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  These types of drugs can cause injury and death to a developing fetus when taken in the second and third trimesters. Because of this, there doesn’t seem to be any reason whatsoever for a woman of child-bearing age to take them.

  CAUTION!

  Think Twice About Taking These Drugs If . . .

  Please think twice about taking an ACE inhibitor no matter what, especially captopril. They are especially risky for people with some types of kidney or liver disease, and the elderly, who tend to have decreased kidney function as a matter of aging. Don’t go near this drug if there is any possibility of pregnancy.

  What Are the Interactions with Food? Capsaicin, or cayenne, used as a spice and as an alternative medicine treatment for a variety of ailments, may make an ACE-inhibitor-caused cough worse. Capsaicin is also used topically to treat herpes zoster (shingles). Levels of captopril may be significantly reduced if it is taken with food, so take it an hour before or after eating. Other ACE inhibitors may be reduced less significantly. (Enalapril, benazepril, and lisinopril do not seem to be affected by food.)

  Examples of Calcium Channel Blockers (Calcium Antagonists)

  Amlodipine (Norvasc)

  Barnidipine (HypoCa)

  Diltiazem (Cardizem, Dilacor, Tiazac, Diltiazem HCl Extended Release)

  Felodipine (Plendil)

  Isradipine (DynaCirc, Prescal)

  Nicardipine (Cardene)

  Nifedipine (Adalat, Procardia)

  Nimodipine (Nimotop)

  Nisoldipine (Baymycard, Sular, Syscor)

  Verapamil (Calan, Isoptin, Verelan, Covera)

  What Do They Do in the Body? The movement of calcium in and out of some cells of the heart and arteries plays an important role in their contraction. Calcium channel blockers block the movement of calcium, lowering blood pressure by suppressing the contraction of artery muscles, dilating the arteries, and reducing arterial resistance to blood flow.

  What Are They Prescribed For? Calcium channel blockers are prescribed for a variety of heart problems, including angina, arrhythmias (irregular heartbeat), rapid heartbeat, high blood pressure, and CHF. They are also prescribed for migraine headaches and Raynaud’s disease. Those prescribed for high blood pressure include amlodipine, verapamil SR, diltiazem, nicardipine, nifedipine, isradipine, felodipine, and nisoldipine.

  What Are the Possible Side Effects? Calcium channel blockers are among the most widely prescribed drugs in North America, and yet they are also among the most dangerous drugs you can take. Although they can be useful in normalizing an irregular heartbeat and spasms in the heart muscle, their long-term use for lowering blood pressure is very questionable.

  There are at least two major studies showing that people who use calcium channel blockers to control high blood pressure have a higher risk of dying from heart disease and a higher overall risk of dying than people who use other antihypertensives.

  In test rats they caused cancer, and the fast-acting forms of nifedipine have been shown in studies conducted by the National Heart, Lung and Blood Institute to increase the risk of a fatal heart attack.

  Some of the more common “adverse reactions” include dizziness; swollen hands and feet (edema); chronic headaches; nausea; giddiness; nervousness; numbness and tingling; diarrhea; constipation; digestive problems such as stomach cramps, gas, and heartburn; dry mouth; gum disease; flushing; urinary tract problems; sexual problems; shortness of breath; muscle cramps and pains; and a cough.

  The different types of calcium channel blockers can vary in their actions and side effects quite a bit, so if you must take one, be sure your physician is experienced in prescribing them and be sure to read the drug insert carefully for yourself. We’re not aware of any evidence that using calcium channel blockers long-term will reduce the risk of heart attack or death.

  CAUTION!

  Think Twice About Taking These Drugs If . . .

  You have kidney or liver disease. Calcium channel blockers are contraindicated with some types of heart disease, such as sick sinus syndrome. This differs with the type of calcium channel blocker. Talk to your physician, and read your drug information sheet. Dangerous side effects tend to occur more often in patients who are also on beta-blockers. This is a potentially dangerous combination.

  What Are the Interactions with Food? Some calcium channel blockers are unaffected by food, some are decreased, and some are increased. Ask your pharmacist, and read your drug information insert. Taking felodipine and nifedipine with grapefruit juice can double drug levels, a potentially deadly interaction, and grapefruit juice can also affect the levels of other types of calcium channel blockers. In general, it’s best not to take medicine with grapefruit juice unless your physician asks you to. Some calcium channel blockers may increase the amount of alcohol that gets into the blood when you have a drink or take medicine containing alcohol.

  What Nutrients Do They Throw out of Balance or Interact With? Excess vitamin D may reduce the effectiveness of verapamil. Some calcium channel blockers, including nifedipine and vera-pamil, may bind with minerals in food or supplements, reducing the availability of the drug.

  Other Tips on These Drugs. Calcium channel blockers can affect the results of blood and urine tests.

  If you’re taking a calcium channel blocker in the dihydropyridine class (i.e., felodipine [Plendil], nifedipine), watch out for dangerous interactions with erythromycin, an antibiotic, which can double felodipine levels. High felodipine levels can cause heart palpitations and low blood pressure.

  Other Antihypertensive (Blood-Pressure-Lowering) Drugs

  None of these drugs are considered primary or single treatments for high blood pressure. They are almost always used in combination with other drugs.

  Examples of Antiadrenergic Agents, Centrally Acting

  Methyldopa, methyldopate (Aldomet)

  What Do They Do in the Body? Methyldopa and methyldopate lower blood pressure, probably by reducing levels of serotonin, dopamine, norepinephrine, and epinephrine and possibly by lowering renin, a substance released by the kidneys in response to low blood pressure.

  What Are They Prescribed For? High blood pressure.

  What Are the Possible Side Effects? Liver disease is a direct contraindication to taking methyldopa. This drug carries a high risk of damaging the liver and of causing blood disorders, including anemia, and can cause a syndrome of symptoms that resembles lupus. Other side effects include sedation or drowsiness (which may impair coordination and the ability to think clearly), fatigue, depression, fever, headache, dizziness, weakness, abnormally slow heartbeat, nausea, rash, breast enlargement in men and women, impotence, and decreased libido. As with all antihypertensive drugs, it carries the risk of abnormally low blood pressure.

  CAUTION!

  Think Twice About Taking These Drugs If . . .

  Please think twice about taking these drugs, period. Many other newer drugs can do the same job without the high risk. Antiadrenergic agents have too many potent and negative effects on too many important bodily systems. If you have any type of liver disease, don’t take them.

  What Are the Interactions with Food? Methyldopa levels will be decreased if taken with food, especially protein. Eating too much salt while taking methyldopa could increase fluid retention and cause edema or water retention.

  What Nutrients Do They Throw out of Balance or Interact With? Methyldopa decreases vitamin B12 levels and probably decreases folic acid levels as well.

  What Else to Take While Taking These Drugs. Preferably, intravenous vitamin B12 and folic acid, but these drugs can cause sensitivity reactions so even that may be risky. At the very least, take sublingual vitamin B12 and folic acid supplements. Be aware that the folic acid may hide evidence of anemia, a side effect of the drugs.

  Other Tips on These Drugs. They affect many blood and urine tests.

  Clonidine

  Clonidine (Catapres)

  What Does It Do in the Body? It has many effects on the body, including lowering blood pressur
e; reducing renin, aldosterone, and catecholamines (all important to normal bodily function); and stimulating growth hormone.

  What Is It Prescribed For? Hypertension and many other miscellaneous conditions such as menopausal flushing (hot flashes) and diabetic diarrhea, reflecting its wide spectrum of effects on the body.

  What Are the Possible Side Effects? The most dangerous aspect of this drug is that if you miss a dose or two, you could experience sudden and dangerously high blood pressure. Since everyone misses medication occasionally, this alone makes it not worth taking this drug. It has also caused degeneration of the retina in animals and has a long list of unpleasant side effects including dry mouth, dizziness, depression, sedation, constipation, fatigue, loss of appetite, nausea, rash, impotence, decreased libido, muscle weakness, dry eyes, and an odd mix of brain dysfunction symptoms such as hallucinations and nightmares.

  CAUTION!

  Think Twice About Taking This Drug If . . .

  Think twice about taking this drug, period. It’s way too dangerous, and there are other better alternatives.

  If you eat too much salt when you’re taking clonidine, it can cause fluid retention.

  Guanfacine

  Guanfacine (Tenex)

  What Does It Do in the Body? Lowers blood pressure and affects many other bodily systems, including the stimulation of growth hormone and the reduction of renin activity and catecholamine levels.

  What Is It Prescribed For? High blood pressure, heroin withdrawal, and migraine headaches.

  What Are the Possible Side Effects? Sedation, drowsiness, depression, fatigue, and if you forget to take a dose, it can cause nervousness, anxiety, and rebound high blood pressure. Other side effects are dry mouth, weakness, dizziness, constipation, impotence, vision and taste disturbances, palpitations, and rash.

  CAUTION!

  This is another drug that simply seems outdated and unnecessary most of the time.

  Guanabenz

  Guanabenz (Wytensin)

  What Does It Do in the Body? Reduces blood pressure by acting on the brain centers that reduce blood pressure.

  What Is It Prescribed For? High blood pressure.

  What Are the Possible Side Effects? The most dangerous side effect of guanabenz is its tendency to rebound high blood pressure if you miss a dose or two. This makes it a potentially dangerous drug. It also can cause drowsiness, sedation, depression, fatigue, dry mouth, dizziness, weakness, and headache. It also interacts dangerously with many other drugs.

  CAUTION!

  Think Twice About Taking This Drug If . . .

  Please think twice about taking this drug at all.

  Antiadrenergic Agents, Peripherally Acting

  Reserpine

  What Does It Do in the Body? Lowers blood pressure by lowering levels of catecholamine and 5-hydroxytryptamine in many parts of the body, including the brain and adrenal glands.

  What Is It Prescribed For? Schizophrenia, psychosis, and hypertension.

  What Are the Possible Side Effects? Depression is the most common and most damaging side effect of reserpine. It shouldn’t be used at all by people with any type of depression. It’s also not a good drug for people with ulcers or kidney damage or disease, and it causes cancer in animals. Other side effects include dry mouth, dizziness, headache, irregular heartbeat, abnormally slow heartbeat, shortness of breath, a set of symptoms resembling Parkinson’s, impotence, and rash.

  CAUTION!

  Think Twice About Taking This Drug If . . .

  Please think twice about taking this drug, period. Major depression is too serious and insidious a side effect to take lightly. This drug is rarely used anymore because of its dangerous side effects.

  Examples of Alpha-1 blockers (Alpha-1-Adrenergic Blockers)

  Doxazosin (Cardura, Carduran)

  Prazosin (Minipress)

  Terazosin (Hytrin)

  What Do They Do in the Body? Lower blood pressure.

  What Are They Prescribed For? Lowering blood pressure, benign prostatic hyperplasia, some types of CHF, and Raynaud’s disease.

  What Are the Possible Side Effects? Prazosin tends to cause sodium and water retention, something that is important to avoid when lowering blood pressure.

  Like some of the other hypertensive drugs, prazosin, terazosin, and doxazosin can cause rebound hypertension if a few doses are missed and can cause dizziness and even fainting upon standing from a sitting or lying position.

  These drugs should not be given to people who have liver damage.

  Doxazosin caused reduced fertility in male rats, and testicular atrophy has occurred in dogs and cats given terazosin or prazosin.

  Doxazosin can cause an abnormal reduction in white blood cell count.

  People taking terazosin tend to gain weight.

  These drugs affect cholesterol levels, but how they affect them seems to vary. Other side effects include dizziness, fatigue, weakness, drowsiness, headache, heart palpitations, nausea, shortness of breath, nasal congestion, and vision disturbances.

  CAUTION!

  Think Twice About Taking These Drugs If . . .

  • You have liver disease or damage.

  • Your immune system is compromised or suppressed.

  • You are obese.

  • Your cholesterol is high.

  Vasodilators

  Hydralazine (Apresoline)

  What Does It Do in the Body? Lowers blood pressure by interfering with the ability of calcium to move in and out of cells and effect the contraction of some parts of the heart and artery muscles. At the same time, it increases heart rate and output. It also increases renin levels, which stimulates the production of angiotensin, which is exactly what other hypertensive drugs block.

  What Is It Prescribed For? High blood pressure.

  What Are the Possible Side Effects? Hydralazine can cause a set of symptoms that resembles lupus, which may not necessarily all go away when the drug is stopped. This happened in 5 to 10 percent of patients, which is a high number.

  It can cause nerve pain in the hands and feet, blood abnormalities, and angina, and has been implicated in myocardial infarctions, a type of heart attack.

  Side effects include headache, loss of appetite, digestive problems, angina, vision problems, numbness and tingling, dizziness, tremors, depression, anxiety, rash, nasal congestion, flushing, water retention, muscle cramps, shortness of breath, difficulty urinating, and of course, abnormally low blood pressure (hypotension).

  CAUTION!

  Think Twice About Taking This Drug If . . .

  You have coronary artery disease, have had a stroke or are at risk for one, have lung disease, have blood abnormalities, or have lupus. This drug should not be at the top of anyone’s list for treating high blood pressure, for obvious reasons.

  What Are the Interactions with Food? Taking with food will increase drug absorption. Eating a lot of salty foods will increase water retention.

  What Nutrients Does It Throw out of Balance or Interact With? Hydralazine depletes vitamin B6. Foods containing a relative of hydralazine called tartrazine, a yellow dye, will also deplete vitamin B6. Symptoms of B6 deficiency are numerous and include depression, memory loss, pain in the fingers and feet, carpal tunnel syndrome, and menstrual symptoms, to name a few.

  What Else to Take While Taking This Drug. Take 50 mg of vitamin B6 daily in addition to your daily multivitamin.

  Minoxidil (Loniten)

  What Does It Do in the Body? Lowers blood pressure, grows hair.

  What Is It Prescribed For? High blood pressure, male pattern baldness.

  What Are the Possible Side Effects? This is such a dangerous drug that it is recommended only as a last ditch effort if no other hypertensive drugs have worked. It can cause a serious condition called pericardial effusion, and it can make angina worse. In animals it caused all kinds of gross abnormalities of the heart, as well as lesions and infertility.

  It can cause fluid and mineral imbalances that are the opposite of w
hat would benefit someone with high blood pressure, as well as an abnormally strong heartbeat and kidney impairment.

  CAUTION!

  Think Twice About Taking This Drug If . . .

  • You have kidney problems.

  • You have angina or have had a heart attack.

  • Please think twice about taking this drug, period. It’s way too dangerous, and there are many better alternatives.

  What Are the Interactions with Other Drugs? This is a bad drug to combine with guanethidine, because it can make the already considerable orthostatic hypotension risks of guanethidine even worse.

  Natural Alternatives to High Blood Pressure Drugs

  High blood pressure is caused by arteries in distress and is one of the easiest symptoms of poor health to treat with simple, natural remedies.

  Since medicines that lower blood pressure do have side effects—many of them risky and unpleasant—it’s important to always begin by treating high blood pressure with nondrug methods. If you’re taking medicine for high blood pressure, your physician should be monitoring you regularly and should have a goal of getting you off the medication. Having said that, almost all physicians consider their patients to be on antihypertensives for life once they begin taking them. This is lazy medicine and is not in the best interests of the patient.

  When you’re taking drugs to lower blood pressure, it’s important not to take herbs that directly lower blood pressure, such as hawthorn, without checking with your doctor and monitoring your blood pressure so you can make the necessary reductions in medication. The following blood-pressure-lowering program works effectively to lower blood pressure, so if you are also taking a hypertension drug, you will need to measure your blood pressure daily at home to be sure it doesn’t drop too low. Everyone taking an antihypertensive should have a blood pressure monitor at home and use it daily. This will help monitor changes in blood pressure as well as increase awareness of what raises or lowers blood pressure.