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Your doctor has just given you a prescription for your high blood pressure (hypertension). As an added benefit, you're told, the prescription may also help control your occasional migraine headaches.

Not only do hypertension drugs help control elevated blood pressure, but some actually offer additional health benefits. These can include treating heart failure, complications of diabetes or symptoms resulting from coronary artery disease. Some may reduce stroke, heart disease and new onset diabetes beyond just the lowering of blood pressure.

Different drugs, different functions

Hypertension is caused by a variety of factors, and different classes of drugs are used to treat these different factors. The drugs may affect parts of your body that aren't related to your blood pressure, resulting in benefits beyond simply lowering your blood pressure. For example, angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARB) act on specific chemicals in your body to lower your blood pressure. At the same time, their effect on these chemicals allows your body to reduce excess thickening in your heart and blood vessels and to use blood sugar (blood glucose) more effectively.

The main classes of hypertension drugs and the added benefits they can provide are listed below.

Initial treatment choices

Diuretics (furosemide, hydrochlorothiazide, indapamide, others). Commonly referred to as water pills, diuretics reduce the amount of fluid in your body. They cause your kidneys to excrete more sodium in your urine than they would normally. The sodium takes with it water from your blood. This means there's a smaller volume of blood pushing through your arteries and, consequently, less pressure on your artery walls.

Diuretics can help reduce the fluid retention (edema) or fluid buildup in your heart, lungs or the rest of your body � especially your legs and feet � that result from heart failure.

Certain types of diuretics decrease the frequency of kidney stones and reduce your risk of developing osteoporosis. These diuretics reduce the amount of calcium in your urine, so less calcium is available for kidney stone formation. This also results in increased amounts of calcium in your blood, which can help reduce your chances of developing osteoporosis or lessen the severity of existing osteoporosis.

In low doses, diuretics may favorably affect type 2 diabetes (formerly called adult-onset or noninsulin-dependent diabetes). For example, many people with diabetes count sodium and fluid retention as the cause of their high blood pressure. By lowering their blood pressure they gain all the usual benefits without aggravating their diabetes.

Spironolactone, another type of diuretic, has been shown to improve heart function in people with heart failure.

Beta blockers (atenolol, metoprolol, propranolol, others). Beta blockers primarily work by blocking the effects of certain adrenaline-related chemicals in your body, causing your heart to beat more slowly and less forcefully.

They may reduce your risk of a second heart attack.

They can help control angina and a rapid heart rate.

They can be used to treat heart failure, glaucoma, migraines, anxiety, hyperthyroidism and some tremors.

Angiotensin-converting enzyme (ACE) inhibitors (benazepril, enalapril, lisinopril, others). ACE inhibitors help relax your blood vessels by blocking the formation of a natural chemical inside your body that narrows blood vessels.

	ACE inhibitors are helpful in treating heart failure by improving heart function.
	They can reduce your risk of a heart attack if you have coronary artery disease and can reduce your chances of developing heart failure after a heart attack.
	They help protect your kidneys from damage, particularly if you have diabetes.
	They reduce the occurrence of a second stroke or transient ischemic attack (TIA) in people with high or high normal blood pressure.
	They reduce the occurrence of new onset diabetes.

Angiotensin II receptor blockers (ARB) (candesartan, irbesartan, losartan, others). ARBs act in a manner similar to ACE inhibitors, but they block the action of the chemical instead of the formation of the chemical.

	Study continues to determine if these drugs provide heart protection similar to ACE inhibitors. They do reverse heart enlargement (left ventricular hypertrophy) from high blood pressure more than beta blockers do.
	ARBs reduce kidney damage, especially in people with diabetes.
	They prevent strokes in high-risk patients.
	They reduce occurrence of new onset diabetes.

Calcium channel blockers (calcium antagonists) (amlodipine, diltiazem, nifedipine, verapamil, others). These medications help relax blood vessel muscles. Some slow your heart rate.

	They can be used to treat angina.
	Some types treat a rapid heart rate.
	Some may be useful for protecting your kidneys, particularly if you have diabetes or can't take an ACE inhibitor or ARB.
	They may be helpful for persistent diarrhea related to irritable bowel syndrome � they can reduce your number of bowel movements per day.
	They may be useful in treating migraines and may benefit people with Raynaud's disease.
	Older people may benefit from certain calcium blockers in preventing stroke.

Supplemental therapy

Alpha blockers (doxazosin, terazosin, others). These drugs prevent muscle contractions in your small arteries. They also reduce the effects of the the natural chemicals in your body that narrow your blood vessels. This class doesn't work as well as diuretics in preventing heart failure and shouldn't be used alone to manage high blood pressure.

	Alpha blockers can improve urine stream for older men with benign prostatic obstruction.
	They may modestly lower your blood cholesterol and triglyceride levels.

Central-acting agents (central adrenergic inhibitors) (clonidine, guanabenz, guanfacine, methyldopa, others). Instead of working on your blood vessels, these medications work on your brain. They prevent your brain from telling your nervous system to increase your heart rate and narrow your blood vessels.

They can help reduce the symptoms of panic attacks.

They can lower your incidence of low blood sugar.

They can reduce the severity of drug or alcohol withdrawal.

Which drug is right for you?

Choosing the right drug or combination of drugs depends on your age, overall health and what medications you already take. Cost may be an additional factor. But consideration should also be given to other medical conditions you have that might be influenced � positively or negatively � by certain hypertension drugs.