HIGH BLOOD PRESSURE Treatment

For most people with high blood pressure, a healthcare provider will develop a treatment plan that may include heart-healthy lifestyle changes alone or with medicines. A risk calculator can help estimate your risk of complications and choose the right treatment. Your provider and a team of experts can help you best manage your blood pressure and prevent complications. This team may include your typical doctor or provider, a nutritionist, a pharmacist, and specialists for any conditions you may have, including those related to your heart. If your high blood pressure is caused by another medical condition or medicine, it may improve once the cause is treated or removed.

Risk calculators

Your healthcare provider may use a risk calculator to estimate your risk of having a stroke or heart attack or dying from a heart or blood vessel disease. This information can help you and your provider choose the best treatment to prevent long term complications. For example, the Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimator external link [external link] considers your cholesterol levels, age, sex, race, and blood pressure. It also factors in whether you smoke or take medicines to manage high blood pressure or cholesterol.

Healthy lifestyle changes

If you have high blood pressure, your provider may recommend that you adopt a heart-healthy lifestyle to help lower and control high blood pressure.

Choose heart-healthy foods such as those in the DASH eating plan.

NHLBI-funded research has shown that DASH combined with a low-salt eating plan can be as effective as medicines in lowering high blood pressure. Living With the DASH Eating Plan and Tips to Reduce Salt and Sodium offer more information.

Avoid or limit alcohol.

Talk to your provider about how much alcohol you drink. You may need to limit it or stop drinking. Resources and support are available at the Alcohol Treatment Navigator from the National Institute on Alcohol Abuse and Alcoholism.

Get regular physical activity.

Many health benefits result from getting the recommended amount of physical activity each week. Studies have shown that physical activity can help lower and control high blood pressure levels. Even modest amounts of physical activity may help. Before starting any exercise program, ask your healthcare provider what level of activity is right for you

Aim for a healthy weight.

If you are an adult who is living with overweight or obesity, losing 5% to 10% of your initial weight over 6 months can improve your health. Even losing just 3% to 5% of your weight can improve blood pressure.

Quit smoking.

Both Smoking and Your Heart and Your Guide to a Healthy Heart focus on heart health and include basic information about how to quit smoking. For free help and support to quit smoking, you can call the National Cancer Institute’s Smoking Quitline at 1-877-44U-QUIT (1-877-448-7848).

Manage stress.

Learning how to manage stress and cope with problems can improve your mental and physical health. Learning relaxation techniques, talking to a counselor, and finding a support group can all help.

Get enough good-quality sleep.

The recommended amount for adults is 7 to 9 hours of sleep per day. Develop healthy sleep habits by going to sleep and getting up at regular times, following a calming bedtime routine, and keeping your bedroom cool and dark. Changing habits can be hard. To help make lifelong heart-healthy changes, try making one change at a time. Add another change when you feel comfortable with the previous one. You’re more likely to manage your blood pressure when you practice several of these healthy lifestyle habits together and can keep them up over time.

Medicines

When healthy lifestyle changes alone do not control or lower high blood pressure, your healthcare provider may prescribe blood pressure medicines. These medicines act in different ways to lower blood pressure. When prescribing medicines, your provider also considers their effect on other conditions you have, such as heart disease or kidney disease. Keep up your healthy lifestyle changes while taking these medicines. The combination of medicines and heart-healthy lifestyle changes can help control and lower your high blood pressure and prevent heart disease. Talk to your healthcare provider if you have any concerns about side effects from the medicines. They may change the dose or prescribe a new medicine. To manage high blood pressure, many people need to take two or more medicines. This is more likely in African American adults.

There are several very common possible high blood pressure medicines your provider may prescribe. Angiotensin-converting enzyme (ACE) inhibitors keep your blood vessels from narrowing as much.
Angiotensin II receptor blockers (ARBs) keep blood vessels from narrowing.
Calcium channel blockers prevent calcium from entering the muscle cells of your heart and blood vessels. This allows blood vessels to relax.
Diuretics remove extra water and sodium (salt) from your body, reducing the amount of fluid in your blood. The main diuretic for high blood pressure treatment is thiazide. Diuretics are often used with other high blood pressure medicines, sometimes in one combined pill.
Beta blockers help your heart beat slower and with less force. As a result, your heart pumps less blood through your blood vessels. Beta blockers are typically used only as a backup option or if you have other conditions.

Frequently Asked Questions

While there is no cure for high blood pressure, it is important for patients to take steps that matter, such as making effective lifestyle changes and taking BP-lowering medications as prescribed by their physicians

Choice of initial therapy in most patients — The three primary options for antihypertensive drug therapy in most patients include an ACE inhibitor (or ARB), a calcium channel blocker, or a thiazide diuretic (preferably a thiazide-like diuretic) [3].