Understanding High Blood Pressure -- Diagnosis & Treatment

Medically Reviewed by James Beckerman, MD, FACC on May 06, 2021

How Do I Know If I Have High Blood Pressure?

In order to diagnose high blood pressure, your health care provider will check your blood pressure with a blood pressure cuff. It's important to pay attention to both the higher (systolic) and the lower (diastolic) numbers in your blood pressure readings

A normal blood pressure is less than 120 (systolic) over less than 80 (diastolic). You may have high blood pressure if your reading is regularly over 130/80.

Although both numbers are felt to be important, systolic blood pressure is probably a better indicator of if you are at risk for heart disease. For people under age 50, the diastolic number is a more important indicator of you may develop heart disease. The USPSTF recommends that all adults 18 years or older be screened for hypertension with office blood pressure measurement.

What Are the Treatments for High Blood Pressure?

Lifestyle Changes to Treat High Blood Pressure 

Making lifestyle adjustments is key to maintaining normal blood pressure. In fact, most doctors will suggest lifestyle changes before prescribing drugs. Lifestyle changes are also the recommended treatment for elevated blood pressure, a condition in which blood pressure readings are higher than 120 and less than 80, but below 130/80.

  • Quit smoking. This is perhaps the most important step a person can take to improve health.
  • Lose weight. Losing excess weight can help decrease your blood pressure. If you're overweight, work with your doctor to design a safe weight loss plan to get closer to your ideal weight.
  • Eat right. Studies show that a diet low in salt and high in fruits and vegetables can significantly lower blood pressure. Also, make sure you get enough vitamins and minerals -- some studies show that having the recommended daily amounts of vitamin C, vitamin E, potassium, magnesium, and calcium can improve heart health. There is no real evidence regarding the benefits of multi-vitamins. Getting your vitamins through your food is a better alternative.
  • Exercise. Regular aerobic activity, such as brisk walking on most days of the week, can lower blood pressure. Regularity of exercise is as important as intensity.
  • Limit alcohol. Women should drink no more than one alcoholic drink per day; men should limit intake to two drinks or fewer. "One drink" means one 5-ounce glass of wine, one 12-ounce beer, or one 11/2-ounce shot glass of hard liquor.
  • Reduce stress. Emotional factors play a role in blood pressure. Studies show that relaxation techniques such as meditation, yoga, or even therapy to help you cope with stress may reduce blood pressure.

Women should discuss with a doctor the increased risk of high blood pressure from taking birth control pills -- especially if they're over 35 and overweight.

Drugs to Treat High Blood Pressure

Sometimes, high blood pressure requires drug therapy, either because of its severity or because it doesn't respond to lifestyle changes and self-help measures. Blood pressure medications do not cure hypertension but help keep blood pressure readings in a healthier range. They usually need to be taken for life. A number of drugs can be used alone or in combination to treat high blood pressure:

  • Diuretics, or "water pills," rid the body of salt and excess fluids.
  • Beta-blockers make the heart beat more slowly and with less force. These are particularly effective in people with heart disease.
  • Calcium-channel blockers reduce blood pressure by dilating blood vessels.
  • Angiotensin-converting enzyme (ACE) inhibitors block factors that cause blood vessels to constrict, which makes vessels dilate and thus reduces blood pressure. These drugs can decrease the risk of kidney disease, heart disease, and stroke, and are especially useful in people with heart disease or diabetes.
  • Angiotensin II receptor blockers (ARBs) are a newer type of blood pressure medicine, which work in a similar way to ACE inhibitors.
  • Alpha1-adrenergic blockers and centrally-acting agents lower blood pressure by relaxing and dilating arteries.
  • Alpha-beta blockers have the combined effects of relaxing arteries, slowing the heartbeat, and reducing the force of the heart beat.
  • Centrally-acting agents prevent your brain from sending signals to your nervous system to increase your heart rate and narrow your blood vessels.
  • Vasodilators prevent arteries from narrowing by a direct action on the muscles in the walls of the arteries.

Warning: Do not stop taking prescribed medication until you have consulted your doctor; stopping abruptly can be harmful.

WebMD Medical Reference


SOURCES: "Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressue," (JNC VII), JAMA Express, May 15, 2003. "Hypertension: Journal of the American Heart Association," Summer 2003. Elliot W., "Clinical Features and Management of Selected Hypertensive Emergencies," Journal of Clinical Malignant Phase Hypertension," The West Birmingham Malignant Hypertension Register. Journal of Human Hypertension, Jan. 2005. The American Heart Association.

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