be especially helpful when blood pressure is accompanied by elevated heart rate or rhythm disturbance.

Monitoring includes:

heart rate
blood pressure
symptom review (e.g. fatigue, dizziness)

Common examples include bisoprolol, atenolol, and propranolol, though their use varies depending on the underlying condition.

Medicines Used in Heart Rhythm and Heart Function

Some heart medications are prescribed primarily to manage rhythm disorders or support heart function rather than to treat blood pressure directly.

These may include:

rate-limiting medications
rhythm control medicines
combination therapies for heart failure

Such treatments often require:

ECG monitoring
specialist input
structured follow-up

Primary care frequently works alongside cardiology services in these situations.

Monitoring and Long-Term Review

Heart and blood pressure medications often require ongoing review. This may include:

home blood pressure readings
pulse monitoring
blood tests to check kidney function and electrolytes
symptom assessment

Monitoring ensures the medication remains effective and safe over time. Dose adjustments are common as circumstances change.

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Common Side Effects

Most people tolerate cardiovascular medications well. However, possible side effects may include:

dizziness, particularly when standing
ankle swelling
fatigue
changes in blood tests
altered heart rate

Side effects are often dose-related and may be managed by adjustment or switching medication.

Lifestyle and Medication

Medication works best alongside lifestyle measures such as:

reducing salt intake
maintaining a healthy weight
regular physical activity
moderating alcohol intake
stopping smoking

Lifestyle changes may reduce the number or dose of medications required.

Heart and Blood Pressure Medication in Remote GP Care

Blood pressure reviews are often suitable for remote consultation, particularly when reliable home readings are available.

If new symptoms, abnormal readings, or concerning features arise, in-person assessment or specialist input may be recommended.

Frequently Asked Questions

1. Do blood pressure medications need to be taken for life?

In many cases, blood pressure treatment is long term because hypertension is often a chronic condition. However, medication plans can change. If blood pressure improves with lifestyle changes or weight reduction, treatment may be adjusted under medical supervision. Stopping medication without advice is not recommended.

2. What happens if my blood pressure medication makes me feel dizzy?

Dizziness can occur, especially when starting treatment or increasing the dose. This is sometimes due to blood pressure lowering too quickly. If dizziness is persistent, severe, or associated with fainting, a GP should review the medication and blood pressure readings.

3. Can I take more than one blood pressure medication?

Yes. Many people require a combination of medications that work in different ways to control blood pressure effectively. Using lower doses of multiple medicines can sometimes improve control while reducing side effects. Treatment combinations are tailored to the individual.