Dozens of high blood pressure medications (antihypertensives) are available, each with pros and cons.

The National High Blood Pressure Education Program — a coalition of professional, public, and voluntary organizations and federal agencies — has established guidelines that recommend high blood pressure medications to use when trying to lower high blood pressure.

Here's a look at their high blood pressure medication recommendations. Keep in mind that the medication your doctor suggests for you may be different because of your specific situation.

You're on the road to developing high blood pressure. Even though you likely feel fine, if your blood pressure falls within this range you stand a good chance of developing full-blown high blood pressure.

But don't panic. With proper lifestyle modifications, you can reduce your chance of developing high blood pressure. To avoid problems:

• Don't smoke.
• Eat a healthy diet, focusing on fruits, vegetables and low-fat dairy products and especially control your salt (sodium) intake.
• Maintain a healthy weight.
• Exercise by getting 30 minutes of moderate activity — even a brisk walk is good — on most days of the week.
• Limit your daily alcohol intake — one drink for women and two for men.

You probably won't need to take high blood pressure medications if you have prehypertension but are otherwise healthy. However, if you have diabetes, kidney disease or heart disease, your doctor might prescribe medications such as diuretics (water pills). Diuretics work by flushing excess water and sodium from the body, thus lowering blood pressure.

If you have stage 1 hypertension, you have a systolic pressure (top number) ranging from 140 to 159 or a diastolic pressure (bottom number) ranging from 90 to 99. If both numbers are in this range, you also have stage 1 high blood pressure.

Your doctor may suggest first trying diuretics — also called water pills. Diuretics work by flushing excess water and sodium from the body, thus lowering blood pressure, and may be enough along with lifestyle changes to control your blood pressure.

Follow healthy lifestyle habits along with medications to treat high blood pressure.

Although three types of diuretics are available, the first choice is usually a thiazide diuretic. Thiazide diuretics typically have fewer side effects than other types of diuretics. They also offer strong protection against conditions that high blood pressure can cause, such as stroke and heart failure.

A diuretic may be the only high blood pressure medication you need. But under some circumstances, your doctor may also recommend adding another medication. Those choices include:

• Beta blockers. These work by reducing nerve signals to the heart and blood vessels, thus lowering blood pressure.
• Angiotensin-converting enzyme (ACE) inhibitors. These help blood vessels relax by blocking the production of a hormone that causes blood vessels to narrow.
• Angiotensin II receptor blockers. These allow blood vessels to widen by preventing a hormone called angiotensin from affecting vessels.
• Calcium channel blockers. These prevent calcium from going into heart and blood vessel muscle cells, thus causing the cells to relax, which lowers blood pressure.

Adding one of these medications can lower your blood pressure more quickly than can taking only a diuretic. This may reduce the risk of developing complications from high blood pressure. Combining two medications may also allow you to take a smaller dose of each, which can reduce side effects and perhaps be less expensive. The choice of medications in combination again depends on your individual circumstances.

If you have stage 2 high blood pressure, you have a systolic pressure of 160 or higher or a diastolic pressure of 100 or higher. (If both readings are high, you also have stage 2 high blood pressure). In this case, you'll likely need to take at least two high blood pressure medications when you start treatment.

As with stage 1 hypertension, your doctor will likely prescribe a thiazide diuretic. Diuretics work by flushing excess water and sodium from the body, thus lowering blood pressure. Along with a diuretic, your doctor may recommend that you also take:

• An ACE inhibitor. This medication helps blood vessels relax by blocking the production of a hormone that causes blood vessels to narrow.
• An angiotensin II receptor blocker. This medication allows blood vessels to widen by preventing a hormone called angiotensin from affecting vessels.
• A beta blocker. This class of drugs works by reducing nerve signals to the heart and blood vessels, thus lowering blood pressure.
• A calcium channel blocker. This medication prevents calcium from going into heart and blood vessel muscle cells, thus causing the cells to relax, which lowers blood pressure.

When your blood pressure is this severely elevated, it's important to reduce it quickly to prevent or delay complications. A two-drug combination generally works faster than does a single drug to get your blood pressure under control. And as with stage 1 hypertension, this one-two punch can offer protection against heart disease, kidney failure and stroke. Sometimes a third, or more, medication may be needed to achieve your blood pressure goal.

Sometimes only the systolic, or top, blood pressure reading is elevated. This becomes more common with age, especially once you pass age 60. Though only the upper reading is high, your doctor will still probably recommend a high blood pressure medication. In most cases, he or she will probably suggest a low dose of a thiazide diuretic (water pill). Your doctor might also suggest trying long-acting calcium antagonists (calcium channel blockers).

High blood pressure often goes hand in hand with other health problems. Certain conditions are compelling enough to warrant more aggressive treatment. Those conditions are:

• Heart failure
• Previous heart attack
• High risk of coronary artery disease
• Enlarged left chamber of the heart (left ventricular hypertrophy)
• Diabetes
• Chronic kidney disease
• Previous stroke

Hypertension itself puts you at higher risk of having one of these conditions. If you already have one or more of these conditions plus high blood pressure, your chance of developing a life-threatening complication increases. A more aggressive treatment approach may reduce your risk of these complications.

Your doctor may recommend specific high blood pressure medications to treat these conditions, as well as additional medications for your high blood pressure. For example, if you have chest pain (angina), your doctor may recommend a beta blocker, which can lower your blood pressure and also prevent your chest pain, reduce your heart rate and decrease your risk of death. If you have diabetes and high blood pressure, taking a thiazide diuretic plus an ACE inhibitor can decrease your risk of heart attack and stroke. If you have diabetes, high blood pressure and kidney disease, you may need to add additional medications to the mix, such as an angiotensin II receptor blocker.

No matter what your health situation, finding the dose or combination of medication that effectively controls your blood pressure often takes time, patience and diligence. The process can be challenging. But the stakes are high. If you don't reduce your blood pressure, you face such complications as heart failure, heart attack, stroke, kidney failure, dementia and vision loss.

Don't be satisfied until you find a treatment strategy that reduces your blood pressure to the goal you and your doctor have set. It's not unusual to try several different medications or doses before finding what works best for you.

But the good news is that in most cases, a combination of medication and lifestyle changes can help you successfully control your blood pressure. Once that's done, your doctor may recommend a gradual reduction in medications while monitoring your response; however, don't attempt to do this on your own.

Keeping your blood pressure in check may take some time, but in the long run it may mean a longer life, with fewer health problems to contend with.