Yes, exercise is an excellent way to help lower your blood pressure. Of course, before you start any exercise program, be sure to talk to your doctor. With your doctor’s guidance, exercise can be a healthy way to help get your blood pressure under control. Exercise strengthens your heart and makes it work more efficiently. This means it won’t have to pump as hard, which leads to lower blood pressure.
Your doctor may also use a device called an ophthalmoscope to look at the blood vessels in your eyes. Doctors can see if these vessels have thickened, narrowed, or burst, which may be a sign of high blood pressure. Your doctor will also use a stethoscope to listen to your heart and the sound of blood flowing through your arteries. In some cases, a chest x-ray and electrocardiogram may be needed.

Dietary changes: The health care provider might recommend a diet that includes more vegetables (especially leafy green vegetables), fruits, low-fat dairy products, and fiber-rich foods, and fewer carbohydrates, fats, processed foods, and sugary drinks. He or she also might recommend preparing low-sodium dishes and not adding salt to foods. Watch out for foods with lots of hidden salt (like bread, sandwiches, pizza, and many restaurant and fast-food options).

Many kids and teens with high blood pressure have an unhealthy lifestyle — a bad diet, excess weight, stress, and too little physical activity. So the health care provider might recommend weight loss, exercise, reduced screen time (time spent watching TV, or using a computer or mobile devices), dietary changes, and even relaxation techniques. Teens with hypertension should not smoke because it can make the long-term associated heart problems worse.
Spironolactone is a medication that has been used to treat high blood pressure since the 1960s. While there is some belief spironolactone reduces blood pressure, there are concerns due to the potential for this drug to cause adverse effects. The aim of this review was to determine the extent to which spironolactone reduces blood pressure, the nature of spironolactones adverse effect profile, and to determine the clinical impact of its use for hypertension. The search revealed 5 cross-over trials with a total of 137 patients that received both spironolactone followed by placebo or vice verse, in a random order. One other trial was found that randomly gave 42 patients either spironolactone (22 patients) or placebo (20 patients). The daily doses of spironolactone used in these studies ranged from 25-500 mg daily. Studies followed patients for 4 to 8 weeks of therapy. None of the studies reported on the clinical impact of spironolactone (i.e. whether spironolactone reduced heart attacks or strokes compared to placebo). Overall reporting of adverse effects was poor so no conclusions can be drawn about the adverse effect profile. This meta-analysis shows that spironolactone reduces systolic/diastolic blood pressure by approximately 20/7 mm Hg compared to placebo.
For example, if you have chest pain (angina), your doctor may recommend a beta blocker, which can lower your blood pressure and also prevent your chest pain, reduce your heart rate and decrease your risk of death. If you have diabetes and high blood pressure, taking a diuretic plus an ACE inhibitor can decrease your risk of a heart attack and stroke. If you have diabetes, high blood pressure and kidney disease, you may need an ACE inhibitor or an angiotensin II receptor blocker.

If your blood pressure reading is 180/120 or higher, wait about five minutes and retake your blood pressure. If you have two readings that are this high, but you aren’t having any other concerning symptoms such as chest pain, back pain, shortness of breath, change in vision, numbness/weakness, or difficulty speaking - you are experiencing hypertensive urgency.

James, P.A., Oparil, S., Carter, B.L., Cushman, W.C., Dennison-Himmelfarb, C., Handler, J., & Ortiz, E. (2013, December 18). 2014 evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the eighth joint national committee. Journal of the American Medical Association. Retrieved from http://jamanetwork.com/journals/jama/fullarticle/1791497


For example, in a hypertensive patient with asthma, it may be inadvisable to prescribe a beta blocker, as these drugs can aggravate that respiratory condition. Similarly, in patients prone to constipation (the elderly, for example) use of certain calcium channel blockers might best be avoided -- along with diuretics -- as both these classes of drugs can inhibit proper bowel function.
Beta-blockers cause the heart to slow down and so some of their side effects can be traced to that mechanism of action. Dizziness, weakness, fatigue, and fainting are possible. Beta-blockers also affect the respiratory system, so other side effects include shortness of breath, difficulty breathing, and chest pain. Beta-blockers should not be withdrawn suddenly, as that could result in a heart attack or sudden death.

Hydralazine has been used for the treatment of high blood pressure since the 1950's. It is believed that hydralazine reduces blood pressure, however there are concerns due to the potential for this drug to cause adverse effects. The aim of this review was to determine the extent to which hydralazine reduces blood pressure, the nature of hydralazines adverse effect profile, and to determine the clinical impact of its use for hypertension. Unfortunately, the search revealed no randomized controlled trials which compared hydralazine to placebo as monotherapy for primary hypertension, therefore we are unable to make firm conclusions regarding its effects on blood pressure, adverse effects, or clinical outcomes. Some of the adverse effects related to hydralazine and that have been reported in the literature include reflex tachycardia, hemolytic anemia, vasculitis, glomerulonephritis, and a lupus-like syndrome.
What is a normal blood pressure? Blood pressure is essential to life because it forces the blood around the body, delivering all the nutrients it needs. Here, we explain how to take your blood pressure, what the readings mean, and what counts as low, high, and normal. The article also offers some tips on how to maintain healthy blood pressure. Read now

Diuretics can lead to an increase in potassium loss, known as hypokalemia, which, in turn can affect muscular function -- including the muscles of the heart. There is also an increased risk for gout with diuretics -- as well as the possibility of weakness, thirst, dehydration, and increased urination. Changes in blood sugar levels are also possible. Skin reactions, some severe, are possible with thiazide diuretics (such as hydrochlorothiazide). Potassium-sparing diuretics, such as spironolactone (Aldactone) may cause breast enlargement in males.
Too much booze is known to raise blood pressure. But having just a little bit could do the opposite. Light to moderate drinking (defined as one drink or fewer per day) is associated with a lower risk for hypertension in women, according to research from Boston’s Brigham and Women’s Hospital. Moderate drinking could play a role in heart disease prevention too, studies show.
The kidneys produce renin when they detect low blood pressure. Renin stimulates the production of angiotensin I, a protein which is converted to angiotensin II by angiotensin-converting enzyme (ACE) in the lungs. Angiotensin II is a powerful constrictor of blood vessels, and constricting blood vessels increases blood pressure. Angiotensin II also causes the secretion of an additional blood pressure elevating hormone in the adrenal glands called aldosterone, which helps the body retain sodium. Aliskiren blocks the effects of renin and angiotensin so that blood pressure does not increase.

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Garlic: Garlic has long been thought to reduce hypertension. Studies show that garlic extract can lower blood pressure, although the optimal dose, frequency, and form are not well established. Garlic may produce this effect by acting directly on the kidneys to eliminate excess salt. It is considered a safe spice to consume, although it can cause some stomach upset. 
Everybody’s blood pressure goes up and down throughout the day. Walking to work, meditating, stressing about your Facebook feed, taking that sweet afternoon nap, and pounding a triple shot espresso all influence your blood pressure. There’s even a thing called “White Coat Hypertension” where people report higher than normal blood pressure readings due to the stress of just being in a doctor’s office with a cuff strapped to your arm. Blood pressure is a moving target. It’s not the end of the world if it spikes every now and then.
Electrocardiogram (ECG): This tests the heart's electrical activity. This test is more commonly used for patients at high risk of heart problems, such as hypertension and elevated cholesterol levels. The initial ECG is called a baseline. Subsequent ECGs may be compared with the baseline to reveal changes which may point to coronary artery disease or thickening of the heart wall.
A study shows that drinking 2 cups of a mix of three parts beetroot and one part apple juice can make your systolic blood pressure (the top number) go down in just a few hours. Men may see a bigger benefit than women. High systolic pressure can raise your chances of strokes. Cooked beets and beet greens, which pack lots of potassium, are a good alternative.
For most people, the first-choice medication for high blood pressure is a thiazide diuretic. For other people, a diuretic alone is not enough to control blood pressure. In these cases, a diuretic may be combined with a beta-blocker, ACE inhibitor, angiotensin II receptor blocker, or calcium channel blocker. Adding a second medication may lower your blood pressure more quickly than using a diuretic alone. Also, it allows you to take less of each medication, which may reduce side effects.
A long-term study concluded in 2014 found that people who ate more protein had a lower risk of high blood pressure. For those who ate an average of 100 grams of protein per day, there was a 40 percent lower risk of having high blood pressure than those on a low-protein diet (33). Those who also added regular fiber into their diet saw up to a 60 percent reduction of risk.
Obesity: As body weight increases, the blood pressure rises. Obesity is defined as having a body mass index (BMI) greater than 30 kg/m. A BMI of 25-30 kg/m is considered overweight (BMI=weight in pounds x 703/ height in inches). Being overweight increases the risk of high blood pressure. Healthcare professionals recommend that all individuals who are obese and have high blood pressure lose weight until they are within 15% of their healthy body weight.
The medical world experienced yet another guideline update in 2018 telling doctors more medication is better. This guideline for treating hypertension was put out by the American College of Cardiology and the American Heart Association, and effectively lowered the definition of hypertension from 140/90 down to 130/80. The organizations also recommended drug treatment for all individuals with blood pressure greater than 140/90, regardless of underlying risk.

While you shouldn't shrug off the change, there's also no need to panic. "Obviously, nothing happened overnight inside a woman's body or to her health with the release of the guidelines," says Dr. Naomi Fisher, director of hypertension service and hypertension innovation at the Brigham and Women's Hospital Division of Endocrinology, Diabetes, and Hypertension, and associate professor of medicine at Harvard Medical School.
In some cases, medication is necessary to lower blood pressure. It really depends on how high your blood pressure is and other risk factors, like family history of heart attack and stroke. Based on these risks and your current lifestyle, your doctor may prescribe common hypertension medications like lisinopril, amlodipine, losartan, and hydrochlorothiazide.
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