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).

High blood pressure is usually caused by lifestyle factors as well as being genetically predisposed making up about 90-95% of cases hence being known as primary high pressure. Lifestyle factors can involve having excess sodium in the diet, high levels of body fat, smoking as well as alcohol. Secondary high blood pressure on the other hand is caused by an identifiable caused which is often time’s chronic kidney disease or even the use of birth control pills.
When you get a high blood pressure reading at the doctor's office, it might be tough for you to understand exactly what impact those numbers can make on your overall health, since high blood pressure has no unusual day-to-day symptoms. But the truth is, having high blood pressure is a serious health risk—it boosts the risks of leading killers such as heart attack and stroke, as well as aneurysms, cognitive decline, and kidney failure. What's more, high blood pressure is a primary or contributing cause of death in more than 1,000 deaths a day in the United States.
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 

Enlarged heart. High blood pressure increases the amount of work for your heart. Like any heavily exercised muscle in your body, your heart grows bigger (enlarges) to handle the extra workload. The bigger your heart is, the more it demands oxygen-rich blood but the less able it is to maintain proper blood flow. As a result, you feel weak and tired and are not able to exercise or perform physical activities. Without treatment, your heart failure will only get worse.
Beta-1 selective blockers are a subclass of beta blockers that are commonly used to treat high blood pressure. Drugs in this class include atenolol (Tenormin), metoprolol (Lopressor), nebivolol (Bystolic) and bisoprolol (Zebeta, Monocor). We developed a comprehensive methodology to examine how different doses and drugs in this class of drugs lower blood pressure.
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.
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.
According to the Centers for Disease Control and Prevention (CDC), an estimated 75 million Americans have high blood pressure. Many risk factors for high blood pressure are out of your control, such as age, family history, gender, and race. But there are also factors you can control, such as exercise and diet. A diet that can help control blood pressure is rich in potassium, magnesium, and fiber and lower in sodium.
She'll inflate the cuff to a pressure higher than your systolic blood pressure, and it will tighten around your arm. Then she'll release it. As the cuff deflates, the first sound she hears through the stethoscope is the systolic blood pressure. It sounds like a whooshing noise. The point where this noise goes away marks the diastolic blood pressure.
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.
Dr Jacomien de Villiers qualified as a specialist physician at the University of Pretoria in 1995. She worked at various clinics at the Department of Internal Medicine, Steve Biko Hospital, these include General Internal Medicine, Hypertension, Diabetes and Cardiology. She has run a private practice since 2001, as well as a consultant post at the Endocrine Clinic of Steve Biko Hospital.
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).
Pre-hypertension is when your systolic blood pressure is between 120 and 139 or your diastolic blood pressure is between 80 and 89 on multiple readings. If you have pre-hypertension, you are likely to develop high blood pressure at some point. Therefore, your doctor will recommend lifestyle changes to bring your blood pressure down to normal range.
"The recommendations are neither a policy nor a prescription for physicians," says Claude Lenfant, MD, director of the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health. "Nobody is advocating some sort of cookbook medicine. The physician will have to decide whether this medication or that medication is the best depending on many considerations."
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.
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:

Swearing off cigarettes is probably the single best thing you can do for your heart. It’s good for your health in general, too. Not only does smoke hurt you over the long term, but your blood pressure goes up every time you have a cigarette. Lower your blood pressure and prolong your life by quitting. If you need help getting started, talk to your doctor.

For a normal reading, your blood pressure needs to show a top number (systolic pressure) that’s between 90 and less than 120 and a bottom number (diastolic pressure) that’s between 60 and less than 80. The American Heart Association (AHA) considers blood pressure to be within the normal range when both your systolic and diastolic numbers are in these ranges.


Regular visits with your doctor are also key to controlling your blood pressure. If your blood pressure is well-controlled, check with your doctor about how often you need to check it. Your doctor may suggest checking it daily or less often. If you're making any changes in your medications or other treatments, your doctor may recommend you check your blood pressure starting two weeks after treatment changes and a week before your next appointment.
If you’re interested in working with a personal trainer but are concerned about the cost, Parker notes that trainers don’t have to be expensive. Some trainers offer group sessions that are cheaper than individual training sessions. College students getting degrees in kinesiology, the study of human movement or physical activity, also train people at reduced cost.
Blood tests may be done to assess risk factors for heart disease and stroke as well as looking for complications of hypertension. These include complete blood count (CBC), electrolytes, BUN (blood urea nitrogen), and creatinine and GFR (glomerular filtration rate) to measure kidney function. A fasting lipid profile will measure cholesterol and triglyceride levels in the blood. If appropriate, blood tests may be considered to look for an underlying cause of high blood pressure (secondary hypertension)including abnormal thyroid or adrenal gland function.
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.
Some examples of aerobic exercise you may try to lower blood pressure include walking, jogging, cycling, swimming or dancing. You can also try high-intensity interval training, which involves alternating short bursts of intense activity with subsequent recovery periods of lighter activity. Strength training also can help reduce blood pressure. Aim to include strength training exercises at least two days a week. Talk to your doctor about developing an exercise program.
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.
When you get a high blood pressure reading at the doctor's office, it might be tough for you to understand exactly what impact those numbers can make on your overall health, since high blood pressure has no unusual day-to-day symptoms. But the truth is, having high blood pressure is a serious health risk—it boosts the risks of leading killers such as heart attack and stroke, as well as aneurysms, cognitive decline, and kidney failure. What's more, high blood pressure is a primary or contributing cause of death in more than 1,000 deaths a day in the United States.
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. 

A little tomato on your menu could be the key to healthier blood pressure. In addition to boasting plenty of vitamin C and quercetin, tomatoes are a great source of lycopene, which researchers at Ben-Gurion University in Israel have linked to significant reductions in blood pressure. Just don’t try to get your fix from ketchup or bottled tomato sauce; the combination of sugar and salt in most recipes can send your blood sugar through the roof.
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.
An apple a day really does keep the doctor away, particularly for those struggling with high blood pressure. In addition to the 4.5 grams of blood pressure-lowering fiber you’ll get from each apple, you’ll also enjoy a healthy helping of quercetin, which has been deemed an effective antihypertensive, according to the results of a study conducted at the University Complutense of Madrid School of Medicine.

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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.
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.

Blood spots in the eyes : Blood spots in the eyes (subconjunctival hemorrhage) are more common in people with diabetes or high blood pressure, but neither condition causes the blood spots. Floaters in the eyes are also not related to high blood pressure. However, an eye doctor (ophthalmologist) may be able to detect damage to the optic nerve caused by untreated high blood pressure.   


Some high blood pressure medications initially cause drowsiness, dizziness, and lightheadedness. Some even cause fainting on the first dose. The body usually adjusts to the effects of these medications and the side effects disappear. Consuming alcohol during the early phase of antihypertensive treatment could be risky because alcohol can also cause dizziness, drowsiness, and lightheadedness.
Your blood pressure is said to be “high” when either your systolic blood pressure is 140 or above, or your diastolic blood pressure is 90 or above, or both. So if your blood pressure is found to be 142/88 (systolic = 142, diastolic = 88), you are diagnosed as having high blood pressure, according to current definitions. The same would be true if your blood pressure was found to be 135/92, or 152/95. In each case, either the systolic is high, or the diastolic is high, or both. Any of these findings result in a diagnosis of high blood pressure.
Blood pressure control is a lifelong challenge. Hypertension can progress through the years, and treatments that worked earlier in life may need to be adjusted over time. Blood pressure control may involve gradually making lifestyle changes like diet, weight loss, exercise, and possibly taking medicine if necessary. In some situations, medications may be recommended immediately. As with many diseases, you and your doctor should work together to find the treatment plan that works for you.
Many of us have had our blood pressure measured at the doctor but don’t really understand why it’s important. Find out why (and how) your doctor measures your blood pressure, what’s normal and what’s not, and what to do if you have high blood pressure.How is blood pressure measured?Blood pressure is measured using an instrument called a sphygmomanometer. It consists of an inflatable cuff, an inflating bulb, and a gauge to show the blood pressure.The cuff is wrapped around the upper arm, and inflated to a pressure which temporarily stops the blood from flowing through the brachial artery – the main blood vessel in your arm. At this point, the doctor will not be able to feel a pulse in the arm. The cuff pressure is then raised slightly above this point, and then slowly lowered.As the pressure is lowered, your doctor will listen through a stethoscope for the sound of blood starting to pulse through the brachial artery again. The pressure reading on the sphygmomanometer when the sound of blood is first heard pulsing through the artery is known as the systolic pressure. As the doctor continues to lower the pressure in the cuff, the sounds will disappear. Usually, the point at which the sounds disappear is known as the diastolic pressure.The systolic reading (the first number of the 2) indicates the pressure of blood within your arteries during a contraction of the left ventricle of the heart. The diastolic reading (the second number) indicates the pressure within the arteries when the heart is at rest. Blood pressure is measured in millimetres of mercury (mmHg), for example 120/80 mmHg (known as 120 over 80).What is normal blood pressure?According to the Heart Foundation of Australia, as a general guide:blood pressure below 120/80 mmHg can be classified as 'optimal';blood pressure between 120/80 and 129/84 mmHg is 'normal'; andblood pressure between 130/85 and 139/89 mmHg is classified as 'high-normal'.A person is defined by the Heart Foundation as having high blood pressure (hypertension) if they:have a systolic pressure greater than or equal to 140 mmHg; and/ora diastolic pressure greater than or equal to 90 mmHg.High blood pressure is further classified as mild, moderate or severe as the pressure increases above this level.Low blood pressure, or hypotension, is not as easy to define as it is usually relative to a person’s normal blood pressure reading, and varies between different people. It generally refers to a blood pressure below an average of about 90/60 mmHg.Getting an accurate readingAccording to the Heart Foundation, the diagnosis of high blood pressure should be based on multiple blood pressure measurements taken on separate occasions.It is recommended that you do not smoke or drink caffeine-containing drinks for 2 hours before having your blood pressure monitored, as this can cause an increase in your readings.Self-monitoring of blood pressure in your own environment (home blood pressure monitoring) or ambulatory monitoring of blood pressure is also used to help diagnose high blood pressure.For ambulatory blood pressure monitoring, you wear a portable automatic blood pressure machine for 24 hours while going about your usual daily routine. The portable monitor will measure your blood pressure multiple times during the 24 hours. Your doctor will ask you to record your activities over the 24 hours, plus any symptoms you experience (and when they occur). Variations in blood pressure are normal and may occur depending on where and when the blood pressure is taken.Some people who have raised blood pressure readings taken at the doctor’s surgery actually have acceptable levels outside the surgery, when under normal stress levels. This is known as ‘white-coat’ hypertension.There are also people with ‘reverse white-coat’ hypertension (also known as masked hypertension), who have normal blood pressure when measured in the clinic but high ambulatory blood pressure readings (those recorded during normal daily activities).Keeping on targetYour target blood pressure may vary according to whether you have other conditions that can increase your risk of cardiovascular (heart and blood vessel) disease or conditions that have been caused by high blood pressure.Raised blood pressure is a major risk factor for cardiovascular disease, and the higher your blood pressure, the greater your chance of having heart disease or stroke. For this reason it is important that you have your blood pressure monitored regularly, and that you always take any high blood pressure treatments that have been recommended, including medicines that have been prescribed.Hypertension can also be controlled to a large extent by lifestyle measures such as:losing excess weight;undertaking regular physical activity;quitting smoking; andchanging your diet (reducing your alcohol and salt intake, and following a healthy eating plan).These steps can help to lower your blood pressure and reduce your risk of cardiovascular disease. Last Reviewed: 8 February 2017
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.
Eat dark chocolate. Dark chocolate and cocoa powder are both full of heart-healthy plant compounds called flavonoids. Flavonoids are good for you because they cause your blood vessels to dilate, which can help lower blood pressure. Just make sure your chocolate doesn’t have too much sugar. Choose chocolate that is at least 70 percent dark for best results. You can buy individually wrapped chocolate pieces that are the perfect size. Eat one or two a day and enjoy the delicious heart-protective effects.
Note: The fasting and high blood pressure study described in this article was funded in part by a grant from the National Health Association. It was conducted at the Center for Conservative Therapy in Penngrove, California. The results appeared in the article, “Medically Supervised Water-Only Fasting in the Treatment of Hypertension,” published in June 2001 in the Journal of Manipulative and Physiological Therapeutics.
×