You Can’t Feel High Blood Pressure

Some people get headaches when their blood pressure is very high. But in most cases, high blood pressure is “silent”—and you can’t feel it. Blood pressure pills only work when you take them each day as your doctor prescribes. These medicines need to build up to a certain level in your blood and stay there all the time—whether you feel like your blood pressure is high or not. They are not like pain pills that you take only when you feel pain.

Check your blood pressure at home with a blood pressure monitor to see if your treatment is working. Your VA doctor can write a prescription for a blood pressure monitor so you can get one to take home.

 

Diuretics (“Water Pills”) Make You Urinate More

High blood pressure can be a cause—or a result—of kidney problems. Either way, treating it can help reduce your risk of having a heart attack or a stroke. If you have a kidney problem, keeping your blood pressure in the target range can also help protect your kidneys from more damage. Exercise and diet can help treat high blood pressure. In most cases, you will need to take blood pressure pills, too. Blood pressure pills come in “classes.”

A common class of blood pressure pills is diuretics (“water pills”). These are the first pills most people get for high blood pressure. While your kidneys still work, “water pills” help rid your body of extra water and salt. This means that you will make more urine—at least for the first few weeks. This can wake you up at night. Talk to your care team about what time to take a water pill so it doesn’t affect your sleep.

Water pills are only useful while you still make urine. If your kidneys fail and you stop making urine, “water pills” won’t work.

To learn more, visit How to Slow Kidney Disease: When You Have High Blood Pressure.

 

“Water Pills” Can Change Electrolyte Levels in Your Blood

“Water pills” can change the levels of sodium and potassium (electrolytes) in your blood. You may need to have blood tests and change what you eat to be sure these levels stay in the safe range.

Having too much or not enough potassium in your blood can stop your heart—so this is important! Always tell your care team about any new symptoms you have after you start on a new medicine. To learn more about potassium, you can visit the Nutrition Room, or visit the Laboratory.

 

Some Blood Pressure Pills Keep Arteries Relaxed

ACE inhibitors and ARBs are two more classes of blood pressure pills. These are used often in people with kidney problems. They can help protect the kidneys from further damage if you have diabetes or another health problem where there is protein in your urine. If you are a woman, ACE inhibitors and ARBs are NOT SAFE if you become pregnant. Talk with your doctor about this.

A class of blood pressure pills called alpha blockers and one called central agonists also work by keeping your arteries relaxed. If your doctor prescribes a central agonist, it’s important to not stop taking it suddenly—your blood pressure could rise very quickly to dangerous levels.

 

Side Effects of ACE Inhibitors

ACE inhibitors can cause a dry, tickly cough in some people. If you take an ACE inhibitor and this happens to you, tell your doctor. You may need to switch to an ARB instead. ARBs do not cause a cough.

 

Some BP Medicines Slow Your Heart Rate

Beta blockers and calcium channel blockers are two more classes of blood pressure pill. If your heart rhythms are not even and you have high blood pressure, your doctor may prescribe one of these. These medicines slow your heart rate and reduce your body’s “fight or flight” response to stress. Because they can block the effects of the sleep hormone melatonin, they can cause problems sleeping. They can also make you feel tired.

If you take a calcium channel blocker, don’t drink grapefruit juice! The juice reacts with the medicine and could make it build up in your body to unsafe levels.

 

You May Need More Than One Type of Blood Pressure Medicine

Sometimes one blood pressure pill doesn’t do the trick. Often, people with kidney problems need to take more than one class of blood pressure pills to get their blood pressure into the target range and protect their kidneys. This may be because the kidneys are causing high blood pressure. But sometimes it happens when someone doesn’t take the pills the doctor prescribes. Then, the doctor prescribes more pills, thinking that the first one is not working.

Be honest with your care team. If a blood pressure pill is causing problems for you, say so. It’s better to switch to a new medicine than to have more and more pills prescribed and not take them.

 

See How You Feel Before You Get Behind the Wheel

Any medicine can cause side effects. You may be at risk of a fall or other accident. Protect yourself:

• Sit before you stand up, in case you may feel dizzy.
• See if you need help to walk.
• Don’t drive a car or run heavy machinery until you know how a new blood pressure pill makes you feel.

If you are a man, you may know that blood pressure pills can cause problems getting erections, or make this problem worse. A change in medicine or dose can help if this happens to you. Talk to your doctor—but DO take your blood pressure pills!