High Blood Pressure Treatment

Revising Medical Author: John P. Cunha, DO
Revising Medical Editor: Jay W. Marks, MD
Previous contributing medical author: Dwight Makoff, MD

• What is high blood pressure (hypertension)?
• Which lifestyle modifications are beneficial in treating high blood pressure?
  • Alcohol
  • Smoking
  • Coffee
  • Salt
  • Other dietary considerations
  • Obesity
  • Exercise
• How is high blood pressure treated?
  • Starting treatment for high blood pressure
  • Treatment with combinations of drugs for high blood pressure
  • Emergency treatment for high blood pressure
  • Treatment during pregnancy
• Which medications are used to treat high blood pressure
  • Angiotensin converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers
  • Beta-blockers
  • Diuretics
  • Calcium channel blockers (CCBs)
  • Alpha-blockers
  • Clonidine
  • Minoxidil
• What about the patient's compliance with medication regimes?
• Is alternative medicine used to treat high blood pressure?
• What's new in high blood pressure?
• More in-depth information about High Blood Pressure

Dangers of Mixing Medications Benjamin C. Wedro, MD, FAAEM Medical Editor: Melissa Conrad Stöppler, MD "Better things for Better Living… through Chemistry" worked well as a slogan for DuPont, but mixing chemicals in the body can lead to disaster. The world has become healthier because of medications that are available to treat and control disease and illness. But a problem exists when the medications interact with each other, causing complications, or are abused. Some drug interactions are easy to predict. Take a narcotic pain pill, add a few drinks after dinner, and toss in a sleeping pill. The combination of three sedative medications may cause problems with the brain forgetting to tell the body to breathe. Other interactions are tougher to predict. For example, warfarin (Coumadin), a blood thinner, will become too active in the body and cause significant bleeding if almost any antibiotic is added. The healthcare provider needs to predict the problem and take action to avoid possible deadly complications. The body is a breeding ground for drug interactions. Whether the drug is an over-the-counter (OTC) medication, a prescription drug, a holistic compound, a dietary supplement, a food, or an illegal drug, the potential for interaction exists. The problem occurs when people forget - or choose not to divulge - what they put in their body. Read more about the dangers of mixing medications » Top Searched High Blood Pressure Terms: signs and symptoms, diet, guidelines, medications, pregnancy, warning signs, detection, hypertension

What is high blood pressure?

High blood pressure or hypertension means high pressure (tension) in the arteries. Arteries are vessels that carry blood from the pumping heart to all the tissues and organs of the body. High blood pressure does not mean excessive emotional tension, although emotional tension and stress can temporarily increase blood pressure. Normal blood pressure is below 120/80; blood pressure between 120/80 and 139/89 is called "pre–hypertension", and a blood pressure of 140/90 or above is considered high.

The top number, which is the systolic blood pressure, corresponds to the pressure in the arteries as the heart contracts and pumps blood into the arteries. The bottom number, the diastolic pressure, represents the pressure in the arteries as the heart relaxes after the contraction. The diastolic pressure reflects the lowest pressure to which the arteries are exposed.

An elevation of the systolic and/or diastolic blood pressure increases the risk of developing heart (cardiac) disease, kidney (renal) disease, hardening of the arteries (atherosclerosis or arteriosclerosis), eye damage, and stroke (brain damage). These complications of hypertension are often referred to as end–organ damage because damage to these organs is the end result of chronic (long duration) high blood pressure. For that reason, the diagnosis of high blood pressure is important so efforts can be made to normalize blood pressure and prevent complications.

It was previously thought that rises in diastolic blood pressure were a more important risk factor than systolic elevations, but it is now known that in people 50 years and older systolic hypertension represents a greater risk.

Affecting approximately one in four adults in the United States, hypertension is clearly a major public health problem.

Which lifestyle modifications are beneficial in treating high blood pressure?

Lifestyle modifications refer to certain specific recommendations for changes in habits, diet and exercise. These modifications can lower the blood pressure as well as improve a patient's response to blood pressure medications.

Alcohol

People who drink alcohol excessively (over two drinks per day) have a one and a half to two times increase in the prevalence of hypertension. The association between alcohol and high blood pressure is particularly noticeable when alcohol intake exceeds five drinks per day. The connection is a dose–related phenomenon. In other words, the more alcohol consumed, the stronger is the link with hypertension. For further information, please see the Alcohol Abuse and Alcoholism article.

Smoking

Although smoking increases the risk of vascular complications (for example, heart disease and stroke) in people who already have hypertension, it is not associated with an increase in the development of hypertension. But cigarette smoking can repeatedly produce an immediate, temporary rise in the blood pressure of 5 to10 mm Hg. Steady smokers however, may have a lower blood pressure than nonsmokers. The reason for this is that nicotine in cigarettes causes a decrease in appetite, which leads to weight loss. This, in turn, lowers blood pressure. For further information please read the Smoking & Quitting Smoking article.

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