High Blood Pressure (Hypertension)

Management and Treatment

What should I do if I have high blood pressure?

If your healthcare provider has diagnosed you with high blood pressure, they will talk with you about your recommended blood pressure target or goal. They may suggest that you:

• Check your blood pressure regularly with a home blood pressure monitor. These are automated electronic monitors and are available at most pharmacies or online.
• Eat healthy foods that are low in salt and fat.
• Reach and maintain your best body weight.
• Limit alcohol to no more than two drinks each day for men and less than one drink each day for women. One drink is defined as 1 ounce of alcohol, 5 ounces of wine, or 12 ounces of beer.
• Be more physically active.
• Quit smoking and/or using tobacco products.
• Work on managing anger and managing stress.

What diet helps manage high blood pressure?

• Eat foods that are lower in fat, salt and calories, such as skim or 1% milk, fresh vegetables and fruits, and whole-grain rice and pasta. (Ask your healthcare provider for a more detailed list of low sodium foods to eat.)
• Use flavorings, spices and herbs to make foods tasty without using salt. The optimal recommendation for salt in your diet is to have less than 1,500 milligrams of sodium a day. Don't forget that most restaurant foods (especially fast foods) and many processed and frozen foods contain high levels of salt. Use herbs and spices that do not contain salt in recipes to flavor your food. Don’t add salt at the table. (Salt substitutes usually have some salt in them.)
• Avoid or cut down on foods high in fat or salt, such as butter and margarine, regular salad dressings, fatty meats, whole milk dairy products, fried foods, processed foods or fast foods and salted snacks.
• Ask your provider if you should increase potassium in your diet. Discuss the Dietary Approaches to Stop Hypertension (DASH) diet with your provider. The DASH diet emphasizes adding fruits, vegetables and whole grains to your diet while reducing the amount of sodium. Since it’s rich in fruits and vegetables, which are naturally lower in sodium than many other foods, the DASH diet makes it easier to eat less salt and sodium.

What medications are used to treat high blood pressure?

Four classes of high blood pressure medications are considered “first line” (most effective and commonly prescribed) when starting treatment. Sometimes other medications are coupled with these first-line drugs to better manage your high blood pressure. First-line, pressure-lowering medications are:

• Angiotensin-converting enzyme (ACE) inhibitors block the production of the angiotensin II hormone, which the body naturally uses to manage blood pressure. When angiotensin II is blocked, your blood vessels don’t narrow. Examples: lisinopril (Zestril® or Prinivil®), enalapril or captopril.
• Angiotensin II receptor blockers (ARBs) block this same hormone from binding with receptors in the blood vessels. ARBs work the same way as ACE inhibitors to keep blood vessels from narrowing. Examples: metoprolol (Lopressor®; Toprol® XL), valsartan (Diovan® or Prexxartan®) or losartan.
• Calcium channel blockers prevent calcium from entering the muscle cells of your heart and blood vessels, allowing these vessels to relax. Examples: amlodipine (Norvasc® or Katerzia®), nifedipine (Procardia®XL or Nifedical®XL), diltiazem (Cardizem®, Dilacor® XR or Tiazac®).
• Diuretics (water or fluid pills) flush excess sodium from your body, reducing the amount of fluid in your blood. Diuretics are often used with other high blood pressure medicines, sometimes in one combined pill. Examples: indapamide, hydrochlorothiazide (Microzide® or Oretic®) or chlorothiazide.

Talk to your healthcare provider about what side effects and problems are possible when you take your blood pressure medicine. You should avoid some medications during pregnancy. If you get side effects that concern you, call your provider. They may change your dose or try a different medication. Don’t stop taking the medicine on your own.