Let your doctor know if your treatment isn’t helping your blood pressure. You may have high blood pressure that is independent of an underlying medical condition. This type of high blood pressure is the most common type and is known as essential hypertension. Patients with essential hypertension will likely require lifelong medication to control it.


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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.
Medications used to lower blood pressure include diuretics (e.g., hydrochlorothiazide*), beta-blockers (e.g., atenolol, metoprolol), ACE inhibitors (e.g., ramipril, enalapril, lisinopril), calcium channel blockers (e.g., nifedipine, amlodipine), angiotensin II receptor blockers (e.g., losartan, valsartan), and direct renin inhibitors (e.g., aliskiren).
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The best evidence indicates that high blood pressure does not cause headaches or nosebleeds, except in the case of hypertensive crisis, a medical emergency when blood pressure is 180/120 mm Hg or higher. If your blood pressure is unusually high AND you have headache or nosebleed and are feeling unwell, wait five minutes and retest. If your reading remains at 180/120 mm Hg or higher, call 9-1-1.  
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Echocardiogram is an ultrasound examination of the heart It is used to evaluate the anatomy and the function of the heart. A cardiologist is required to interpret this test and can evaluate the heart muscle and determine how thick it is, whether it moves appropriately, and how efficiently it can push blood out to the rest of the body. The echocardiogram can also assess heart valves, looking for narrowing (stenosis) and leaking (insufficiency or regurgitation). A chest X-ray may be used as a screening test to look for heart size, the shape of the aorta, and to assess the lungs.
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. 
"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."
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.
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.
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.
A diet that’s low in fat and carbohydrates can improve artery function, according to a 2012 study by Johns Hopkins researchers. After six months, those on the low-carb diet had lost more weight, and at a faster pace. But in both groups, when weight was lost—and especially when belly fat shrank—the arteries were able to expand better, allowing blood to travel more freely. The study shows that you don’t have to cut out all dietary fat to shrink belly fat. For heart health, simply losing weight and exercising seems to be key. 
The sweet serves up flavanols that help lower blood pressure by relaxing blood vessels and boosting blood flow. On average, regular dark chocolate consumption could help lower your systolic blood pressure (the top number) by 5 points and your diastolic blood pressure (the bottom number) by almost 3 points, suggests an Australian analysis. How dark are we talking? Experts haven't been able to determine an ideal percentage of cocoa, says Vivian Mo, MD, Clinical Associate Professor of Medicine at the Keck School of Medicine of the University of Southern California. But the higher you go, the more benefits you'll get.
Hypertension is a common diagnosis in medical practice and is usually considered to bear a serious connotation. Arterial hypertension has been described as the most common and important of all types of heart diseases.1 Yet the levels which constitute abnormally high blood pressure at various ages have not been accurately determined. The various figures now in use—140, 150 or 160 mm. of mercury systolic and 90 to 100 mm. of mercury diastolic—are arbitrary, particularly when age is concerned. The observation that many persons with high blood pressure live to old age suggests that undue significance is frequently attached to the degree of hypertension.2
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.
Because of the need for emergency care, it is important to recognize the early signs of malignant hypertension. The first giveaway is blood pressure of 180/120. You might have bleeding in the eyes due to rupture of the small blood vessels. Other malignant hypertension symptoms can include chest pain, dizziness, a headache, numbness in your extremities, and confusion.
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