I'm a senior male whose blood pressure was inching into the danger zone.  Sensing it was just a matter of time before treatment was going to be necessary, I set about to consider options.  This page is a summary of what I found.

I opted to give the Natural Alternatives a try.

Diuretics          ACE Inhibitors          ARBs    

 Calcium Channel Blockers          Beta Blockers

 Renin Inhibitors            Natural Alternatives
         

Hypertension Medicines

Diuretics (water pills)

Your doctor might first suggest diuretics, which remove excess water and sodium from your body. That decreases the amount of fluid flowing through your blood vessels, which reduces pressure on your vessel walls.

There are three types of diuretics: thiazide, loop and potassium-sparing. The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends that most people try thiazide diuretics first to treat high blood pressure and heart problems related to high blood pressure.

Types:

For high blood pressure, diuretics, commonly known as "water pills," help your body get rid of unneeded water and salt through the urine. Getting rid of excess salt and fluid helps lower blood pressure and can make it easier for your heart to pump. Diuretics may be used to treat a number of heart-related conditions, including high blood pressure, heart failure, kidney and liver problems, and glaucoma.

  • Thiazide diuretics, such as Esidrix or Zaroxolyn, can be used to lower blood pressure, or to treat edema in heart failure.
  • Loop diuretics (Lasix, Bumex) are often used when people have congestive heart failure symptoms and are especially useful in emergencies. However, they do not significantly lower blood pressure.
  • Potassium-sparing diuretics (like Aldactone, Dyrenium) help your body retain potassium and are used more often in congestive heart failure patients. They are often prescribed in conjunction with the other two types of diuretics, but also do not significantly lower blood pressure.

Side Effects

  • Frequent urination. This may last for several hours after a dose.
  • Arrhythmia (abnormal heart rhythm)
  • Electrolyte abnormalities -- Blood test monitoring of blood chemistries or electrolytes, such as potassium, sodium, or kidney function, is important before and during drug use.
  • Extreme tiredness or weakness.These effects should decrease as your body adjusts to the medication. Call your doctor if these symptoms persist.
  • Muscle cramps or weakness. If you take potassium supplements, be sure that you are taking your potassium supplement correctly, if prescribed. Contact your doctor if these symptoms persist.
  • Dizziness , lightheadedness. Try rising more slowly when getting up from a lying or sitting position.
  • Blurred vision, confusion, headache, increased perspiration (sweating), and restlessness. If these effects are persistent or severe, contact your doctor.
  • Dehydration . Signs include dizziness, extreme thirst, excessive dryness of the mouth, decreased urine output, dark-colored urine, or constipation. If these symptoms occur, don't assume you need more fluids, call your doctor.
  • Fever , sore throat, cough, ringing in the ears, unusual bleeding or bruising, rapid and excessive weight loss. Contact your doctor right away.
  • Skin rash . Stop taking the medication and contact your doctor right away.
  • Loss of appetite, nausea,vomiting, or muscle cramps. Be sure that you are taking your potassium supplement correctly, if prescribed.

Angiotensin-Converting Enzyme (ACE) Inhibitors

These help relax blood vessels by preventing the formation of a hormone called angiotensin, a substance in your body that narrows blood vessels.

Examples of ACE inhibitors include:

  • Accupril (quinapril)
  • Aceon (perindopril)
  • Altace (ramipril)
  • Capoten (captopril)
  • Lotensin (benazepril)
  • Mavik (trandolapril)
  • Monopril (fosinopril)
  • Prinivil, Zestril (lisinopril)
  • Univasc (moexipril)
  • Vasotec (enalapril)

ACE Inhibitor side effects

Cough: If this persists or is severe, contact your doctor. Ask what type of cough medicine you can use to ease it.

Red, itchy skin rash: If you have this, don’t treat the rash yourself. Call your doctor.

Dizziness, lightheadedness, or faintness when you get up: This may be strongest after your first dose, especially if you’ve been taking a water pill (diuretic). Get up more slowly. If it keeps up, reach out to your medical team.

Salty or metallic taste, or a decreased ability to taste: This usually goes away as you continue taking the medicine.

Angiotensin II receptor blockers (ARBs)

These help relax blood vessels by blocking the action, not the formation, of angiotensin, a chemical in your body that narrows blood vessels.

Examples of ARBs include:

  • Atacand (candesartan)
  • Avapro (irbesartan)
  • Benicar (olmesartan)
  • Cozaar (losartan)
  • Diovan (valsartan)
  • Micardis (telmisartan)
  • Teveten (eprosartan)

ARB side effects:

  • Dizziness , lightheadedness, or faintness upon rising, This side effect may be strongest after the first dose, especially if you have been taking a diuretic (water pill). Contact your doctor if these symptoms are persistent or severe.
  • Physical problems, diarrhea, muscle cramps or weakness, back or leg pain, insomnia (difficulty sleeping), irregular heartbeat, or fast or slow heartbeat, sinusitis or upper respiratory infection. Contact your doctor if these symptoms are persistent or severe.
  • Confusion. Contact your doctor right away.
  • Severe vomiting or diarrhea. If you become sick with severe vomiting or diarrhea you may become dehydrated, which can lead to low blood pressure. Contact your doctor.
  • Abnormalities in blood chemistry laboratory tests.
  • Cough, though less commonly than with ACE inhibitors.

Calcium Channel Blockers

These medications prevent calcium from entering heart and blood vessel muscle cells, thus causing the cells to relax.

Examples of calcium channel blockers include:

  • Norvasc (amlodipine)
  • Plendil (felodipine)
  • DynaCirc (isradipine)
  • Cardene (nicardipine)
  • Procardia XL, Adalat (nifedipine)
  • Cardizem, Dilacor, Tiazac, Diltia XL (diltiazem)
  • Sular (Nisoldipine)
  • Isoptin, Calan, Verelan, Covera-HS (verapamil)

Calcium Channel Blockers Side Effects

Potential side effects from taking a calcium channel blocker include:

  • Dizziness or lightheadedness
  • Low blood pressure
  • Heart rhythm problems
  • Dry mouth
  • Edema (swelling of ankles, feet, or lower legs)
  • Headache
  • Nausea
  • Fatigue
  • Skin rash
  • Constipation or diarrhea
  • Gastroesophageal reflux disease (GERD)

Beta Blockers

 Also known as beta-adrenergic blocking agents, these work by blocking the effects of the hormone epinephrine, also known as adrenaline. They cause your heart to beat slower and with less force.

There are several beta-blockers available, including:

  • Sectral (acebutolol)
  • Tenormin (atenolol)
  • Kerlone (betaxolol)
  • Zebeta, Ziac (bisoprolol)
  • Coreg (carvedilol)
  • Normodyne, Trandate (labetalol)
  • Lopressor, Toprol-XL (metoprolol)
  • Corgard (nadolol)
  • Nebivolol (bystolic)
  • Levatol (penbutolol)
  • Visken (pindolol)
  • Inderal, Inderal LA (propanolol)
  • Blocadren (timolol)

Side Effects of Beta-Blockers

Potential side effects of beta-blockers include:

  • Dizziness or lightheadedness
  • Problems with sexual performance and ability
  • Sleeping problems and drowsiness
  • Fatigue
  • Cold hands and feet
  • Slow heartbeat
  • Edema (swelling in ankles, feet, or legs)
  • Trouble breathing, especially asthma symptoms
  • Depression

Renin Inhibitors

Renin is an enzyme produced by your kidneys that starts a chain of chemical steps that increases blood pressure. Aliskiren (Tekturna) slows the production of renin, reducing its ability to begin this process.

Renin Inhibitor Side Effects

Call or other emergency services right away if you have:
  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor if you have:

  • Hives.

Common side effects of this medicine include:

  • Dizziness.
  • Headache.
  • Diarrhea.
  • Stuffy nose.

L-Critrulline

L-Citrulline, a non-essential amino acid, is changed in the kidneys to L-arginine and  nitric oxide.

These compounds are important for supporting  your heart and blood vessel health. They may also boost the immune system.

L-Citrulline boosts nitric oxide production in the body. Nitric oxide helps  arteries relax and work better, which improves blood flow throughout the body. This can be helpful for supporting blood pressure in the normal range.

There are no reported side effects of L-citrulline.

However, the supplement may affect the way certain drugs work in your body. Do not take this supplement if you are taking:

  • Nitrates for heart disease
  • ED drugs such as Cialis, Levitra, or Viagra

Hawthorn Extract

According to Dr. Weil, "The berries have been used in traditional medicine since the first century, and contain phytonutrients called anthocyanidins and proanthocyanidins, antioxidants that have a variety of therapeutic effects including strengthening the walls of blood vessels. Extracts of hawthorn berries, leaves and blossoms also contain compounds that have a tonifying effect on the heart and vascular system. Hawthorn has been studied for its use in treating health concerns related to the heart and blood vessels. This includes congestive heart failure, irregular heartbeat, chest pain, low and high blood pressure, angina, atherosclerosis, and high cholesterol. A meta-analysis based on data from 14 studies concluded that a hawthorn extract offers “significant benefit” as an adjunct to conventional treatment of chronic heart failure. Specifically, symptoms including shortness of breath and fatigue were significantly alleviated, compared to placebo treatment."

Hawthorn Extract Side Effects

In some people, hawthorn can cause nausea, stomach upset, fatigue, sweating, headache, dizziness, palpitations, nosebleeds, insomnia, agitation, and other problems.

Heart disease: Hawthorn can interact with many prescription drugs used to treat heart disease. If you have a heart condition, don’t use hawthorn without the recommendation of your healthcare provider.

Magnesium

According to Dr. Joseph Mercola, magnesium may reduce blood pressure in people with high blood pressure, according to new findings. The study adds to data from epidemiological studies that have reported more magnesium, potassium, and calcium may reduce your risk of hypertension. Read more from his article here.

Side Effects of Magnesium

Magnesium is LIKELY SAFE for most people when taken by mouth appropriately or when the prescription-only, injectable product is used correctly. In some people, magnesium might cause stomach upset, nausea, vomiting, diarrhea, and other side effects.

Doses less than 350 mg daily are safe for most adults. When taken in very large amounts, magnesium is POSSIBLY UNSAFE. Large doses (much larger than 350mg daily) might cause too much magnesium to build up in the body, causing serious side effects including an irregular heartbeat, low blood pressure, confusion, slowed breathing, coma, and death.

Garlic Extract

Garlic extract is potent natural remedy for supporting healthy blood pressure, and the use of garlic for high blood pressure (also called hypertension) has been around for millennia. Hypertension affects 70 million Americans, including about 65% of the population that is 65 years old and greater.

This from the Doctor's Health Press.  Read complete article here.

Side Effects of Garlic Extract

Side effects include upset stomach, bloating, bad breath, body odor, and a stinging sensation on the skin from handling too much fresh or dried garlic. Handling garlic may also cause skin lesions. Other, more rare side effects that have been reported by those taking garlic supplements include headache, fatigue, loss of appetite, muscle aches, dizziness described as vertigo, and allergies such as an asthmatic reaction or skin rash.

Garlic acts like a blood thinner. Too much garlic can increase your risk for bleeding during or after surgery. It may also interact with blood-thinning medications.

People with ulcers or thyroid problems should ask their doctors before taking garlic.

Probiotics

Comparing results from randomized, controlled trials on humans, there were a total of 9 studies included in the analysis. Participants received supplemental probiotics in the form of yogurt, cultured milk (kefir), supplements, rose hip drinks or cheese. Overall, the analysis showed that consumption of probiotics led to a significant decrease in both diastolic and systolic blood pressure measurements. As could be expected, larger changes were seen in those who started with high blood pressure than those who were healthy to begin with. 

Also see NIH article

Side effects from Probotics

Temporary reactions such as minor bloating or a mild laxative or constipating effect are signs that the beneficial bacteria are remodeling, detoxifying and improving the gut environment.