Treatment for high blood pressure depends on the severity of the disease and whether you have other health problems, such as heart failure or diabetes, or you are pregnant. Your doctor may want you to try lifestyle changes first, including losing weight, increasing activity, and eating a balanced diet. If your blood pressure is above a certain level, your doctor may prescribe medicine along with the lifestyle changes.

Some people may only need lifestyle changes to control their high blood pressure, while others need medicine as well. Either way, treating high blood pressure usually is a lifelong process.

Treatment of primary high blood pressure, especially moderate or severe high blood pressure, decreases the risk of heart failure, coronary artery disease, heart attack, abnormal heartbeats, stroke, and kidney disease, and it reduces the risk of death from these conditions.

Overall, goals of treatment are to:

• Prevent death and disease associated with high blood pressure (heart disease, stroke, and kidney disease). High blood pressure is associated with 35% of heart disease caused by coronary artery disease and 49% of all cases of heart failure.⁸
• Reduce systolic blood pressure below 140 millimeters of mercury (mm Hg) and diastolic blood pressure below 90 mm Hg. The blood pressure goal is lower, less than 130/80 mm Hg, for people with certain health conditions like diabetes, kidney disease, heart failure, or coronary artery disease.
• Control other risk factors, such as smoking, lack of exercise, and high cholesterol, that can lead to complications such as a heart attack and stroke.
• Minimize side effects of medicines.
• Live a full and active life.

Initial treatment

If you fall into the prehypertension range (120–139/80–89), your doctor will likely recommend lifestyle changes, including:

• Losing excess weight.
• Exercising.
• Limiting alcohol to 2 drinks a day for men, and 1 drink a day for women.
• Cutting back on salt.
• Quitting smoking.
• Following the Dietary Approaches to Stop Hypertension (DASH) diet.

The DASH eating plan is a low-fat and low-saturated-fat diet that emphasizes eating more fruits, vegetables, whole grains, and low-fat dairy foods. For more information, see:

High blood pressure: Using the DASH diet.

If you have high blood pressure (140–159/90–99 mm Hg) and you do not have any organ damage or other risk factors for heart disease (this is called uncomplicated high blood pressure), your doctor will likely recommend lifestyle changes and possibly medicines. Most people with high blood pressure will need two or more medicines, including a thiazide-type diuretic, to lower their blood pressure to below 140/90 mm Hg, which is the goal for people with uncomplicated hypertension. If you have other conditions, such as diabetes, heart failure, coronary artery disease, or chronic kidney disease, your goal blood pressure is lower: less than 130/80 mm Hg. For more information, see:

Should I take medicines for high blood pressure?