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An Overview of High Blood Pressure Treatment

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.

High blood pressure is now classified as a blood pressure greater than 140/90 in people under 60, and greater than 150/90 in people over 60.

To prevent high blood pressure, everyone 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 in people younger than 60, and less than 150/90 in people older than 60.

Treating high blood pressure involves lifestyle changes and possibly drug therapy.

Lifestyle Changes to Treat High Blood Pressure

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

  • 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 less than 1,500 milligrams a day if you have high blood pressure. Healthy adults should try to limit their sodium intake to no more 2,300 milligrams a day (about 1 teaspoon of salt).
  • 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 high blood pressure drugs.

Drugs to Treat High Blood Pressure

There are several types of drugs used to treat high blood pressure, including:

  • Angiotensin-converting enzyme (ACE) inhibitors
  • Angiotensin II receptor blockers (ARBs)
  • Diuretics
  • Beta-blockers
  • Calcium channel blockers
  • Alpha-blockers
  • Alpha-agonists
  • Renin inhibitors
  • Combination medications

Diuretics are often recommended as the first line of therapy for most people who have high blood pressure. 

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 choice for a people with diabetes. If one drug doesn't work or is disagreeable, additional medications or alternative medications may be recommended.

If your blood pressure is more than 20/10 points higher than it should be, your doctor may consider starting you on two drugs or placing you on a combination drug.

High Blood Pressure Treatment Follow-Up

After starting high blood pressure 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 may check the level of potassium in your blood (diuretics can lower this, and ACE inhibitors and ARBs may increase this) and other electrolytes 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 you have other diseases such as heart failure.

 

WebMD Medical Reference

Reviewed by James Beckerman, MD, FACC on December 22, 2013
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