Taking your high blood pressure medications properly

High blood pressure is a lifelong disease that, if not controlled, can lead to heart or kidney disease and stroke. Even though you may not feel sick when you have high blood pressure, taking your medicine exactly as directed helps lower your risk for these conditions.

The amount and types of medicines you take will depend on your blood pressure reading, whether you have organ damage from high blood pressure, and whether you have other medical conditions. Follow your doctor's recommendations carefully, and do not skip any of your medicines.

Key points:

• Make your medication schedule as simple as possible. Plan times to take your medicines when you are doing other things, like eating a meal or getting ready for bed. This will make it easier for you to remember to take your medicines.
• Take a list of your medicines or bring your medicines with you when you visit your doctor. Include any medicines that were prescribed to you by other doctors and any nonprescription medicines. Review the list with your doctor and discuss any side effects you are having or need to watch for.
• Talk with your doctor if you are having problems with your medication schedule. Your doctor may be able to change your medicines or change the times you are taking them.
• Talk with your doctor if you have any changes in your health that might affect your blood pressure, such as weight gain, side effects of medicines, or another medical condition.
• Use any tools, like daily or weekly pill containers, that make taking your medicines simple.
• Follow healthy lifestyle habits, including maintaining a healthy weight; exercising; not smoking; and following an eating plan that emphasizes fruits, vegetables, low-fat dairy foods, and less salt. This may allow your doctor to reduce the amount of medicine you take and will help the medicines work better.

 What do medications do for high blood pressure?
 Why is it important that I take my medications properly?
 How can I take my blood pressure medications properly?
 Where to go from here

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Medicines control but do not cure most cases of high blood pressure, so you will need to take them for the rest of your life. Medicines used to treat high blood pressure work in various ways and are used in different combinations.

• Diuretics cause the kidneys to remove more sodium and water from the body. This decreases the volume of blood circulating through the body, which lowers blood pressure, especially systolic blood pressure. These drugs may also have a direct effect on blood vessels, causing blood pressure to decrease. Diuretics are often combined with other blood pressure medicines.
• Angiotensin-converting enzyme (ACE) inhibitors block an enzyme needed to form a substance that causes blood vessels to narrow (constrict). As a result, blood vessels relax and widen (dilate), making it easier for blood to flow through the vessels, which reduces blood pressure. These medicines also increase the release of water and sodium to the urine, which also lowers blood pressure.
• Angiotensin II receptor blockers (ARBs) block the action of a hormone that causes blood vessels to narrow. As a result, blood vessels may relax and open up. This makes it easier for blood to flow through the vessels, which reduces blood pressure. These drugs also increase the release of sodium and water into the urine, which also lowers blood pressure.
• Beta-blockers lower the heart rate, the amount of blood the heart pumps out with each beat, and the force of the heart beat, all of which lower blood pressure.
• Calcium channel blockers work by reducing the amount of narrowing of the blood vessels caused by high blood pressure. This makes it easier for blood to flow through the vessels and lowers blood pressure.
• Direct renin inhibitors block the enzyme renin from starting a process that helps regulate blood pressure. As a result, blood vessels relax and widen, making it easier for blood to flow through the vessels, which lowers blood pressure.

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Medicines work in a delicate balance with each other and with your body. But some medicines should not be combined with other prescription or nonprescription medicines. Make sure your doctor knows all of the medicines you are taking.

A combination of medicines given in a lower dose than a single medicine may work better to lower your high blood pressure and may cause fewer side effects.

Finding the right combination of medicines with the fewest side effects can take some time, so it is important to take your medicines in the right combination and at the right time, as your doctor has prescribed. If you don't take your medicines properly:

• Your blood pressure may not be controlled, which can lead to kidney and heart disease and stroke.
• You may develop eye damage (retinopathy).
• You may develop peripheral arterial disease.

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Here's how you can get started on taking your medicines properly.

Develop a medication plan

Work with your doctor to develop your medication plan. Talk with your doctor about the following:

1. Names of all medicines. Get a clear explanation of the actions and purposes of each medicine that your doctor prescribes for you. If you understand what you are taking and how it is helping you, it may be easier to stay on your schedule. Write down both the prescription and generic names for your medicines. Have your doctor check the list. You can use this list to verify that the medicines you get from the pharmacy are correct.
2. Medication schedule. Be sure you understand how much of each medicine to take and when to take each one. Ask your doctor if you can make your pill schedule simpler. This may make it much easier for you to remember to take your medicines as directed. You may be able to substitute longer-acting medicines for shorter-acting ones. Longer-acting, once-a-day medicines are easier for people to remember to take.
3. How to handle missed doses. Talk with your doctor about what you should do if you accidentally miss a dose of a medicine. Discuss what to do for each medicine—it may be different for each one.
4. Medication costs. If cost is a consideration in developing your medication plan, ask your doctor if less expensive, equally effective generic brands would be appropriate for you. Compare prices between several pharmacies and consider mail-order pharmacies.
5. Medicines to avoid. You may need to avoid certain medicines. Many medicines can reduce the effectiveness of blood pressure medicines and raise your blood pressure. Talk to your doctor if you are taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (for example, Advil, Motrin, or Nuprin), indomethacin (Indocin), ketoprofen, naproxen (for example, Aleve or Naprosyn), or piroxicam (Feldene). Decongestants, such as pseudoephedrine (Sudafed, for example), may also cause a problem. Talk to your doctor as well if you are taking any herbal or homeopathic remedies, which also can affect blood pressure.

Get organized

Taking medicines properly means taking the right dose of the right medicine at the right time. When you are taking several different medicines, it may be hard to keep the times and dosages straight. To be sure you are taking your medicines properly, you may want to develop a system to keep track of when and how you take your pills.

1. Make a list of all your medicines. Complete the master list of medicines and keep it up to date. At every visit with your doctor, review your master list of medicines(What is a PDF document?).
2. Plan a daily schedule of medications. Post your medication schedule in a prominent place near your medicine cabinet. Take it along when you travel. Record your medication schedule in a daily planner that has spaces for hourly entries.(What is a PDF document?)
3. Use a pillbox. Get a pillbox that holds a week's worth of pills.
4. Post reminders. Get sticky note pads and post reminders to take your medicines near clocks or on the bathroom mirror, to keep you on schedule.

Taking your medicines

Keep the following in mind as you follow your medication plan.

1. Store medicines properly. Keeping medicines in a location that is too hot or too cold may decrease the effectiveness of the medicine. Find out from your doctor or pharmacist how to properly store your medicines. Always remember to store medicines out of the reach of children.
2. Watch for side effects. Ask your doctor or pharmacist about what side effects to expect. Be sure to tell your doctor if you are having side effects from your medicines.
3. Avoid other medicines. Post your list of medicines to avoid in a place where you can refer to it whenever you need to. Always check with your doctor before taking any additional medicines, prescription or nonprescription. This includes any herbal or "natural" supplements.
4. Review your master medication list. Take your master list with you for each visit with your doctor. Take time to review your list and report any side effects you are having.
5. Communicate with your doctor. Notify your doctor immediately if you have any serious side effects. Let your doctor know if you have any changes in your health that might affect your heart condition, such as weight gain or another medical condition.

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Now that you have read the information on taking your medicines properly for high blood pressure, you are ready to develop your system for taking your medicines properly.

Talk with your doctor

If you have questions about this information, take it with you when you visit your doctor. You may want to use a highlighter to mark areas or make notes in the margins of the pages where you have questions.

If you don't have a medication plan already, schedule a time with your doctor to develop one. If you would like more information on taking your medicines properly, the following resources are available:

If you would like more information on high blood pressure, the following resources are available:

Organization

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