Most doctors will consider some type of treatment for patients whose diastolic pressure (the bottom number) is above 95 and or whose systolic pressure (the top number) isHigh blood pressure treatment above 160.

If your pressures are immediately below these figures (140-160/90-95), your doctor will take into account your age and other individual factors before recommending any medical treatment.

Non-drug therapy

A variety of non-pharmacologic approaches to managing high blood pressure are useful. In some cases of mild hypertension, these approaches are enough to reach satisfactory levels of blood pressure:

  • Quit smoking.
  • Trim down if you are overweight. Obese people are 2-6 times more likely to develop high blood pressure (and even a small weight loss can improve blood pressure).
  • Eat a healthy diet and avoid salty foods.
  • Reduce alcohol consumption.
  • Begin an program of regular physical activity.
  • Get adequate dietary calcium.
  • Control your stress.

Drug therapy

If lifestyle changes do not or cannot lower your blood pressure enough, your doctor will begin drug therapy. Prescribing diuretics and beta-blockers is the first choice of treatment for high blood pressure as they cause few complicating problems, such as heart disease.

Diuretics or “water pills” (thiazide, hydroclorathyazide, chlorathalidone and indapamide) increase the elimination of salt and water through urination, thereby lessening blood volume and pressure.

Beta-blockers (such as propranolol, atenolol, nadolol, pindolol and labetolol) lower blood pressure by reducing the amount of blood pumped by the heart.

If this first line of treatment is ineffective or you have other medical conditions, other types of medications which may be used:

Angiotensin converting enzyme (ACE) inhibitors (captopril, enalapril and lisinopril) lower blood pressure by blocking the production of a hormone known as angiotensin, which increases blood pressure.

Calcium-channel blockers (nifedipine, nicardipine, verapamil and diltiazem) relax blood-vessel walls, thereby lowering pressure.

Vasodilators (hydralazine and minoxidil) relax the smooth muscle of the peripheral arteries, which causes them to dilate and so reduce the resistance to blood flow.

Centrally acting drugs (clonidine and guanabenz) block the transmission of nerve impulses with the autonomic nervous system, which controls the involuntary action of the heart and blood vessels among other organs.

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