Common Medication Guide for Hypertension: How to Choose Antihypertensive Drugs?

High blood pressure (hypertension) is one of the most common chronic diseases. According to the Centers for Disease Control and Prevention (CDC), nearly half of adults in the United States have high blood pressure. Hypertension often has no obvious symptoms, which is why it is frequently referred to as the "silent killer."

For Chinese Americans living in the U.S., encountering English drug names like Lisinopril, Losartan, Amlodipine, and Hydrochlorothiazide often leads to confusion about what these medications are, how they differ, and why doctors might prescribe two or more blood pressure medications simultaneously.

This article, based on current U.S. hypertension treatment guidelines, introduces the basic classifications of common blood pressure medications in the U.S. and important considerations for their use.

Important Note: Hypertension medications are prescription drugs. This article is for health education purposes only and should not replace a doctor's diagnosis or individualized treatment. It is also not advisable to start, stop, or adjust prescription medications based on this article alone.

1. What Blood Pressure Readings Are Considered High?

According to the current U.S. blood pressure classification:

Normal Blood Pressure: Systolic blood pressure below 120 mmHg AND diastolic blood pressure below 80 mmHg

Elevated Blood Pressure: Systolic blood pressure 120–129 mmHg AND diastolic blood pressure below 80 mmHg

Stage 1 Hypertension: Systolic blood pressure 130–139 mmHg OR diastolic blood pressure 80–89 mmHg

Stage 2 Hypertension: Systolic blood pressure ≥140 mmHg OR diastolic blood pressure ≥90 mmHg

A single high reading does not necessarily mean you have hypertension. Doctors usually make a diagnosis based on multiple measurements, home blood pressure records, and your overall health status.

For most adults, the latest U.S. guidelines aim to control blood pressure to below 130/80 mmHg, but specific targets may need to be adjusted individually based on age, physical condition, pregnancy status, and other medical conditions.

2. What Are the Most Common Blood Pressure Medications in the U.S.?

1. ACE Inhibitors

Common English generic names include:

• Lisinopril

• Benazepril

• Enalapril

• Ramipril

These medications work by affecting the renin-angiotensin system, causing blood vessels to relax, which helps lower blood pressure.

Some patients may experience a persistent dry cough after taking ACE inhibitors. If you experience swelling of the face, lips, or tongue, or difficulty breathing or swallowing, seek immediate medical attention.

ACE inhibitors can also affect kidney function and blood potassium levels, so your doctor may order blood tests for monitoring.

If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor so they can determine the appropriate treatment plan.

2. ARBs (Angiotensin II Receptor Blockers)

Common medications in the U.S. include:

• Losartan

• Valsartan

• Irbesartan

• Olmesartan

ARBs act on a similar blood pressure regulation system as ACE inhibitors but typically cause the dry cough associated with ACE inhibitors less frequently.

Losartan is one of the more familiar blood pressure medications for many Chinese American patients.

ARBs can also affect blood potassium levels and kidney function, so laboratory tests should be performed as requested by your doctor.

Do not self-switch between Losartan and Lisinopril just because you think they are "both blood pressure medications."

3. Calcium Channel Blockers (CCB)

One of the most common medications is:

Amlodipine

This is a very common blood pressure medication in the U.S.

It primarily lowers blood pressure by helping blood vessels relax.

Some patients may experience:

• Swelling in the ankles or lower legs

• Dizziness

• Headache

• Palpitations or facial flushing

If you experience significant swelling after taking the medication, do not stop taking it on your own. Instead, contact your doctor or pharmacist to discuss it.

4. Diuretics

Common medications include:

• Hydrochlorothiazide

• Chlorthalidone

Diuretics are sometimes informally called "water pills" or "drainage pills," as they help lower blood pressure by helping the body eliminate excess sodium and water.

During use, your doctor may monitor:

• Potassium

• Sodium

• Kidney function

• Uric acid

• Blood sugar

If you are taking other medications or supplements, you should inform your doctor and pharmacist.

5. Beta Blockers

Common medications include:

• Metoprolol

• Carvedilol

• Atenolol

These medications can lower heart rate and reduce the workload on the heart.

In addition to high blood pressure, doctors may also prescribe these medications for coronary artery disease, heart rhythm problems, heart failure, or other cardiovascular conditions.

Therefore, do not stop taking them on your own just because your blood pressure is normal.

Suddenly stopping some beta blockers can carry risks, so adjustments should be made under your doctor's guidance.

3. Why Did My Doctor Prescribe Two Blood Pressure Medications?

This is a question many Chinese American patients frequently ask their pharmacists.

The answer is: It's very common.

Different types of blood pressure medications control blood pressure through different mechanisms. For some patients, combining two medications with different mechanisms is more appropriate than simply increasing the dosage of a single medication.

According to the 2025 U.S. hypertension guidelines, for patients with Stage 2 hypertension, the use of two different classes of first-line blood pressure medications is usually preferred; when appropriate, a single-pill combination can also reduce the number of pills needed daily, improving long-term medication adherence.

Therefore, if your doctor prescribed both Amlodipine and Losartan, it does not mean your "condition is particularly serious," and you should not choose to take only one of them on your own.

4. Can I Stop Taking My Medication Once My Blood Pressure Is Normal?

Do not stop medication on your own.

Many patients will find:

"My blood pressure has been 120/75 recently, so do I no longer need to take medication?"

It's important to note that normal blood pressure may precisely indicate that your current treatment is working.

If you stop taking medication on your own, your blood pressure may rise again, and high blood pressure usually has no obvious symptoms.

If your blood pressure significantly improves after consistent weight loss, dietary improvements, and increased exercise, you can bring your home blood pressure records to your doctor, who can then determine if a dosage or medication adjustment is necessary.

5. What Should I Pay Attention to When Measuring Blood Pressure at Home?

Home blood pressure monitoring is an important part of hypertension management.

It is recommended to choose a validated upper-arm electronic blood pressure monitor.

Before measuring:

• Rest quietly for about 5 minutes

• Avoid measuring immediately after exercise

• Sit with your back supported

• Keep your feet flat on the ground

• Support your arm

• Position the cuff roughly at heart level

If your doctor asks you to record your home blood pressure, you can measure it at similar times each day and keep a record.

Do not change your medication dosage on your own based on a single unusually high or low reading.

Currently, the American Heart Association also does not recommend relying on unverified cuffless devices or smartwatches to replace standard blood pressure monitors for hypertension management.

6. Do I Still Need to Control My Diet While Taking Blood Pressure Medication?

Yes, you do.

Medication therapy does not replace lifestyle management.

U.S. hypertension guidelines recommend focusing on:

• Reducing sodium intake

• Eating more fruits and vegetables

• Adopting a heart-healthy eating pattern, such as the DASH diet

• Maintaining regular physical activity

• Maintaining a healthy weight

• Reducing or avoiding alcohol consumption

• Managing stress

• Quitting smoking

It's especially important to note that many processed foods, canned foods, pickled foods, soups, and takeout foods in the U.S. have high sodium content.

For Chinese households accustomed to Chinese cuisine, soy sauce, oyster sauce, bean paste, pickled vegetables, and some soup bases can also contribute a large amount of sodium.

7. Why Do Hypertension Patients Need to Be Extra Careful When Buying OTC Medications?

This is a point many patients tend to overlook.

When experiencing a cold, nasal congestion, pain, or other common symptoms, do not assume that all over-the-counter (OTC) medications are suitable for people with high blood pressure.

Some OTC products or other medications can affect blood pressure, kidney function, or interact with your current blood pressure medications.

Therefore, when purchasing cold medicine, pain relievers, nasal decongestants, or dietary supplements, you can proactively tell the pharmacist:

"I have high blood pressure, and I am currently taking these medications."

It's best to prepare a complete Medication List, including:

• All prescription medications

• OTC non-prescription medications

• Vitamins

• Herbal medicines

• Dietary supplements

This allows your doctor and pharmacist to more thoroughly check for potential interactions.

8. What Should I Do If My Blood Pressure Is Over 180/120?

If you measure a very high blood pressure reading, you should re-measure it using the correct method and promptly contact a healthcare professional.

If your blood pressure reaches or exceeds this severe range and you also experience symptoms such as:

• Chest pain

• Shortness of breath

• Obvious neurological abnormalities

• Changes in consciousness

• Severe vision changes

• Other sudden severe symptoms

You should seek immediate emergency medical attention.

Do not attempt to double your dose of blood pressure medication at home to quickly lower your blood pressure.

Starside Drugs Pharmacist Tip

The most important aspect of hypertension management is not "finding the strongest blood pressure medication," but rather finding a long-term treatment plan that suits you and consistently taking your medication correctly and monitoring your blood pressure.

If you are seeing different doctors, specialists, or hospitals simultaneously, it is recommended to bring an updated complete medication list to each appointment.

If you have any questions about the English names of medications, dosing times, common side effects, or drug interactions, you can consult your doctor or pharmacist.

Starside Drugs Pharmacy provides pharmacy services to the New York community and offers Chinese language support to help Chinese patients better understand their medications and daily health management.

Frequently Asked Questions (FAQ)

Which is better, Losartan or Amlodipine?

There is no single answer that applies to all patients. Both are different types of blood pressure medications, and the choice depends on factors such as blood pressure, age, kidney function, other medical conditions, current medications, and side effects. Some patients may even use both simultaneously.

Do I need to take blood pressure medication for the rest of my life?

Not everyone's situation is exactly the same. Hypertension usually requires long-term management, but as weight, diet, exercise, and overall health change, doctors may adjust the treatment plan. Do not stop medication on your own.

What if I forget to take a dose of blood pressure medication?

The handling of missed doses may differ for various medications. Do not double up on doses to make up for a missed one without understanding the specific medication requirements; you can check the prescription label or consult your pharmacist.

Can I measure blood pressure with a smartwatch?

Currently, home hypertension management should still prioritize the use of validated upper-arm blood pressure monitors with appropriate cuff sizes. Smartwatches or other cuffless devices should not currently be used as a substitute for standard blood pressure measurement.

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Medical Disclaimer

This article is provided by Starside Drugs Pharmacy for general health education and drug knowledge dissemination only. It does not constitute personal medical diagnosis, prescription, or treatment advice. Individual situations may vary. Please consult your doctor, pharmacist, or other qualified healthcare professional before starting, stopping, or adjusting any prescription medication. In case of a medical emergency, please seek immediate medical attention.