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Diseases & Conditions

Hypertension Treatment Overview

Hypertension, or high blood pressure, is dangerous because it can lead to strokes, heart attacks, heart failure, or kidney disease. The goal of hypertension treatment is to lower harmful high pressures and protect important organs, such as the brain, heart, and kidneys. In studies, treatment for hypertension has been associated with reductions in stroke (reduced an average of 35 percent to 40 percent), heart attack (20 percent to 25 percent), and heart failure (more than 50 percent).

The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure has classified "normal blood pressure" as less than 120/80 mmHg, "pre-hypertension" as 120-139/80-89 mmHg, and "hypertension" as greater than 140/90 mmHg. All patients with blood pressure readings greater than 120/80 should be encouraged to make lifestyle modifications. Treatment with medicine is recommended to lower blood pressure to less than 140/90 mmHg. For patients who have diabetes, or chronic kidney disease, the recommended blood pressure is less than 130/80 mmHg.

Treatment of hypertension involves lifestyle changes and drug therapy.

Lifestyle changes

A critical step in preventing and treating hypertension is a healthy lifestyle. You can lower your blood pressure with these lifestyle changes:

  • Losing weight if you are overweight or obese
  • Quitting smoking
  • Eating a healthy diet, including the Dietary Approaches to Stop Hypertension (DASH) eating plan (more fruits, vegetables, and low-fat dairy products, less saturated and total fat)
  • Reducing the amount of salt in your diet to 2,400 milligrams (about 6 grams or 1 teaspoon) a day or less
  • Getting regular aerobic exercise (such as brisk walking at least 30 minutes a day, several days a week)
  • Limiting alcohol to two drinks a day for men, one drink a day for women

In addition to lowering blood pressure on their own, these measures enhance the effectiveness of antihypertensive medicines.

Drug therapy

There are several classes of drugs used to treat hypertension, including:

  • Angiotensin-converting enzyme (ACE) inhibitors
  • Angiotensin receptor blockers (ARBs)
  • Diuretics
  • Beta blockers
  • Calcium channel blockers

The Joint National Committee recommends thiazide-type diuretics as the first line of therapy for most people who have hypertension. If the patient has problems with one drug or if it isn’t effective, he or she can be switched to another drug.

A doctor might start a medicine other than a diuretic as the first line of therapy if a patient has certain medical problems. For example, ACE inhibitors are often a good choice for a patient with diabetes.

If a patient’s blood pressure is more than 20/10 mmHg higher than it should be, the doctor might consider starting the patient on two drugs.

Follow-up

  • After starting antihypertensive drug therapy, the patient should see his or her doctor at least once a month until the blood pressure goal is reached.
  • The doctor should check the patient’s serum potassium (diuretics can lower this) and creatinine (to check the health of the kidneys) once or twice a year.
  • After the blood pressure goal is reached, the patient should see the doctor every three to six months, depending on whether he or she has any diseases such as heart failure.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 2/6/2011...#12274