All of these medications have different functions--the Enalapril or Vacotec is an ACE inhiboter Spironolact is a diruretic (to get rid of fluid build up) Hydralazine is a smooth muscle relaxer for the heart and it relaxes and is used in conjunction with other hypertention meds. Metoprolol is a selective beta1 receptor blocker (often prescribed as Toprol). You may have heard this type of medication referred to as a beta-blocker. Inderal is the most common--it slows the heart rate down, thus decreasing the force of blood pressure. It is not unusual at all for docs to prescripe several different medications for 1 condition. Obviously they are concerned that his high blood pressure is what caused his stroke. The Plavix is used to prevent blood clots. There are some medications that do combine the actions of some of these drugs. For instance, Uniretic is both a diuretic and an Ace inhibitor. It sounds like this doc. is covering all bases and using all the standard meds that are used for high BP. Aside from taking the meds your brother needs to reduce his salt intake, if he smokes he has to stop, get exercise and watch his weight. This article discussed that doctors need to try combinations of meds to see if these will lower his pressure. Quite often, one medication can do the trick. See the Mayo Clinic s discussion on this issur http://www.mayoclinic.com/health/high-blood-pressure-medication/HI00028