"The implications and potential benefits of such healthier lifestyles could be great, particularly since about 22% of the adult population falls into the prehypertensive category," says Chobanian, who is also dean of the Boston University School of Medicine. "In fact, the blood pressure effects of weight reduction or adoption of the DASH eating plan can be comparable to those achieved with any single blood pressure medication."

Dairy or soy—it’s your choice. Replacing some of the refined carbohydrates in your diet with foods high in soy or milk protein (like tofu or low-fat dairy) can bring down systolic blood pressure if you have hypertension or prehypertension, findings suggest. "Some patients get inflammation from refined carbohydrates, which will increase blood pressure," says Matthew J. Budoff, MD, FACC, Professor of Medicine at the David Geffen School of Medicine and Director of Cardiac CT at the Division of Cardiology at the Harbor-UCLA Medical Center.

It’s important to determine whether your low blood pressure is “a primary problem or secondary problem,” notes Lawrence. A primary problem means that the body’s reflexes are not working as they should. Secondary causes mean that the low blood pressure is a result of things like dehydration or the effects of certain medications. “Some anti-hypertensive [medications] are more likely to cause hypotension than others, and a lot of it is dose-dependent,” says Lawrence. “In most people, there will be some easily identifiable secondary cause, or some easy solution to what may even be a chronic problem that has no secondary cause, and that’s why it’s important to see your doctor, so they can make an appropriate assessment.”

SOURCES: The Journal of the American Medical Association, May 21, 2003. Aram Chobanian, MD, dean, Boston University School of Medicine and chair of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Claude Lenfant, MD, director of the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health. Edward Roccella, PhD, MPH, coordinator of the National High Blood Pressure Education Program at NHLBI. John Laragh, MD, Cardiovascular Hypertension Center at New York Hospital/Cornell University Medical Center and editor-in-chief of the American Journal of Hypertension. WebMD Medical News: "Diuretics Best for High Blood Pressure."
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).
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.

“Stopping the blood pressure medication immediately can cause your blood pressure to increase. When your blood pressure increases, it can put a lot of strain on a lot of different organs,” said Anant Mandawat, a cardiac oncologist at Emory Healthcare. The American Heart Association concurs. A statement on its website warns ““DO NOT stop taking your medicine without contacting your doctor.”


Unlike the smooth action of the hot tub pump, the human heart expands and contracts mightily each second or so, causing your blood pressure to be comparatively high one moment, and comparatively low in the next. That is why we need two measurements when checking your blood pressure: one at the moment when the pressure is highest (your systolic blood pressure), and one a moment later, when the pressure is lowest (your diastolic 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.
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.

A class of drugs called angiotensin receptor blockers (ARBs) is commonly used to lower high blood pressure. This class includes drugs such as losartan (brand name: Cozaar), candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), telmisartan (Micardis) and valsartan (Diovan). We asked how much this class of drugs lowers blood pressure and whether there is a difference between individual drugs within the class. The available scientific literature was searched to find all trials that had assessed these questions.
Angiotensin II receptor blockers (ARBs) are medications used to treat elevated blood pressure, or hypertension. These medications that block the action of angiotensin II by preventing angiotensin II from binding to angiotensin II receptors on the muscles surrounding blood vessels. As a result, blood vessels enlarge (dilate), and blood pressure is reduced. Reduced blood pressure makes it easier for the heart to pump blood and can improve heart failure. In addition, the progression of kidney disease due to high blood pressure or diabetes is slowed. ARBs have effects similar to ACE inhibitors, but ACE inhibitors act by preventing the formation of angiotensin II rather than by blocking the binding of angiotensin II to muscles on blood vessels.
Diuretics are among the oldest known medications for treating high blood pressure. They work in the tiny tubes (tubules) of the kidneys to promote the removal of salt from the body. Water (fluid) also is removed along with the salt; however, the exact mechanism whereby diuretics lower blood pressure is not clearly known. The leading theory is that they directly cause the muscles surrounding blood vessels to relax. Diuretics may be used alone for high blood pressure. More frequently, however, low doses of diuretics are used in combination with other medications for high blood pressure to enhance the effect of the other medications.
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.

In most cases, the goal of treatment is to bring down the systolic pressure to less than 140 mm Hg and the diastolic pressure to less than 90 mm Hg. For people with diabetes, target blood pressure goals are lower (e.g., less than 130/80 mm Hg). For some people are who at high risk of cardiovascular complications such as stroke or heart attack, your doctor may recommend a systolic pressure target of less than 120 mm Hg. Your doctor will determine the most appropriate goal for you.
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.

According to the CDC, a whopping 75 million Americans—that’s nearly 1/3 of the adult population—are struggling with high blood pressure, increasing their risk of heart attack, stroke, and other life-altering health consequences along the way. Skipping the salt and squeezing in some regular workouts can help keep your blood pressure from reaching dangerous levels, but it takes a more proactive approach to keep your blood pressure under control in the long run.
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.
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