How is high blood pressure (hypertension) treated?

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.

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