Hypertension is typically treated by making changes in your lifestyle, and with drug therapy.
Lifestyle Changes to Treat Hypertension
Lifestyle changes include eating a healthy diet (such as the DASH diet, which includes lowering sodium but including daily servings of fruits, vegetables, and whole grain foods), stopping smoking, losing weight, and getting enough exercise, especially aerobic exercise.
Medicine to Treat Hypertension
Several types of drugs are available to treat hypertension.The major types of medication used to control high blood pressure include:
Thiazide diuretics. These medications act on your kidneys to help your body eliminate sodium and water, reducing blood volume. Thiazide diuretics are often the first — but not the only — choice in high blood pressure medications. Still, diuretics are often not prescribed. If you’re not taking a diuretic and your blood pressure remains high, talk to your doctor about adding one or replacing a drug you currently take with a diuretic.
Beta blockers. These medications reduce the workload on your heart, causing your heart to beat slower and with less force. When prescribed alone, beta blockers don’t work as well in blacks — but they’re effective when combined with a thiazide diuretic.
Angiotensin-converting enzyme (ACE) inhibitors. These medications help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels. ACE inhibitors may be especially important in treating high blood pressure in people with coronary artery disease, heart failure or kidney failure. Like beta blockers, ACE inhibitors don’t work as well in blacks when prescribed alone, but they’re effective when combined with a thiazide diuretic.
Angiotensin II receptor blockers. These medications help relax blood vessels by blocking the action — not the formation — of a natural chemical that narrows blood vessels. Like ACE inhibitors, angiotensin II receptor blockers often are useful for people with coronary artery disease, heart failure and kidney failure.
Calcium channel blockers. These medications help relax the muscles of your blood vessels. Some slow your heart rate. Calcium channel blockers may work better for blacks than do ACE inhibitors or beta blockers alone. A word of caution for grapefruit lovers, though. Grapefruit juice interacts with some calcium channel blockers, increasing blood levels of the medication and putting you at higher risk of side effects. Researchers have identified the substance in grapefruit juice that causes the potentially dangerous interaction, which may one day lead to commercial grapefruit juices that don’t pose a risk of interaction. For now, however, talk to your doctor or pharmacist if you’re concerned about interactions.
Renin inhibitors. A new drug Tekturna (aliskiren) is a renin inhibitor. Renin is an enzyme produced by your kidneys that starts a cascade of chemical steps that increases blood pressure. Tekturna works by reducing the ability of renin to begin this process. Tekturna acts earlier in your body’s blood pressure regulation process than most other blood pressure medications. It also can be used well with the other major classes of blood pressure drugs to improve their actions. Tekturna can be used alone, but it’s more effective when used in combination with existing high blood pressure medications, such as water pills (diuretics). Tekturna’s effects on blood pressure last more than 24 hours, so it can be taken once daily in oral tablet form.
If you’re having trouble reaching your blood pressure goal with combinations of the above medications, your doctor may prescribe:
Alpha blockers. These medications reduce nerve impulses to blood vessels, reducing the effects of natural chemicals that narrow blood vessels.
Alpha-beta blockers. In addition to reducing nerve impulses to blood vessels, alpha-beta blockers slow the heartbeat to reduce the amount of blood that must be pumped through the vessels.
Central-acting agents. These medications prevent your brain from signaling your nervous system to increase your heart rate and narrow your blood vessels.
Vasodilators. These medications work directly on the muscles in the walls of your arteries, preventing the muscles from tightening and your arteries from narrowing.
Once your blood pressure is under control, your doctor may add aspirin to your regimen to reduce your risk of cardiovascular disorders.
Jeff Behar, MS, MBA regularly writes about hot topics in the areas of health, fitness, disease prevention, nutrition, bodybuilding, men’s health, women’s health, weight management, weight loss, vitamins and supplements and alternative medicine. His work also often appears in several of the major health and fitness newsletters, blogs, RSS Feeds, as well as print magazines, and many other online health, nutrition,and fitness websites.
