Home › Chronic disease › Heart and blood pressure medicines
Reviewed by Dr. Arjun Mehta, PharmD — Head Pharmacist. Updated May 2025.
Healthy target
Main drug classes
Need 2+ drugs
High blood pressure (hypertension) is the leading risk factor for stroke, heart attack and kidney disease worldwide, and almost half of US adults have it. It is usually symptom-free until it causes harm, which is why it is called the silent killer — and why measuring it regularly matters.
Most people with hypertension need one or more daily medicines, alongside lifestyle changes (less salt, more activity, reduced alcohol, weight loss if needed). The four main classes are ACE inhibitors, ARBs, calcium-channel blockers and thiazide diuretics; beta-blockers are used selectively. Most patients end up on a combination.
Ramipril, lisinopril, enalapril. First-line for many patients. Cheap, well-studied, kidney-protective.
Losartan, telmisartan, valsartan. Like ACE inhibitors but without the cough. Often preferred in newer guidelines.
Amlodipine, nifedipine. Excellent in older patients and Black African heritage.
Indapamide, hydrochlorothiazide. Older but very effective, especially in combination.
Healthy adults: under 120/80. Hypertension is diagnosed at 130/80 or above on repeated readings. Targets vary with age and other conditions.
No — hypertension is usually symptomless, and stopping medication often returns BP to dangerous levels within weeks. Always discuss changes with your prescriber.
Most people need a combination to reach target. Multiple low-dose drugs cause fewer side effects than one high-dose drug.

/our-pharmacists/arjun-mehta/ — Reviewed May 2025
This guide is reviewed every 12 months or sooner when clinical guidance changes. If you have a specific medical question, call our pharmacist team — we answer the phone, not a bot.
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