There are many medications for controlling hypertension: beta blockers, calcium
channel blockers, diuretics, etc. What are the pros and cons of each kind? Which
are the most benevolent (i.e., least harmful)?

Hi,

There are many types of medications used to control hypertension (high blood 
pressure). They include diuretics, beta blockers, angiotensin converting enzyme 
(ACE) inhibitors, calcium channel blockers, alpha-blockers, alpha-beta blockers 
and others.

There are many websites that list antihypertensive medications and talk about 
their mechanism of action, e.g.

National Institutes of Health: Types of Medications for High Blood Pressure
www.nih.gov/health/hbp-tifl/

(If that link doesn't work, try the version cached by Google at:
http://216.239.51.100/search?q=cache:tGwQFCFTyGwC:www.nih.gov/health/hbp-
tifl/+site:www.nih.gov+high+blood+pressure&hl=en )

National Heart, Lung and Blood Institute: Heart Disease and Medications
http://www.nhlbi.nih.gov/actintime/hdm/hdm.htm

National Heart, Lung and Blood Institute: Your Guide to Lowering High Blood 
Pressure: Types of Blood Pressure Medications
http://www.nhlbi.nih.gov/hbp/treat/bpd_type.htm

Healthsquare: Drugs that bring pressure down (PDR Family Guide to Prescription 
Drugs)
http://www.healthsquare.com/hbp5.htm

This page lists side effects, in addition to mechanisms of action:

UC Davis Health Journal: What drugs do
http://healthjournal.ucdavis.edu/sep_oct_98_hj/articles/drugs.html

However, the best resource of information on medication side effects is the 
Medline database at the National Library of Medicine (drug information section):
http://www.nlm.nih.gov/medlineplus/druginformation.html 

Search that site for 

antihypertensive side effects

and you will get a list of side effects for all types of medications. Or use 
the specific medication name you're interested in, and search for it, e.g., 
like this:

verapamil side effects

In general, it's a good idea to visit high blood pressure news sites frequently 
and look for news on medications: new risks and side effects are being 
discovered every month.

Good sites to search:

National Institutes of Health' News
http://www.nih.gov/news/

American Heart Association's News
http://www.americanheart.org/presenter.jhtml?identifier=1200031

Lifeclinic.com: Blood Pressure
http://www.lifeclinic.com/focus/blood/default.asp 

Sample recent news releases:

NIH Statement: Calcium Channel Blockers and Breast Cancer Risk
http://www.nih.gov/news/pr/oct97/nhlbi-14.htm 

"A new analysis linking some calcium channel blockers to an increased risk of 
breast cancer in older women appears in the October 15 issue of the journal 
Cancer. According to the study, postmenopausal women who took calcium channel 
blockers had twice the risk of developing breast cancer than other women. The 
overall cancer risk was not increased."

NHLBI Stops Part of Study — High Blood Pressure Drug Performs No Better Than 
Standard Treatment
http://www.nih.gov/news/pr/mar2000/nhlbi-08.htm 

"The alpha-adrenergic blocker is doxazosin; the diuretic is chlorthalidone. 
Users of doxazosin had 25 percent more cardiovascular events and were twice as 
likely to be hospitalized for congestive heart failure as users of 
chlorthalidone. The drugs were similarly effective in preventing heart attacks 
and in reducing the risk of death from all causes. 

Of the approximately 24 million Americans who take medication to treat their 
hypertension, about 1 million use an alpha blocker. Doxazosin, the alpha 
blocker used in ALLHAT, is sold under the brand name Cardura®. (Other alpha 
blockers used for hypertension are terazosin, sold under the brand name Hytrin, 
and prazosin, sold under the brand name Minipres)."

Also, search Medline (National Library of Medicine) for specific drug names or 
types and "side effects":
http://www4.ncbi.nlm.nih.gov/entrez/query.fcgi

Useful Google searches:

"high blood pressure" drug OR drugs OR medication OR medications
hypertension OR hypertensive OR antihypertensive drug OR drugs OR medication OR 
medications
hypertension medication side OR adverse effects
hypertension medication risks

---

Clarification of Answer by gale-ga on 22 Apr 2002 11:50 PDT

Regarding your question about "least harmful" medications, the ACE inhibitors 
usually have fewer and less severe side effects than the others, as a rule 
limited to cough; other medications have a range of side effects including 
headaches, dizziness, fainting, edema, diarrhea, and others.

One more detailed resource of blood pressure information can be found at

The Heart Center Online: Blood Pressure Center
http://www.heartcenteronline.com/myheartdr/articles_about_the_heart/The_Blood_Pr
essure_Center.html

Scroll to the bottom, and pick the type of medication you're interested in from 
the Related Patient Guide list.

---

Clarification of Answer by gale-ga on 22 Apr 2002 11:54 PDT

One more thing I'd like to add: the same medication may have almost no risks 
for some people, and very serious risks for others. Everything depends on your 
pre-existing conditions. For example, cough may be considered a severe side 
effect in someone with a respiratory condition.

If you're interested in natural medicines, I happen to know some
(found out after my wife had hypertension problems).

Made juice from cucumber/celery, you may mix some sugar to make it
tastier, then drink as often as you can (my wife drank 4 glasses a
day).
Will take about 24 hours to start showing the effect.

My wife was on antenolol (? forgot, it's been some time) for days with
no result, so finally we ask our elders, which happens to know some
natural remedies that will actually works.

Hopefully it'd be useful to anyone.

Thank you, Sufhemi, for your suggestion of a natural remedy. I
actually do juice and generally make a vegetable juice from tomatoes,
cucumbers, celery, carrots, beet root, and parsley. I wonder why
cucumbers and celery alone would affect hypertension? Unless it acts
like a diuretic, which is my guess.

I also know that adding calcium and magnesium to my diet may help as
well.

You might want to visit www.heartcenteronline.com - its an amazing site.