If you have diabetes, there is a good chance you also have hypertension, or high blood pressure. Heart disease is the leading cause of death among those with Type 2 diabetes, and high blood pressure can lead to heart disease, so it is extremely important to treat this condition.
Your doctor will most likely prescribe one or more antihypertensive medications to lower your blood pressure, but there are several different classes, or types, of drugs that treat hypertension.
High blood pressure is classified as Stage 1 (140/90 to 159/99) or Stage 2 (160/100 and above). The drug(s) your doctor prescribes may depend on which stage your blood pressure is in. Listed below are the main classes of high blood pressure drugs, along with a description of how they work and what their side effects are.
- Diuretics
- ACE Inhibitors
- Beta-blockers
- Angiotensin-2 Receptor Blockers(ARBs)
- Calcium Channel Blockers
Diuretics
How they work:Excess water and sodium (salt) in the body can result in high blood pressure. Diuretics work by getting rid of excess sodium and water through increased frequency of urination. If you have stage 1 hypertension, your doctor will likely prescribe a diuretic first.
Possible side effects:Diuretics may decrease the amount of potassium in your body, which can lead to weakness, leg cramps or fatigue. You can counteract this side effect by eating more potassium-rich foods. Diuretics may also increase blood sugar levels in those with diabetes. Your doctor may change your diabetes medication or dose of insulin to regulate your blood sugar.
ACE Inhibitors
How they work:Angiotensin is a substance produced by the body that causes blood vessels to contract, or tighten. ACE inhibitors (Angiotensin-Converting Enzyme) keep the body from producing angiotension, which allows blood vessels to relax and expand so that blood flows more easily. If you have stage 2 high blood pressure, your doctor may prescribe an ACE inhibitor along with a diuretic.
Possible side effects:Rash, dry cough, loss of taste. Women who are pregnant or trying to become pregnant should not take this drug, as it may be harmful to both mother and baby.
Beta Blockers
How they work: This class of drugs blocks beta-adrenergic receptors within the body, which in turn slows the heart rate and reduces the heart’s demand for oxygen and output of blood. Beta blockers improve a person’s survival rate following a heart attack.
Possible side effects:Insomnia, fatigue, depression, cold hands and feet, asthma-like symptoms, slow heartbeat, impotence. If you have diabetes and you take insulin, be sure to monitor your reaction to beta blockers. Women who are pregnant or trying to become pregnant should not take this drug, as it may be harmful to both mother and baby.
Angiotensin-2 Receptor Blockers (ARBs)
How they work: Instead ofdecreasing the levels of angiotensin in the body or stopping its production entirely, angiotensin-2 receptor blockers (ARBs) prevent angiotensin from having any effects on the heart and blood vessels. This allows the blood vessels to relax and increases the supply of blood and oxygen to the heart. ARBs are commonly prescribed for those who have had side effects with ACE inhibitors.
Possible side effects: Occasional dizziness. Women who are pregnant or trying to become pregnant should not take this drug, as it may be harmful to both mother and baby.
Calcium Channel Blockers
How they work:When calcium enters the smooth muscle cells of the heart and blood vessels, the blood vessels become narrower and the heart has to work harder to pump blood. Calcium channel blockers prevent calcium from entering the heart and blood vessel muscle cells, which relaxes the blood vessels and reduces the heart rate.
Possible side effects:Dizziness, headache, constipation, swollen ankles or heart palpitations.
The drugs your doctor prescribes to treat your high blood pressure depend on their effectiveness and any side effects you may experience. For example, if your blood pressure does not respond to a particular medication or you experience side effects, your doctor may prescribe another drug instead. It may take some trial and error to find the best combination for your situation, so it’s extremely important to report any side effects and follow your doctor’s orders.
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