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Treating hypertension: how to lower your blood pressure

By Jenilee Matz, M.P.H., Staff Writer, myOptumHealth

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If you have high blood pressure (hypertension), prompt treatment is key. The higher your blood pressure is, and the longer it stays untreated, the greater your risk for serious medical problems.

The condition can be managed by changing your habits and by possibly taking medication. Treatment can lower your risk for complications, such as heart disease, stroke and kidney failure.

Note that high blood pressure cannot be cured. If your pressure goes down, it does not mean you can go back to your old habits or stop taking your medicine, unless directed by your doctor. Managing your blood pressure is a lifelong commitment.

Lifestyle changes

The first step to treating high blood pressure is to make some lifestyle changes. This alone might be enough to get your blood pressure in target range:

• Reach or maintain a healthy weight. Lose weight if you are overweight. A weight loss of only 10 pounds can often help lower blood pressure.
• Follow the DASH (Dietary Approaches to Stop Hypertension) diet. Studies show that the DASH diet helps control high blood pressure. The diet emphasizes foods high in calcium, potassium, magnesium and fiber. Not getting enough of these nutrients is linked with high blood pressure. Eat plenty of vegetables, fruit and low-fat dairy. Limit foods high in saturated and total fat and cholesterol.
• Limit sodium (salt) intake. Eating a diet high in salt may raise your blood pressure. Keep sodium intake to 2,300 mg or less per day. Some people can lower their blood pressure even more if they limit sodium intake to 1,500 mg per day.
• Get active. Work in up to 30 minutes of physical activity most days of the week. Check with your doctor before you start or increase your activity level.
• Limit alcohol. If you choose to drink, limit yourself to two drinks a day for a man or one drink a day for a woman.
• Quit smoking. Smoking raises your risk for heart disease and other serious medical problems.

Medication

Changes to your lifestyle are often not enough to control your blood pressure. Your doctor may also prescribe a blood pressure-lowering medication. Two out of three people will need more than one medicine to help keep their blood pressure in check. Medicines can cut your risk of heart failure and other complications in half. Take your medication as directed by your doctor.

Some medicines work by relaxing or widening the blood vessels. This allows blood to pass through more easily which, in turn, lowers blood pressure. Others may work through the heart or kidneys to help lower the blood pressure.

Some common medicines include:

• Diuretics or "water pills" work along with the kidneys to get rid of extra water and salt in your body.
• Angiotensin-converting enzyme (ACE) inhibitors relax the blood vessels. They also stop the hormone angiotensin II from forming, which prevents the blood vessels from narrowing.
• Angiotensin II Receptor blockers (ARBS) protect the cells in blood vessels from angiotensin II. This makes the blood vessels wider.
• Beta-blockers make the heart beat slower and with less force.
• Calcium channel blockers stop calcium from entering the cells in the heart and blood vessels. As a result, the blood vessels relax.
• Vasodilators relax the muscle in the vessel walls.

How will I know if treatment is working?

You will meet with your doctor regularly to make sure your high blood pressure treatment plan is working, especially if you take medication.

Your doctor may also want you to check your blood pressure at home and keep track of your readings. Bring the record with you to your doctor visits. This will help your doctor see if treatment is helping. Your doctor can help you choose a home blood pressure monitor.

View the original Treating hypertension: how to lower your blood pressure article on myOptumHealth.com 

SOURCES:

• National Heart, Lung and Blood Institute (NHLBI) Information Center. Your guide to lowering blood pressure with DASH. Accessed: 05/22/2007

• National Heart Lung and Blood Institute. Types of blood pressure medications. Accessed: 09/22/2009

• American Heart Association. Home monitoring of high blood pressure. Accessed: 12/17/2007

• National Heart Lung and Blood Institute. National High Blood Pressure Education Program. The seventh report on the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Accessed: 03/11/2009