How Is High Blood Pressure Treated?

High blood pressure (HBP) is treated with lifestyle changes and medicines.

Most people who have HBP will need lifelong treatment. Sticking to your treatment plan is important. It can prevent or delay the problems linked to HBP and help you live and stay active longer.

Goals of Treatment

The treatment goal for most adults is to get and keep blood pressure below
140/90 mmHg. For adults who have diabetes or chronic kidney disease, the goal is to get and keep blood pressure below 130/80 mmHg.

Lifestyle Changes

Healthy habits can help you control HBP. Healthy habits include:

• Following a healthy eating plan
• Doing enough physical activity
• Maintaining a healthy weight
• Quitting smoking
• Managing your stress and learning to cope with stress

If you combine these measures, you can achieve even better results than taking single steps. Making lifestyle changes can be hard. Start by making one healthy lifestyle change and then adopt others.

Some people can control their blood pressures with lifestyle changes alone, but many people can’t. Keep in mind that the main goal is blood pressure control. If your doctor prescribes medicines as a part of your treatment plan, keep up your healthy habits. This will help you better control your blood pressure.

Follow a Healthy Eating Plan

Your doctor may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan if you have HBP. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and lower in sodium (salt).

This eating plan is low in fat and cholesterol. It also features fat-free or low-fat milk and dairy products, fish, poultry, and nuts. The DASH eating plan suggests less red meat (even lean red meat), sweets, added sugars, and sugar-containing beverages. The plan is rich in nutrients, protein, and fiber.

To help control HBP, you should limit the amount of salt that you eat. This means choosing low-salt and “no added salt” foods and seasonings at the table or when cooking. The Nutrition Facts label on food packaging shows the amount of sodium in the item. You should eat no more than about 1 teaspoon of salt a day.

You also should try to limit alcoholic drinks. Too much alcohol will raise your blood pressure. Men should have no more than two alcoholic drinks a day. Women should have no more than one alcoholic drink a day.

Do Enough Physical Activity

Regular physical activity can lower HBP and also reduce your risk for other health problems.

Check with your doctor about how much and what kinds of activity are safe for you. Unless your doctor tells you otherwise, try to get at least 30 minutes of moderate-intensity activity on most or all days of the week. You can do it all at once or break it up into shorter periods of at least 10 minutes each.

Moderate-intensity activities include brisk walking, dancing, bowling, riding a bike, working in a garden, and cleaning the house.

If your doctor agrees, you also may want to do more intense activities, such as jogging, swimming, and playing sports. 

Maintain a Healthy Weight

Staying at a healthy weight can help control blood pressure and also reduce your risk for other health problems.

If you’re overweight or obese, aim to reduce your weight by 7 to 10 percent during your first year of treatment. This amount of weight loss can lower your risk for health problems related to HBP.

After the first year, you may have to continue to lose weight so you can lower your body mass index (BMI) to less than 25.

BMI measures your weight in relation to your height and gives an estimate of your total body fat. A BMI between 25 and 29 is considered overweight. A BMI of 30 or more is considered obese. A BMI of less than 25 is the goal for keeping blood pressure under control.

You can measure your BMI using the NHLBI’s online calculator, or your health care provider can help.

For more information on losing weight and keeping it off, see the Diseases and Conditions Index Overweight and Obesity article.

Quit Smoking

Smoking can damage your blood vessels and raise your risk for HBP. It also can worsen health problems related to HBP. Smoking is bad for everyone, especially those who have HBP.

If you smoke or use tobacco, quit. Talk to your doctor about programs and products that can help you quit. The U.S. Department of Health and Human Services has information on how to quit smoking. Also, take steps to protect yourself from secondhand smoke.

Managing Stress

Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health.

Physical activity helps some people cope with stress. Other people listen to music or focus on something calm or peaceful to reduce stress. Some people learn yoga, tai chi, or how to meditate.

Medicines

Today’s blood pressure medicines can safely help most people control their blood pressures. These medicines are easy to take. The side effects, if any, tend to be minor.

If you have side effects from your medicines, talk to your doctor. He or she may be able to adjust the doses or prescribe other medicines. You shouldn’t decide on your own to stop taking your medicines.

Blood pressure medicines work in different ways to lower blood pressure. Some remove extra fluid and salt from the body to lower blood pressure. Others slow down the heartbeat or relax and widen blood vessels. Often, two or more medicines work better than one.

Diuretics

Diuretics are sometimes called water pills. They help your kidneys flush excess water and salt from your body. This lessens the amount of fluid in your blood, and your blood pressure goes down.

Diuretics often are used with other HBP medicines and sometimes combined into one pill.

Beta Blockers

Beta blockers help your heart beat slower and with less force. Your heart pumps less blood through your blood vessels, and your blood pressure goes down.

ACE Inhibitors

ACE inhibitors keep your body from making a hormone called angiotensin II. This hormone normally causes blood vessels to narrow. ACE inhibitors prevent this, so your blood pressure goes down.

Angiotensin II Receptor Blockers

Angiotensin II receptor blockers (ARBs) are newer blood pressure medicines that protect your blood vessels from angiotensin II. As a result, blood vessels relax and widen, and your blood pressure goes down.

Calcium Channel Blockers

Calcium channel blockers (CCBs) keep calcium from entering the muscle cells of your heart and blood vessels. This allows blood vessels to relax, and your blood pressure goes down.

Alpha Blockers

Alpha blockers reduce nerve impulses that tighten blood vessels. This allows blood to flow more freely, causing blood pressure to go down.

Alpha-Beta Blockers

Alpha-beta blockers reduce nerve impulses the same way alpha blockers do. However, they also slow the heartbeat like beta blockers. As a result, blood pressure goes down.

Nervous System Inhibitors

Nervous system inhibitors increase nerve impulses from the brain to relax and widen blood vessels. This causes blood pressure to go down.

Vasodilators

Vasodilators relax the muscles in blood vessel walls. This causes blood pressure to go down.

Treatment for Children and Teens

If another condition is causing your child’s HBP, treating it often resolves the HBP. When the cause of a child or teen’s HBP isn’t known, the first line of treatment is lifestyle changes (as it is for adults).

If lifestyle changes don’t control blood pressure, children and teens also may need to take medicines. Most of the medicines listed above for adults have unique doses for children.

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Your doctor will diagnose high blood pressure (HBP) using the results of blood pressure tests. These tests will be done several times to make sure the results are correct. If your numbers are high, your doctor may have you return for more tests to check your blood pressure over time.

If your blood pressure is 140/90 mmHg or higher over time, your doctor will likely diagnose you with HBP. If you have diabetes or chronic kidney disease, a blood pressure of 130/80 mmHg or higher is considered HBP.

The HBP ranges in children are different. (For more information, see below.)

How Is Blood Pressure Tested?

A blood pressure test is easy and painless. This test is done at a doctor’s office or clinic.

To prepare for the test:

• Don’t drink coffee or smoke cigarettes for 30 minutes prior to the test. These actions may cause a short-term rise in your blood pressure.
• Go to the bathroom before the test. Having a full bladder can change your blood pressure reading.
• Sit for 5 minutes before the test. Movement can cause short-term rises in blood pressure.

To measure your blood pressure, your doctor or nurse will use some type of a gauge, a stethoscope (or electronic sensor), and a blood pressure cuff.

Most often, you will sit or lie down with the cuff around your arm as your doctor or nurse checks your blood pressure. If he or she doesn’t tell you what your blood pressure numbers are, you should ask.

Diagnosing High Blood Pressure in Children and Teens

Doctors measure blood pressure in children and teens the same way they do in adults. Your child should have routine blood pressure checks starting at 3 years of age.

Blood pressure normally rises with age and body size. Newborn babies often have very low blood pressure numbers, while older teens have numbers similar to adults.

The ranges for normal blood pressure and HBP are generally lower for youth than for adults. These ranges are based on the average blood pressure numbers for age, gender, and height.

To find out whether a child has HBP, a doctor will compare the child’s blood pressure numbers to average numbers for his or her age, height, and gender.

What Does a Diagnosis of High Blood Pressure Mean?

If you’re diagnosed with HBP, you will need treatment. You also will need to have your blood pressure tested again see how treatment affects it.

Once your blood pressure is under control, you will need to stay on treatment. “Under control� means that your blood pressure numbers are normal. You also will need regular blood pressure tests. Your doctor can tell you how often you should be tested.

The sooner you find out about HBP and treat it, the better your chances to avoid problems like heart attack, stroke, and kidney failure.

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