Treatment of Blood Pressure

Treatment for High Blood Pressure

The goal of treatment is to reduce blood pressure so that you have a lower risk of complications. There are many different medicines that can be used to treat high blood pressure. Most of the time, hypertension can be controlled with medicine and lifestyle changes. Such medicines include:

Alpha blockers, Angiotensin-converting enzyme (ACE) inhibitors, Angiotensin receptor blockers (ARBs), Beta-blockers, Calcium channel blockers, Central alpha agonists, Diuretics, Renin inhibitors, including aliskiren (Tekturna) and Vasodilators.

Medicines used if the blood pressure is very high may include: Clonidine, Diazoxide, Furosemide, Hydralazine, Minoxidil and Nitroprusside.

There many different types of medicines are available to control high blood pressure. These medicines work in different ways. Some lower blood pressure by removing extra fluid and salt from your body. Others affect blood pressure by slowing down the heartbeat, or by relaxing and widening blood vessels. Often, two or more drugs work better than one.

Treatment of blood pressure can start with lifestyle modifications, usually as the first step, and, if needed, with medications. Lifestyle factors to treat high blood pressure include weight control, exercise, healthy diet, limiting alcohol use, and other lifestyle modifications.

Sometimes blood pressure stays too high even when a person makes these kinds of healthy changes. In that case, it is necessary to add medicine to help lower blood pressure. Medicines will control your blood pressure, but they cannot cure it. You will need to take blood pressure medicine for a long time.

Usually, the goal is to keep your blood pressure below 140/90 mmHg (130/80 mmHg if you have diabetes or chronic kidney disease). Ask your doctor what your blood pressure goal should be.

High Blood Pressure Medication

Blood pressure-lowering drugs can help control blood pressure when appropriate diet and regular physical activity alone have not succeeded. If you are taking any of the medications discussed here, it is important that you do not stop taking them without consulting your doctor.

Diuretics (water pills)

Diuretics (sometimes called water pills) lower blood pressure by causing the body to rid itself of excess fluids and sodium through urination. If the desired effects aren't achieved with diuretics alone, in combination they may enhance the effect of other blood pressure medications.

Angiotensin-Converting Enzyme (ACE) Inhibitors

These drugs expand blood vessels and decrease resistance. This allows blood to flow more easily and makes the heart's work easier or more efficient. ACE inhibitors are used to treat symptoms of heart failure and to lower blood pressure. These should not be taken if you are pregnant or planning to become so. If you already take these and find you are pregnant you should discontinue immediately and speak with your doctor. A common side effect of ACE inhibitors is cough.

Combination Therapy - ACE Inhibitor with Diuretic

Angiotensin -2 Receptor Antagonists

Angiotensin-2 (AT-2) receptor antagonists have been shown to produce effects similar to those produced by ACE inhibitors. They may be better tolerated because they produce less cough. Rather than lowering levels of angiotensin II (as ACE inhibitors do), angiotensin II receptor blockers prevent this chemical from having any effects on the heart and blood vessels. This keeps blood pressure from rising. These drugs should not be taken if you are pregnant or planning to become so. If you already take them and find you are pregnant, you should discontinue immediately and speak with your doctor.

Combination Therapy - Angiotensin-2 Receptor Antagonist with Diuretic

Beta Blockers

Beta blockers decrease the heart rate and cardiac output, which lowers blood pressure. They're also used with therapy for cardiac arrhythmias and in treating angina pectoris.

Combination Therapy - Beta Blocker/Diuretic

Calcium Channel Blockers

Calcium channel blockers, also known as "calcium antagonists," interrupt the movement of calcium into heart and vessel cells. They're also used to treat angina (chest pain) and/or some arrhythmias (abnormal heart rhythms).

Combination Therapy - ACE inhibitor/calcium channel blocker

Alpha Blockers - reduce nerve impulses that tighten blood vessels, allowing blood to pass more easily and causing blood pressure to go down

Central Alpha Agonists and combinations

Combined Alpha and Beta Blockers

Antiadrenergics

Nervous system inhibitors relax blood vessels by controlling nerve impulses from the brain. This causes blood vessels to become wider and blood pressure to go down.

Vasodilators open blood vessels by directly relaxing the muscle in the vessel walls, causing blood pressure to go down

It is important that you take your blood pressure medicine at the same time each day and not skip days or cut pills in half to save money. If you are taking any of the medications discussed here, it is important that you do not stop taking them without consulting your doctor.

DASH Diet

DASH - stands for "Dietary Approaches to Stop Hypertension." This is the name of a clinical study that tested the effects of nutrients in food on blood pressure. Study results indicated that you can reduce high blood pressure by following an eating plan that emphasizes fruits, vegetables, and fat-free or low-fat milk and milk products, and is low in saturated fat, total fat, and cholesterol can reduce high blood pressure. The DASH eating plan includes whole grains, poultry, fish, and nuts, and has reduced amounts of red meats, sweets, added sugars, and beverages containing sugars. A second study, called "DASH-Sodium," showed that eating less salt also lowered blood pressure in people following either the DASH eating plan or the typical American diet. But those following DASH, especially those with high blood pressure, benefited the most. The DASH menus and recipes are given for two levels of daily sodium consumption 2,300 and 1,500 milligrams per day. The lower your salt intake is the lower your blood pressure.

Eat a healthy diet that includes fruit and vegetables and that is low in fat. Select foods low in calories and fat but high in starch and fiber. Work to eliminate the use of caffeine, alcholol and any tobacco products. Reduce your intake of a salt; use spices and herbs instead of salt.