How Is High Blood Pressure Treated?

High blood pressure (HBP) is treated with lifestyle changes and medicines.

Most people who have HBP will need lifelong treatment. Sticking to your treatment plan is important. It can help prevent or delay problems related to HBP and help you live and stay active longer.

For more tips on controlling your blood pressure, go to the National Heart, Lung, and Blood Institute's (NHLBI's) "Your Guide to Lowering Blood Pressure."

Goals of Treatment

The treatment goal for most adults is to get and keep blood pressure below 140/90 mmHg. For adults who have diabetes or chronic kidney disease, the goal is to get and keep blood pressure below 130/80 mmHg.

Lifestyle Changes

Healthy lifestyle habits can help you control HBP. These habits include:

• Following a healthy diet
• Being physically active
• Maintaining a healthy weight
• Quitting smoking
• Managing your stress and learning to cope with stress

If you combine healthy lifestyle habits, you can achieve even better results than taking single steps.

You may find it hard to make lifestyle changes. Start by making one healthy lifestyle change and then adopt others.

Some people can control their blood pressure with lifestyle changes alone, but many people can't. Keep in mind that the main goal is blood pressure control.

If your doctor prescribes medicines as a part of your treatment plan, keep up your healthy lifestyle habits. They will help you better control your blood pressure.

Following a Healthy Diet

Your doctor may recommend the DASH (Dietary Approaches to Stop Hypertension) eating plan if you have HBP. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and low in fat, cholesterol, and sodium (salt).

DASH also focuses on fat-free or low-fat dairy products, fish, poultry, and nuts. The DASH eating plan is reduced in red meats (including lean red meats), sweets, added sugars, and sugar-containing beverages. It's rich in nutrients, protein, and fiber.

To help control HBP, you should limit the amount of salt that you eat. This means choosing low-sodium and no added salt foods and seasonings at the table and while cooking. The Nutrition Facts label on food packaging shows the amount of sodium in an item. You should eat no more than about 1 teaspoon of salt a day.

Also, try to limit alcoholic drinks. Too much alcohol will raise your blood pressure. Men should have no more than two alcoholic drinks a day. Women should have no more than one alcoholic drink a day. One drink is a glass of wine, beer, or a small amount of hard liquor.

For more information, go to the NHLBI's "Your Guide to Lowering Your Blood Pressure With DASH."

Being Physically Active

Routine physical activity can lower HBP and reduce your risk for other health problems. Talk with your doctor before you start a new exercise plan. Ask him or her how much and what kinds of physical activity are safe for you.

People gain health benefits from as little as 60 minutes of moderate-intensity aerobic activity per week. The more active you are, the more you will benefit.

For more information about physical activity, go to the U.S. Department of Health and Human Services' "2008 Physical Activity Guidelines for Americans," the Health Topics Physical Activity and Your Heart article, and the NHLBI's "Your Guide to Physical Activity and Your Heart."

Maintaining a Healthy Weight

Maintaining a healthy weight can help you control HBP and reduce your risk for other health problems.

If you're overweight or obese, aim to reduce your weight by 5 to 10 percent during your first year of treatment. This amount of weight loss can lower your risk for health problems related to HBP.

To lose weight, cut back your calorie intake and do more physical activity. Eat smaller portions and choose lower calorie foods. Don't feel that you have to finish the entrees served at restaurants. Many restaurant portions are oversized and have too many calories for the average person.

After your first year of treatment, you may have to continue to lose weight so you can lower your body mass index (BMI) to less than 25. BMI measures your weight in relation to your height and gives an estimate of your total body fat.

A BMI between 25 and 29.9 is considered overweight. A BMI of 30 or more is considered obese. A BMI of less than 25 is the goal for controlling blood pressure.

You can use the NHLBI's online BMI calculator to figure out your BMI, or your doctor can help you.

For more information about losing weight and keeping it off, go to the Health Topics Overweight and Obesity article.

Quit Smoking

If you smoke or use tobacco, quit. Smoking can damage your blood vessels and raise your risk for HBP. Smoking also can worsen health problems related to HBP.

Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke.

If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking.

For more information about how to quit smoking, go to the Health Topics Smoking and Your Heart article and the NHLBI's "Your Guide to a Healthy Heart."

Managing Stress

Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health.

Physical activity helps some people cope with stress. Other people listen to music or focus on something calm or peaceful to reduce stress. Some people learn yoga, tai chi, or how to meditate.

Medicines

Today's blood pressure medicines can safely help most people control their blood pressure. These medicines are easy to take. The side effects, if any, tend to be minor.

If you have side effects from your medicines, talk with your doctor. He or she might adjust the doses or prescribe other medicines. You shouldn't decide on your own to stop taking your medicines.

Blood pressure medicines work in different ways to lower blood pressure. Some remove extra fluid and salt from the body to lower blood pressure. Others slow down the heartbeat or relax and widen blood vessels. Often, two or more medicines work better than one.

Diuretics

Diuretics sometimes are called water pills. They help your kidneys flush excess water and salt from your body. This reduces the amount of fluid in your blood, and your blood pressure goes down.

Diuretics often are used with other HBP medicines and sometimes combined into one pill.

Beta Blockers

Beta blockers help your heart beat slower and with less force. As a result, your heart pumps less blood through your blood vessels. This causes your blood pressure to go down.

ACE Inhibitors

ACE inhibitors keep your body from making a hormone called angiotensin II. This hormone normally causes blood vessels to narrow. ACE inhibitors prevent this, so your blood pressure goes down.

Angiotensin II Receptor Blockers

Angiotensin II receptor blockers are newer blood pressure medicines that protect your blood vessels from the angiotensin II hormone. As a result, blood vessels relax and widen, and your blood pressure goes down.

Calcium Channel Blockers

Calcium channel blockers keep calcium from entering the muscle cells of your heart and blood vessels. This allows blood vessels to relax, and your blood pressure goes down.

Alpha Blockers

Alpha blockers reduce nerve impulses that tighten blood vessels. This allows blood to flow more freely, causing blood pressure to go down.

Alpha-Beta Blockers

Alpha-beta blockers reduce nerve impulses the same way alpha blockers do. However, they also slow the heartbeat like beta blockers. As a result, blood pressure goes down.

Nervous System Inhibitors

Nervous system inhibitors increase nerve impulses from the brain to relax and widen blood vessels. This causes blood pressure to go down.

Vasodilators

Vasodilators relax the muscles in blood vessel walls. This causes blood pressure to go down.

Treatment for Children and Teens

If another condition is causing your child's HBP, treating it often resolves the HBP. When the cause of a child or teen's HBP isn't known, the first line of treatment is lifestyle changes (as it is for adults).

If lifestyle changes don't control blood pressure, children and teens also may need to take medicines. Most of the medicines listed above for adults have special doses for children.

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