5 Outdated Blood Pressure Drugs That Are No Longer Recommended

1. Alpha-Blockers

Alpha-blockers are a class of drugs taken to lower high blood pressure. They work by relaxing muscles in the blood vessel walls, allowing them to widen, which helps lower blood pressure. Some examples of alpha-blockers taken for high blood pressure include Cardura (doxazosin), Minipress (prazosin), and Terazosin. Studies have found that alpha-blockers only have a "modest" effect on lowering blood pressure, with an average of 8 millimeters of mercury (mmHg) for systolic blood pressure and 5 mmHg for diastolic blood pressure.

2. Alpha-2 Agonists

Alpha-2 agonists are a class of drugs taken to lower blood pressure but are not typically a first choice of treatment, according to guidelines. They work by blocking brain signals that increase the heart rate and narrow blood vessels, which helps lower blood pressure. Some examples of alpha-2 agonists include Catapres (clonidine), Guanfacine, and Methyldopa. These medications are often avoided due to safety concerns, including side effects such as drowsiness, dizziness, fatigue, headache, and depression.

3. Beta-Blockers

Beta-blockers are not recommended as a first choice of treatment for high blood pressure, according to guidelines. They work by decreasing the rate and force of the heart pumping blood, which helps lower blood pressure. Some examples of beta-blockers include Lopressor (metoprolol) and Inderal (propranolol). However, beta-blockers can cause side effects such as fatigue, depression, and erectile dysfunction.

What Is the First Blood Pressure Drug of Choice?

First-choice blood pressure medications, according to the American College of Cardiology/American Heart Association Guidelines, include ACE inhibitors, ARBs, and thiazide diuretics. Healthcare providers may start with one or more medications, with selection depending on individual factors.

Medications That Worsen Blood Pressure

Some substances and medications—both over-the-counter (OTC) and prescription—are associated with increased blood pressure, such as alcohol, amphetamines, and certain antidepressants.

Summary

Some blood pressure medications are no longer recommended as first-line treatments due to limited effectiveness or side effects. For example, alpha-blockers, alpha-2 agonists, and vasodilators are not typically preferred as a first choice for lowering blood pressure because they may have modest effects or cause side effects like dizziness, fatigue, or heart problems. Guidelines recommend thiazide diuretics, calcium channel blockers, ACE inhibitors, or ARBs as first-line treatments. Healthcare providers will choose the best option based on individual considerations. Lifestyle changes, such as diet, exercise, and weight loss (if necessary), can also help manage high blood pressure.

FAQs

Q: What are the most effective blood pressure medications?
A: ACE inhibitors, ARBs, and thiazide diuretics are considered first-line treatments for high blood pressure.

Q: What are the side effects of beta-blockers?
A: Beta-blockers can cause side effects such as fatigue, depression, and erectile dysfunction.

Q: What are some substances and medications that worsen blood pressure?
A: Some substances and medications associated with increased blood pressure include alcohol, amphetamines, and certain antidepressants.

Q: What are some lifestyle changes that can help manage high blood pressure?
A: Lifestyle changes such as diet, exercise, and weight loss (if necessary) can help manage high blood pressure.