Thiazide diuretics are a class of drugs commonly recommended as first-line treatment for raised blood pressure because they significantly reduce death, stroke and heart attacks. This class includes bendrofluazide, chlorthalidone, cyclopenthiazide, hydrochlorothiazide, indapamide and metolazone. We asked by how much does this class of drugs lower blood pressure and whether there is a difference between individual drugs within the class. We searched the available scientific literature to find all the trials that had assessed this question. The data included in this review was up to date as of February 2014.
Your total blood pressure reading is determined by measuring your systolic and diastolic blood pressures. Systolic blood pressure, the top number, measures the force your heart exerts on the walls of your arteries each time it beats. Diastolic blood pressure, the bottom number, measures the force your heart exerts on the walls of your arteries in between beats.
The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.
The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

In a hot tub, as the water comes through the pipes, it has a degree of force. This force is caused by the action of the pump, which puts energy into the circulating system and forces the water through the pipes. When the pump is off, there still may be water in the pipes, but there is no force. The degree of force in the system when the pump is on can be gauged in several ways, such as by putting your hand in front of a “jet.” Another way would be to have a device to measure the amount of force that the water exerts against the walls of the pipes as it circulates. Such a device might yield a numerical measurement of the force, or pressure, of the water within the pipes.
While eggs have had a checkered reputation in the past because of their cholesterol content, recent research suggests these protein powerhouses can actually help improve both your cholesterol and your blood pressure while keeping you satisfied. According to the American Journal of Hypertension, a high-protein diet, like one rich in eggs, can help lower blood pressure naturally while promoting weight loss, as well. Just make sure you’re not detracting from the health benefits of your egg-based breakfast by adding the wrong condiments; the sugar in ketchup and high salt content of hot sauce may reduce your protein-rich meal’s blood pressure-lowering effects.
Editor’s Note: Considerable controversy exists about whether fat or cholesterol are, per se, drivers of atherosclerosis. They are implicated in some studies, while others indicate that quality of fat, and placement in a wider dietary pattern, may be more significant to ultimate impact. What seems clear, however, is that a diet high in animal products, sugar, and processed foods is often a recipe for high blood pressure and heart disease.
Some heart attacks are sudden and intense, however most heart attacks start slowly with mild pain and discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain. Shortness of breath may occur, as well as nausea, or lightheadedness. It is vital to get help immediately if any of these symptoms occur.
In addition to medications your doctor may prescribe, there are several lifestyle changes you can make to help to lower your blood pressure. These include things like eating a healthy diet, maintaining a regular exercise routine, quitting smoking and limiting your alcohol intake. Here are five more blood pressure-reducing techniques that don’t require a prescription:
This technique is known to surprisingly few health professionals, though it has proved valuable in the treatment of a wide variety of health problems. Recently, this powerful technique has been shown to be an extremely effective method for allowing the body to rapidly normalize high blood pressure more effectively than any other treatment reported in the scientific literature.
Americans eat far too much dietary sodium, up to three times the recommended total amount, which is 1,500 milligrams (mg) daily for individuals with high blood pressure, says Dr. Fisher. It doesn't take much sodium to reach that 1,500-mg daily cap — just 3/4 of a teaspoon of salt. There's half of that amount of sodium in one Egg McMuffin breakfast sandwich. Weed out high-sodium foods by reading labels carefully. "It is very difficult to lower dietary sodium without reading labels, unless you prepare all of your own food," says Dr. Fisher. Beware in particular of what the American Heart Association has dubbed the "salty six," common foods where high amounts of sodium may be lurking:
Your doctor may recommend the Dietary Approaches to Stop Hypertension (DASH) diet, which focuses on fruits, vegetables, and whole grains, as well as fat-free or lowfat dairy products, fish, poultry, beans, nuts, and vegetable oils. The DASH plan also limits foods high in saturated fats, including fatty meats, full-fat dairy products, and tropical oils, like coconut and palm oils, as well as sugary drinks and other sweets. (5)
In general, lower doses of blood pressure medicine are as effective as higher doses and cause fewer side effects. So, when trying to find effective single-drug therapy, doctors usually begin with a low dose. They may decide to increase the dose a bit if the initial dose is ineffective—but it is rarely useful to “push” the dose of a single-drug therapy into the higher dosage ranges. Instead, if a drug fails to work at a relatively low dose, it is time to switch to a low dose of a different drug.
While fatty foods may seem like they have no place in a high blood pressure-fighting meal plan, fatty fish like salmon are a major exception to that rule. Salmon is loaded with heart-healthy omega-3 fatty acids, which can help reduce inflammation, lower your risk of heart disease, and get your blood pressure into a healthy range. Research published in the June 2012 edition of the British Journal of Nutrition reveals that omega-3 supplementation reduced blood pressure among older patients and those with hypertension, making this tasty protein-rich fish a must-eat for anyone whose blood pressure has crept into a concerning range.
Blood pressure is the force of blood pushing against the walls of arteries. When the doctor measures your blood pressure, the results are given in two numbers. The first number, called systolic blood pressure, is the pressure caused by your heart contracting and pushing out blood. The second number, called diastolic blood pressure, is the pressure when your heart relaxes and fills with blood. Your blood pressure reading is usually given as the systolic blood pressure number over the diastolic blood pressure number, such as 138/72. Normal blood pressure for adults is defined as a systolic pressure of less than 120 and a diastolic pressure of less than 80. This is stated as 120/80.
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The fact that there are so many drugs to choose from means at least two things. First, it means there is no “best” drug for hypertension, that is, there is no drug that works well for almost everyone without causing unacceptable adverse effects. If there were, drug companies would have stopped their efforts to develop new antihypertensive drugs long ago—and the list of approved drugs would be much shorter.
The flagged medications, which include amlodipine/valsartan and amlodipine/valsartan/hydrochlorothiazide combination tablets, contain a potentially dangerous ingredient called N-nitroso-diethylamine (NDEA). The organic chemical is a known animal carcinogen and a suspected human carcinogen, according to the FDA. It can also be toxic to the liver and other organs. 
If these lifestyle changes don't lower your blood pressure to a safe level, your doctor will also prescribe medicine. You may try several kinds or combinations of medicines before finding a plan that works best for you. Medicine can control your blood pressure, but it can't cure it. You will likely need to take medicine for the rest of your life. Plan with your doctor how to manage your blood pressure.
If you have hypertension, ask your doctor if OSA could be behind it. (In addition to loud snoring, common symptoms include excessive daytime tiredness and early morning headaches.) Getting your sleep apnea under control could be helpful for improving your blood pressure, says Robert Greenfield, MD, Medical Director of Non-Invasive Cardiology & Cardiac Rehabilitation at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in Fountain Valley, CA.
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3. Implement strategies to lower inflammation. Several cross-sectional and longitudinal studies connect high blood pressure with chronic inflammation, a driving force for nearly every disease on the planet. Lowering inflammation starts with what you put on your fork. Focus on anti-inflammatory foods like wild-caught seafood (rich in omega-3 fatty acids), freshly ground flax and chia seeds, spices like turmeric, and plenty of colorful plant foods. Good sleep, stress management, exercise, and the right nutrients can also help lower inflammation.
If you had previously been diagnosed with high blood pressure, the new guidelines don't affect you too much, says Dr. Conlin, as you still need to continue your efforts to lower it through medication, diet, exercise, and weight loss. "However, based on new information in the guidelines, your doctor may propose treating your blood pressure to a lower level," he says.
According to the American College of Cardiology and the American Heart Association, the goal of blood pressure treatment is to attain a blood pressure reading that's less than 130/80 mmHg systolic and less than 80mmHg diastolic. In general, if you have hypertension, it is likely that you will need to be treated for the duration of your life to maintain this target blood pressure. 
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
Fifteen natural ways to lower your blood pressure High blood pressure can damage the heart. It is common, affecting one in three people in the U.S. and 1 billion people worldwide. We describe why stress, sodium, and sugar can raise blood pressure and why berries, dark chocolate, and certain supplements may help to lower it. Learn about these factors and more here. Read now
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.
Consider once again the analogy of the garden hose. If you turn on the water “harder,” there is more pressure in the hose. Excessive salt in the diet can result in excessive fluid volume in the blood, which results in elevated blood pressure. This cause, too, is reversible, as a plant-based diet of whole, natural foods, devoid of added salt, is naturally low in sodium chloride.
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.
Why stress happens and how to manage it Stress is essential for survival; the chemicals it triggers help the body prepare to face danger and cope with difficulty. Long-term stress is linked to various health conditions and can cause physical and psychological symptoms. How is it diagnosed, what types of stress are there, and how is it treated or managed? Read now

Fish are a great source of lean protein. Fatty fish like mackerel and salmon are high in omega-3 fatty acids, which can lower blood pressure, reduce inflammation, and lower triglycerides. In addition to these fish sources, trout contains vitamin D. Foods rarely contain vitamin D, and this hormone-like vitamin has properties that can lower blood pressure.
Don’t get too excited. Turns out that dark chocolate (at least 50% to 70% cocoa) can give you a boost of a plant compound called flavanol. As with garlic, this antioxidant can raise your nitric oxide levels and widen blood vessels. That can make your blood pressure drop a notch. It goes without saying that a little bit of chocolate is all you need.
As mentioned earlier, blood pressure increases with age, beginning from infancy to older adulthood. Since most healthy babies and children are typically not at risk for blood pressure problems, most doctors do not check their blood pressure routinely. But, the normal BP range for all adults, regardless of their age, is considered to be lesser than 120/80.
‘White coat syndrome’ refers to elevated blood pressure due to nervousness or anxiety when clients have their blood pressure taken by a healthcare provider. This occurs in approximately 20% of clients. Key message: have the client take their blood pressure at home with an automatic home blood pressure cuff and compare the findings. Alternatively, you can ask the client to sit quietly and leave the room while an automatic cuff takes a client’s blood pressure. The automatic cuff can be programmed to take three measurements and the blood pressure documented is an average of the three readings.

These drugs block the effects of angiotensin, a chemical that causes the arteries to become narrow. Angiotensin needs a receptor- like a chemical "slot" to fit into or bind with- in order to constrict the blood vessel. ARBs block the receptors so the angiotensin fails to constrict the blood vessel. This means blood vessels stay open and blood pressure is reduced.
You can have high blood pressure, or hypertension, and still feel just fine. That's because high blood pressure often does not cause signs of illness that you can see or feel. But, high blood pressure, sometimes called "the silent killer," is very common in older people and a major health problem. If high blood pressure isn't controlled with lifestyle changes and medicine, it can lead to stroke, heart disease, eye problems, kidney failure, and other health problems. High blood pressure can also cause shortness of breath during light physical activity or exercise.
As for when to check your blood pressure, the most important thing is to do it consistently the same time of the day (ask the doctor which time he prefers and also what time in relation to taking your medication). The following article has a lot of good information for someone just starting to monitor their blood pressure: https://www.drugs.com/cg/how-to-take-a-blood-pressure.html
Blood pressure is measured both when the heart is actually beating (systolic pressure – the first measurement) and between beats (the resting rate, or diastolic pressure – the second measurement). It is given as two figures, eg 120/80. A device called a sphygmomanometer is used. An inflatable cuff is wrapped around your upper arm. When inflated the cuff stops the blood flow in the main blood vessel in your arm. The nurse then watches a gauge in the sphygmomanometer and listens through a stethoscope as the air in the cuff is released. When the first sound of the heartbeat is heard, the systolic pressure is recorded. When the sound disappears, the diastolic pressure is recorded. Sometimes a computerised blood pressure machine is used to take the readings automatically.
The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content. 

If your blood pressure reading is 180/120 or higher and you’re experiencing symptoms such as shortness of breath, back pain, chest pain, numbness/weakness, change in vision, or difficulty speaking - you’re having a hypertensive emergency and need to seek emergency medical attention. Do not wait to see if your blood pressure improves. Call 911 or head to the nearest emergency room. To treat this serious condition, doctors may give you blood pressure medications intravenously (IV),  or other treatments aimed to decrease your risk of long-term effects.
Alpha methyldopa (Aldomet)* may produce a greater drop in blood pressure when you're in an upright position (standing or walking), and it may make you feel weak or faint if the pressure has been lowered too far. This drug may also cause drowsiness or sluggishness, dryness of the mouth, fever or anemia. Male patients may experience impotence. If this side effect persists, your doctor may have to change the drug dosage or use another medication.
Hypertension, or high blood pressure, refers to the pressure of blood against your artery walls. Over time, high blood pressure can cause blood vessel damage that leads to heart disease, kidney disease, stroke, and other problems. Hypertension is sometimes called the silent killer because it produces no symptoms and can go unnoticed — and untreated — for years.
Hypertension in African-Americans tends to occur earlier in life and tends to be more severe. Plus, some medications that work to lower blood pressure in other ethnicities may have limited effect on African-Americans. Thiazide diuretics (such as HCTZ) or a calcium channel blocker are recommended first choices along with the possible add-on of a second drug from either the ACE inhibitor class or the angiotensin II receptor blocker group.
Beta blockers are medications that block norepinephrine and epinephrine (adrenaline) from binding to both beta 1 and beta 2 receptors on organs and muscles, including the muscles surrounding blood vessels that cause the blood vessels to narrow and the heart to beat. By blocking the effect of norepinephrine and epinephrine, beta blockers reduce blood pressure by dilating blood vessels and reducing heart rate. They also may constrict air passages because stimulation of beta receptors in the lung cause the muscles that surround the air passages to contract.
Determining the normal blood pressure range in children is a little complicated, and it all depends on the size and age of the child. One rule of thumb that doctors use to determine BP troubles in children is that, a child is considered to be suffering from Prehypertension. If he/she has a blood pressure higher than that of 90% of the children of the same age and size. The child is said to have hypertension if he/she has a blood pressure higher than that of 95% of the children of the same age and size.
Pregnant women with very high blood pressure (hypertension) can reduce their blood pressure with antihypertensive drugs, but the most effective antihypertensive drug during pregnancy is unknown. The aim of antihypertensive therapy is to lower blood pressure quickly but safely for both the mother and her baby, avoiding sudden drops in blood pressure that can cause dizziness or fetal distress.
With age, comes an increased risk for systolic hypertension which can be aggravated by severe atherosclerosis. According to one study, the diuretic chlorthalidone (Hygroton) had significant benefit in elderly patients with systolic hypertension. Along with a diuretic, some calcium channel blockers, ACE inhibitors and angiotensin II receptor blockers may also be good choices. However, beta blockers may not be as effective for hypertension in those over 60; though they may be good choices if co-existing heart disease is present. It also may be preferable in elderly patients to give two high blood pressure medications at a low dose versus one at a higher dose.
Peter, I’ve been using a blood pressure meter for nearly 30 years, so my response is based on my personal experience and information I’ve acquired over the years. First, I suggest that you take your meter to the doctor and have them check several readings of your meter against theirs. For example, If your meter consistently shows it’s 10 points lower than the doctor’s, just delete the 10 points from your meter reading (have them check both numbers so you can adjust both as necessary). Also, it’s common that many doctor’s offices take your blood pressure incorrectly (you should actually sit still for 5 minutes, with your feet on the floor and the cuff at the same level as your heart) . Some of us have”white coat” hypertension, so you may always be elevated at the doctor’s office. If you are a large man, you (and your doctor’s office) may need to use a larger cuff as the wrong size of cuff can affect your reading. Also, I spoke with customer service at one of the companies that makes many of the home & professional meters, and she told me that the automated machines are not very accurate if you have kidney disease or heart failure (I have both). Ask the doctor’s staff to always use the manual system and it will be more accurate than those noisy automatic ones.

However, sometimes a high reading can occur temporarily and then your numbers will return to normal. If your blood pressure measures at this level, your doctor will likely take a second reading after a few minutes have passed. A second high reading indicates that you’ll need treatment either as soon as possible or immediately depending on whether or not you have any of the symptoms described above.


One drink counts as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of spirits. "High levels of alcohol are clearly detrimental," says Obarzanek. "But moderate alcohol is protective of the heart. If you are going to drink, drink moderately." (And if you're trying to keep your weight in check, stick to these low-calorie alcoholic drinks recommended by registered dietitians.)
Blood pressure readings fall into four general categories, ranging from normal to stage 2 high blood pressure (hypertension). The level of your blood pressure determines what kind of treatment you may need. To get an accurate blood pressure measurement, your doctor should evaluate your readings based on the average of two or more blood pressure readings at three or more office visits.

One side effect of diuretics is a loss of potassium, which is carried out of the body in urine along with the sodium. Potassium is needed for proper muscular movement and a deficiency of this mineral can result in fatigue, weakness, leg cramps, and even problems with the heart. So often, patients on traditional diuretics will be advised to take their medication with a potassium-rich food, such as orange juice or a banana, or they'll be prescribed a potassium supplement.
Anyone can develop hypotension, but certain groups of people are more likely to experience it, and there are different types. For instance, orthostatic (positional) hypotension, which occurs when you stand up after sitting or lying down, is more common in older adults. Typically, “your body has certain compensatory mechanisms to prevent your blood pressure from falling when you stand up,” explains Willie Lawrence, MD, an interventional cardiologist at Research Medical Center in Kansas City, Missouri, and a spokesperson for the American Heart Association. But, he adds, “orthostatic hypotension is a problem for some people because these reflexes that should occur, don’t occur.”
However, sometimes a high reading can occur temporarily and then your numbers will return to normal. If your blood pressure measures at this level, your doctor will likely take a second reading after a few minutes have passed. A second high reading indicates that you’ll need treatment either as soon as possible or immediately depending on whether or not you have any of the symptoms described above.
In “guessing” on the best initial single drug to try, most experts now recommend beginning either with either a thiazide diuretic (usually chlorthalidone or hydrochlorothiazide), a long-acting calcium blocker, or an ACE inhibitor. ARBs are generally thought of as substitutes for ACE inhibitors, and generally, are used only when ACE inhibitors are poorly tolerated.
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Other exercise options that don’t require a gym membership include body weight exercises, like pushups, squats, and jumping jacks. These exercises can be done at home or outside. For people who like going to the gym or running, these can be good ways to build community, notes Parker. Apps like Fitbit and MapMyRun can be helpful if you like keeping track of your steps, calories burned, weight, or number of miles run.
Don’t get too excited. Turns out that dark chocolate (at least 50% to 70% cocoa) can give you a boost of a plant compound called flavanol. As with garlic, this antioxidant can raise your nitric oxide levels and widen blood vessels. That can make your blood pressure drop a notch. It goes without saying that a little bit of chocolate is all you need.
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