BP Tablets Names Sorted Into 5 Classes And Explained Easily

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The number of BP tablets names is overwhelming: perindopril, lisinopril, captopril, ramipril, and enalapril; valsartan, telmisartan, candesartan and irbesartan; amlodipine, nifedipine, felodipine and lercanidipine; HCTZ and indapamide; atenolol, propranolol and bisoprolol.

“And these are the commonly prescribed blood pressure tablets; I have left some out.”

I’ll go through it logically.

I will start by listing the BP tablets names in classes.

Briefly explain how each class works.
Discuss the main class side effects.

Disclaimer: The possible side effects of any medication are usually a mile long and listed in the package insert. I will only discuss the most likely side effects. Always call your doctor if you develop new symptoms after starting a medication. Do not stop medication without consulting your doctor.

A quick refresher on how blood pressure works.

The five main classes of blood pressure tablets are:

ACE (Angiotensin Converting Enzyme) inhibitors
Angiotensin Receptor Blockers (ARBs)
Calcium channel blockers
Diuretics
Beta-blockers

1. ACE inhibitors

ACE inhibitor BP tablets names

Perindopril, lisinopril, captopril, ramipril, enalapril, fosinopril, and benazepril

Perindopril is the superior ACE inhibitor, with ramipril second. ³Trials have shown that perindopril helps to prevent death (decreases mortality in fancy medical terms) and protects the heart and arteries. ⁴

How ACE inhibitors work

Refer to Figure 1 to see where they block the RAAS and lower BP. It is very interesting, have a look.

ACE inhibitor side effects

Cough

The most common side effect is a cough and affects 1 to 2 out of 10 patients. ¹⁰

The cough is usually a dry irritation. An annoying slight cough, a niggle. No other symptoms of illness. The patient doesn’t go to the doctor because they are ‘not sick.’ It usually starts within a week to six months after starting treatment. However, it can begin at any time. ¹⁰

No one is 100% sure why ACE inhibitors cause a cough.²This is one theory that might interest you.

ACE doesn’t only work in the RAA system, as shown in Figure 1. It also breaks down bradykinin, an inflammatory peptide. ACE inhibitors block ACE from working, and bradykinin builds up. This, in turn, causes an inflammatory cascade including histamine.

Studies show that ACE inhibitors don’t worsen asthma. ²

Other possible side effects include a runny and blocked nose, dizziness, low blood pressure, and high potassium.

2. ARBs

ARB BP tablets names

Valsartan, telmisartan, losartan, candesartan and irbesartan

How ARBs work

Refer to Figure 1 to see where they block the RAAS and lower BP.

ARBs are as good as ACE inhibitors at lowering BP. However, don’t compete with perindopril on heart and artery protection. ¹²

They are widely prescribed because of their low side-effect profile. However, they are more expensive than ACE inhibitors.

ARB side effects

There are very few side effects. ¹¹

Dizziness, low blood pressure, and high potassium can happen.

The RAAS: How do ACE inhibitors and ARBs work?

The renin-angiotensin-aldosterone system (RAAS) helps to keep your blood pressure constant.

The system is triggered when blood flow to the kidney is low and renin increases.

It increases blood volume.
It constricts arteries, increasing resistance and blood pressure.

By blocking points in the RAAS, blood pressure decreases.

Two BP tablet classes, ACE inhibitors and ARBs, do this.

Figure 1 – The RAAS and where ACE inhibitors and ARBs work

3. Calcium channel blockers

CCB BP tablets names

Older agents – Verapamil and diltiazem

Newer agents – Amlodipine, nifedipine, felodipine, and lercanidipine

Amlodipine is by far the favored CCB. It is potent and a daily dose. It has been in many trials that have shown its benefits. ⁵ It is well priced.

This class works wonders for patients of African descent when compared to ACE inhibitors and ARBs. ⁷

How CCBs work

Heart muscle and blood vessel walls need calcium to help them contract. These medications block the passages that allow calcium transport into the heart and vessel cells. ⁶

The heart contractions are weaker and reduce blood pressure.
Blood vessels dilate, and blood pressure drops.

CCB side effects

Swollen legs

For CCBs, the main side effect is leg swelling.

The higher the dose, the worse the swelling. It can cause warmth and a rash in some patients.⁸

CCBs dilate arteries supplying blood to the limbs. They, however, do not affect the veins returning the blood to the lungs, which stay the same size. This means a flood of blood in the legs, but the veins cannot cope to send it back to the lungs. Blood pools with gravity and causes swelling.

4. Diuretics

Diuretic BP tablets names

Hydroclorothyoxide (HCTZ) and indapamide

Indapamide is the diuretic of choice, as stated in the NICE guidelines. It is less likely to have the side effects listed below. ⁹It also has a slow-release formulation that gives 24-hour coverage. It protects the heart and kidneys from high BP damage. ¹³

How Diuretics work

You might know them as water tablets. They lower blood volume by removing water via the kidneys as urine.

Diuretic side effects

Increased uric acid levels ¹⁴

This can lead to gout and kidney stones.

Insulin resistance and increased glucose levels ¹⁴

Insulin resistance means that glucose tolerance can change. It is a potential pre-diabetic state. Despite this, people with diabetes can use indapamide, especially in combination with perindopril.

5. Beta-blockers

Beta-blocker tablet names

Propranolol, atenolol and bisoprolol

Atenolol and bisoprolol work specifically on the heart and kidney (B1 receptors).

Propranolol acts everywhere (B1 and B2) and is often used for the treatment of anxiety’s physical symptoms and stage fright.

Because of their many side effects, they are often the last class added to a blood pressure treatment plan. Doctors prescribe beta-blockers for conditions other than high BP.

How beta-blockers work

Hormones stimulate the ‘fight or flight’ system by sticking to beta receptors (B1 and B2). There are beta receptors in the heart, kidneys, and many other organs. When activated, the beta receptors stimulate increased heart rate and blood vessel narrowing. This pushes BP up.

Beta-blockers do, as their name suggests, block beta receptors. Heart rate decreases, and vessels dilate. BP drops.

B1 receptors are also in the kidney. When stimulated, more renin is released. Refer to Figure 1 for a refresher course on the RAA system. ¹⁶Beta-blockers prevent this renin spike, stop the RAA system, and drop BP.

Beta-blocker side effects

Beta-blockers have many side effects because beta receptors are found in many organs. ¹⁶

Low heart rate, lower blood pressure, dizziness, and tiredness are common.
Sleep disturbances, constipation, sexual dysfunction, and impotence can occur.
Blocking beta receptors can cause bronchospasm and wheezing, especially in asthmatics.
Weight gain is a possible side effect of older beta-blockers. ^15,16

Summary

I hope this answers whatever question you had in mind when you googled “BP tablets names.” Maybe you learned a bit more about the medication you have been prescribed.

Also read: Tricks To Lower Blood Pressure Instantly ∣ Fact Or Fiction

References

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