Hypertension is the medical term for high blood pressure. It means too much force pushes against the arteries that carry blood from the heart to the body.
According to the American College of Cardiology (ACC), a person should start hypertension treatment involving lifestyle changes, and sometimes medication, when their blood pressure reaches 130/80 millimeters of mercury (mm Hg).
Hypertension affects nearly half of adults in the United States. It can cause damage to the heart, blood vessels, kidneys, and other organs over time, potentially causing heart attacks, strokes, heart failure, or kidney disease.
This article discusses medications, lifestyle adjustments, and alternative medicine for hypertension. It also offers tips for living with hypertension and examines the outlook for the condition.
There is a range of blood pressure medications that have various effects on the body. The following are different classes of drugs, how they work, and their potential side effects:
- Diuretics: These drugs help the body remove excess salt and water. Some also reduce potassium, which may result in weakness. An example is chlorothiazide (Diuril).
- Beta-blockers: These drugs lower the heart’s workload. Side effects may include slow heartbeat and fatigue. An example is metoprolol.
- Angiotensin converting enzyme (ACE) inhibitors: These drugs enable the body to produce less angiotensin, a chemical that narrows the arteries. Side effects may include a rash and loss of taste. An example is captopril (Capoten).
- Angiotensin II receptor blockers (ARBs): These block the effects of angiotensin, enabling blood vessels to stay open. They may sometimes cause dizziness. An example is candesartan (Atacand). Doctors do not prescribe ACE inhibitors and ARBs together because they have similar effects.
- Calcium channel blockers: These drugs prevent calcium from entering the cells of the blood vessels and heart, an effect that relaxes narrowed blood vessels. They may cause swollen ankles and palpitations, which is an irregular heartbeat. Examples are amlodipine and bepridil (Vasocor).
- Alpha blockers: These drugs relax the muscle tone in the artery walls. Side effects may include dizziness and a fast heart rate. An example is doxazosin mesylate (Cardura).
- Alpha-2 receptor agonists: These drugs reduce the activity of the part of the nervous system that produces adrenaline, a hormone that strengthens the force of the heart’s contractions. Side effects may include drowsiness or dizziness. An example is methyldopa (Aldomet).
- Combined alpha and beta blockers: Doctors may order the administration of these drugs via a person’s vein if they are undergoing a hypertensive crisis. They may cause a drop in blood pressure when an individual stands up from a seated position. Examples are labetalol and carvedilol (Coreg).
- Central agonists: These drugs decrease the ability of a blood vessel to contract. Side effects vary with the medication, but they may include dry mouth and drowsiness. An example is clonidine hydrochloride (Catapres).
- Peripheral adrenergic inhibitors: These drugs block chemicals in the brain that send a message to the blood vessels to constrict. Side effects may include heartburn and a stuffy nose. An example is guanadrel (Hylorel).
- Blood vessel dilators: These drugs relax the muscles in the walls of blood vessels. Side effects may include palpitations and headaches. An example is hydralazine hydrochloride (Apresoline).
Doctors define resistant hypertension as blood pressure higher than 140/90 mm Hg after treatment with three or more medications. The medications should include optimal doses of the following:
While scientists do not fully understand the causes of resistant hypertension, they theorize that it involves excessive sodium retention in the kidneys. For this reason, the ACC advises one of these additional treatments:
- Spironolactone: For a person with a potassium level below 4.5 millimoles per liter (mmol/L) if they are likely to respond to this type of medication.
- Other potassium-sparing diuretics: For individuals with a potassium level of less than 4.5 mmol/L who cannot tolerate spironolactone. An example is eplerenone (Inspra), which acts similarly to spironolactone but has fewer side effects.
- A double dose of diuretic: For people with a potassium level higher than 4.5 mmol/L.
Healthy lifestyle practices can help
- Eat a nutritious diet: This includes high-fiber foods, such as fruits and vegetables. It also involves foods plentiful in potassium and protein but low in saturated fat and salt.
- Stay physically active: Current
guidelinesadvise 150–300 minutes of moderate exercise, 75–150 minutes of vigorous exercise, or an equivalent combination of moderate and vigorous exercise per week. The physical activity recommendation for children and adolescents is 60 minutes per week.
- Aim for a moderate weight: Eating a healthy diet and exercising regularly can help with weight management. One approach is the DASH diet (Dietary Approaches to Stop Hypertension), which limits red meat, salt, and added sugars.
- Stop smoking: Because smoking increases blood pressure and the risk of a heart attack and stroke, quitting can help reduce these health issues.
- Get enough sleep: The risk of hypertension, heart disease, and stroke increases when individuals do not have enough regular sleep.
- Limit alcohol intake: Since alcohol can increase blood pressure, people should limit their daily intake. Males should have no more than two drinks per day, and females should have no more than one drink per day.
Research suggests some types of alternative medicine can produce small decreases in blood pressure in individuals with hypertension. These include tai chi, meditation, yoga, and qigong.
Tai chi is an exercise that combines deep diaphragmatic breathing with graceful body movements. An older
Meditation involves focusing the mind on a particular thought or object. A 2017 review evaluated the effects of meditation on the risk of heart and blood vessel diseases. It found a potential benefit but could not draw definite conclusions.
Yoga involves poses and slow, gentle movements. An older
Qigong is an exercise that involves coordinating breathing patterns with meditation and rhythmic movements.
A hypertensive crisis is when an individual has a systolic blood pressure higher than 180 mm Hg or diastolic blood pressure higher than 120 mm Hg. A
Systolic is the top blood pressure reading, which shows the force on the arteries during a contraction of the heart during a heartbeat. Diastolic is the bottom reading, which indicates the force on the arteries as the heart relaxes between beats.
People with a hypertensive emergency need rapid-acting medications that a health care provider administers through a vein. Different conditions can cause this serious issue, and the drug of choice depends on the cause. A doctor treating the person will need to attempt to reduce their blood pressure slowly, to avoid dangerous side effects if the person’s blood pressure drops too fast.
This includes not skipping a dose or cutting a pill in half. Doctors also recommend taking medications at the same time every day.
The American Heart Association (AHA) notes that the risk of death from a heart attack or stroke doubles with every 10 mm Hg diastolic increase or 20 mm Hg systolic blood pressure increase in individuals aged 40–89.
A person’s outlook depends on how well they can control their hypertension. People should visit their doctor regularly to find out their blood pressure measurements and take appropriate action according to their doctor’s advice.
Hypertension, or high blood pressure, is fairly common in the U.S. It can cause heart attacks, strokes, heart failure, or kidney disease because of the damage it can have on organs in the body.
Treatment for hypertension may include medications such as beta-blockers. However, other treatment options exist, including lifestyle adjustments such as eating a balanced diet, and avoiding alcohol and smoking.
Other approaches, such as meditation and certain breathing techniques, may also help.