Hypertension, or high blood pressure, is dangerous because it can lead to strokes, heart attacks, heart failure, or kidney disease. The goal of hypertension treatment is to lower high blood pressure and protect important organs, like the brain, heart, and kidneys from damage. Treatment for hypertension has been associated with reductions in stroke (reduced an average of 35%-40%), heart attack (20%-25%), and heart failure (more than 50%), according to research.

Hypertension is classified as:

Normal blood pressure: less than 120/80 mmHg
Prehypertension: 120-139/80-89 mmHg
Hypertension: greater than 140/90 mmHg
Stage 1 Hypertension:140-159/90-99 mmHg
Stage 2 Hypertension: 160 or greater/ 100 or greater mmHg

All patients with blood pressure readings greater than 120/80 should be encouraged to make lifestyle modifications, such as eating a healthier diet, quitting smoking and getting more exercise. Treatment with medication is recommended to lower blood pressure to less than 140/90 mmHg. For patients who have diabetes or chronic kidney disease the recommended blood pressure is less than 130/80 mmHg.

Treating hypertension involves lifestyle changes and drug therapy.

Lifestyle Changes

A critical step in preventing and treating hypertension is a healthy lifestyle. You can lower your blood pressure with the following lifestyle modifications:

Losing weight if you are overweight or obese.
Quitting smoking.
Eating a healthy diet, including the DASH diet (eating more fruits, vegetables, and low fat dairy products, less saturated and total fat).
Reducing the amount of sodium in your diet to 2,300 milligrams (about 1 teaspoon of salt) a day or less.
Getting regular aerobic exercise (such as brisk walking at least 30 minutes a day, several days a week).
Limiting alcohol to two drinks a day for men, one drink a day for women.

In addition to lowering blood pressure, these measures enhance the effectiveness of antihypertensive medications.

Medications

There are several types of drugs used to treat hypertension, including:

Diuretics are usually recommended as the first line of therapy for most people who have hypertension. If one drug doesn't work or is disagreeable, other types of diuretics are available.

However, your doctor may start a medicine other than a diuretic as the first line of therapy if you have certain medical problems. For example, ACE inhibitors are often a good choice for a people with diabetes.

If your blood pressure is more than 20/10 mmHg higher than it should be, your doctor may consider starting you on two drugs.

Follow-Up

After starting antihypertensive drug therapy, you should see your doctor at least once a month until the blood pressure goal is reached. Once or twice a year, your doctor will check your serum potassium (diuretics can lower this, and ACE inhibitors and ARBs may increase this) and magnesium and BUN/creatinine levels (to check the health of the kidneys).

After the blood pressure goal is reached, you should continue to see your doctor every three to six months, depending on whether other diseases such as heart failure are present.

Reviewed by the doctors at The Cleveland Clinic Heart Center.

WebMD Medical Reference provided in collaboration with the Cleveland Clinic