How to treat hypertension


Hypertension can be effectively treated with lifestyle changes, medications, and natural remedies. Most people with hypertension improve on prescription medications such as diuretics, ACE inhibitors, beta-blockers, or other medications, and some may need more than one prescription medication to achieve optimal blood pressure. If your hypertension has a medical cause (secondary hypertension), you may also need treatment for medical problems that contribute to your high blood pressure.

Illustration by Joshua Song. © Get Information on Medicines, 2018

Home remedies and lifestyle

Hypertension can often improve with lifestyle changes. In some cases, high blood pressure can only return to normal levels with lifestyle changes, especially if you have stage 1 hypertension (systolic blood pressure between 130 and 139 mmHg or diastolic blood pressure between 80 and 89 mmHg. Blood pressure (systolic blood pressure 120 to 129 mmHg and diastolic blood pressure less than 80 mmHg) .

If you have extremely high blood pressure, lifestyle changes can lower your blood pressure, although probably not to optimal levels.

Give up smoking

Smoking is one of the main factors that cause and aggravate hypertension. If you smoke and have high blood pressure, your blood pressure can improve significantly if you stop smoking.


If you are overweight, losing weight can help lower your blood pressure. With some perseverance, most people can do this with a combination of diet and exercise. Bariatric surgery, which some people may need, can also help reduce high blood pressure .

Diet modification

Foods that are high in water, such as fresh fruits and vegetables, help maintain fluid and electrolyte balance, which helps keep blood pressure at ideal levels. Fruits and vegetables also contain antioxidants that help prevent blood vessel damage and related vascular disease, which is often associated with hypertension.

Dietary Approaches to Fight Hypertension (DASH). A diet low in saturated fat, cholesterol, red meat, and sugar is considered a good dietary method for maintaining optimal blood pressure. -fatty dairy products, whole grains, lean proteins, nuts and legumes.

The exercise

Regular physical activity can help you maintain optimal blood pressure, even if you don't need exercise to lose weight. The cardiovascular, hormonal, and cholesterol changes that result from exercise are believed to help maintain healthy blood pressure.

Low in salt

A low sodium diet can help lower blood pressure. Excess salt has been shown to increase blood pressure in some, but not all, people.

It is best to consult a dietitian about salt intake. Some people need a moderate intake of salt, while others need a very low-salt diet to prevent blood pressure from getting too high.


There are many prescription drugs used to treat hypertension. These drugs are classified according to their different mechanisms of action.

Treatment objectives

According to the American College of Cardiology and the American Heart Association, the goal of blood pressure treatment is to achieve blood pressure values below 130/80 mmHg. Art. Systolic and less than 80 mm Hg. Art. Diastolic In general, if you have hypertension, you will likely need lifelong treatment to maintain this target blood pressure.

Diuretics , also called diuretics, increase the amount of fluid excreted in the urine. They are believed to lower blood pressure by reducing the volume of fluid circulating in the blood vessels.

Side effects include low potassium levels, frequent urination, and worsening of gout . Examples of these medications include:

  • Taliton, tenoretic and chlorpres (chlorthalidone)
  • HydroDiuril, Mikroside, and Ezidrix (hydrochlorothiazide)
  • Lozol (indapamide)
  • Zaroxolin, Microx (metolazone)

Angiotensin converting enzyme (ACE) inhibitors lower blood pressure by dilating (widening) the arteries. Side effects include coughing, decreased taste, and increased potassium levels. Examples of ACE inhibitors include:

  • Lotensin (Benazepril)
  • Capoten (captopril)
  • Vasotek, vaseretic (enalapril)
  • Monopril (fosinopril)
  • Adopted, Zestril (lisinopril)
  • Univask (moexipril)
  • Accupril (quinapril)
  • High (ramipril)
  • Mavic (trandolapril)

Calcium channel blockers lower blood pressure by widening the arteries and decreasing the strength of the heart. Side effects include constipation, leg swelling, and headaches. Examples include:

  • Norvasc, Cadue and Lotrel (amlodipine)
  • Cardizem, Dilacor, and Tiazak (diltiazem)
  • Plendil (felodipine)
  • DynaCirc (isradipine)
  • Cardin (nicardipine)
  • Procardia XL, Adalat (nifedipine)
  • Sular (nisoldipin)
  • Isoptin, Kalan, Verelan and Carpet (verapamil hydrochloride)

Beta- blockers reduce the effects of adrenaline on the cardiovascular system, slow down the heart rate, and reduce stress on the heart and arteries. Side effects include increased shortness of breath in chronic obstructive pulmonary disease or asthma ; sexual dysfunction; fatigue; depression; and worsening of symptoms if you have peripheral arterial disease . Examples of beta blockers:

  • Sectral (acebutolol)
  • Tenormin (atenolol)
  • Curlon (Betaxolol)
  • Zebeta, Ziak (bisoprolol)
  • Cartrol (cartolol)
  • Coreg (carvedilol)
  • Normodin, Trandat (labetalol)
  • Lopressor, Toprol (metoprolol)
  • Corgard (nadolol)
  • Levatol (penbutolol)
  • Inderal, Inderal LA (propranolol)
  • Blockadren (timolol)

Angiotensin II receptor blockers (ARBs ) lower blood pressure by dilating the arteries. Side effects include allergic reactions, dizziness , and high potassium levels. EPIRBs include:

  • Atacand (candesartan)
  • Avapro (irbesartan)
  • Cozaar (losartan)
  • Mikardis (Telmisartan)
  • Diovan (valsartan)

Lotensin (minoxidil) is a vasodilator. It works by making blood vessels relax and dilate, reducing the pressure needed to push blood through them. Minoxidil does not act directly on blood vessels. It stimulates the action of an enzyme that produces chemicals that help relax blood vessels.

Side effects include bloating, low blood pressure , dizziness, nausea, loss of appetite, and unwanted hair growth.

Monotherapy and combination therapy

The use of a single antihypertensive drug is called monotherapy. If a drug is ineffective or causes intolerable side effects, your doctor may switch to another monotherapy and then, if necessary, to a third.

If three or more attempts at monotherapy do not lower blood pressure without causing side effects, the next step is combination therapy with two or more prescription antihypertensive medications. Sometimes a combination of drugs with a different mechanism of action can enhance the therapeutic effect without aggravating the side effects.

Resistant hypertension

Resistant hypertension is defined as blood pressure that remains significantly above target despite the use of optimal triple therapy.

There are several factors that can cause persistent hypertension:

  • Refusing to take medications as directed
  • Secondary hypertension
  • Fluid retention is usually the result of kidney failure.

If you have refractory hypertension, your healthcare provider will ask if you are taking your medicine as prescribed; options and / or dosage can be adjusted.

You may also need medical treatment for, or instead of, another condition that may be causing high blood pressure. such as sleep apnea , chronic kidney disease , or aldosteronism (excessive production of hormones by the adrenal glands).

Complementary Medicine (CAM)

There are some natural remedies that can lower your blood pressure, especially if you have prehypertension.

  • Garlic : Garlic has long been thought to reduce hypertension. Research shows that garlic extract can lower blood pressure, although the optimal dosage, frequency, and form of supplementation have not been clearly established. Garlic can cause this effect by acting directly on the kidneys to remove excess salt. This spice is considered safe to consume, although it can cause an upset stomach.
  • Magnesium: Magnesium, found in nuts, seeds, avocados, and green leafy vegetables, has also been suggested as a natural way to lower blood pressure. The supplements are also available in pill form. Research shows that higher magnesium levels are associated with lower blood pressure, but it is not yet entirely clear whether there is a causal relationship.
  • Fish oil: Eating fish regularly has been linked to lowering high blood pressure. The use of fish oil pills has also been studied and it is not clear whether taking the pills has the same effect as eating fish.
  • Stress management and relaxation: Stress and anxiety temporarily increase blood pressure. Stress management techniques are believed to reduce blood pressure marginally in the short term, and more research is needed to gain long-term benefits.

While some of the many herbs can lower blood pressure, some can raise it. If you are using herbal remedies, be sure to read the side effects and drug interactions and discuss them with your doctor.

Hypertension Discussion Guide

Get our printable guide to your next doctor's appointment to help you ask the right questions.

OTC Treatments

There are no over-the-counter blood pressure medications. However, there are several options that can cause high blood pressure as a side effect. While this does not happen to everyone who takes these medications, it may be of concern to you, especially if this is your first time taking the medication.

The most common types of over-the-counter medications that can cause high blood pressure include:

  • Non-steroidal anti-inflammatory drugs (NSAIDs): Medications such as ibuprofen and aspirin can raise blood pressure in some people.
  • Decongestants: Some decongestants contain pseudoephedrine or phenylephrine, stimulants that increase blood pressure.
  • Weight Loss Supplements / Appetite Suppressants – Many of these over-the-counter products contain stimulants and / or caffeine that increase blood pressure.
  • Stimulants / Energy Pills Containing Caffeine – Pills used to keep you awake or awake generally contain caffeine as an active ingredient.

Frequently asked questions

  • Blood pressure medications such as Toprol (metoprolol) may start to work the first day you take them. Certain dietary changes can lower blood pressure for several weeks. A 2017 study found that the DASH diet lowered blood pressure by an average of 4 mmHg per week. Art. For systolic blood pressure and 1 mm Hg. Art. For diastolic blood pressure. The low-sodium diet consistently lowered blood pressure for four weeks.

  • Talk to your doctor about whether you should take medicine. They will help you find one that is safe to take during pregnancy. You can also control your blood pressure by eating healthy foods, staying active whenever possible, monitoring your blood pressure at home, avoiding smoking, and attending all pregnancy appointments.

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