High Blood Pressure - Treatment - Treatment
For most people with high blood pressure, a doctor will develop a treatment plan that may include heart-healthy lifestyle changes alone or with medicines. A risk calculator can help your doctor estimate your risk of complications and choose the right treatment. A healthcare team can help you best manage your blood pressure and prevent complications. This team may include your doctor, 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 doctor 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 in the next 10 years or throughout your lifetime. This information can help your doctor choose the best treatment to prevent complications.
For example, the Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimator 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 doctor 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. Visit Living With the DASH Eating Plan or see Tips to Reduce Salt and Sodium.
- Avoid or limit alcohol. Talk to your doctor about how much alcohol you drink. Your doctor may recommend that you limit or stop drinking alcohol. You can find resources and support at the Alcohol Treatment Navigator from the National Institute on Alcohol Abuse and Alcoholism.
- Get regular physical activity. Many health benefits result from being physically active and 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 doctor what level of physical 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 about 6 months can improve your health. Even losing just 3% to 5% of your weight can improve blood pressure readings.
- Quit smoking. Visit Smoking and Your Heart and our Your Guide to a Healthy Heart. Although these resources focus on heart health, they 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 a 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.
Medicines
When healthy lifestyle changes alone do not control or lower high blood pressure, your doctor may prescribe blood pressure medicines. These medicines act in different ways to lower blood pressure. When prescribing medicines, your doctor will also consider their effect on other conditions you might have, such as heart disease or kidney disease.
Keep up your healthy lifestyle changes while taking these medicines. The combination of the medicines and the heart-healthy lifestyle changes can help control and lower your high blood pressure and prevent heart disease.
Talk to your doctor if you have any concerns about side effects from the medicines. He or she 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.
Possible high blood pressure medicines include:
- Angiotensin-converting enzyme (ACE) inhibitors to keep your blood vessels from narrowing as much.
- Angiotensin II receptor blockers (ARBs) to keep blood vessels from narrowing.
- Calcium channel blockers to prevent calcium from entering the muscle cells of your heart and blood vessels. This allows blood vessels to relax.
- Diuretics to 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 to 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.