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.
6. Cultivate stress management. You don’t need a meta-analysis of cohort studies to prove stress can raise blood pressure, but they exist. You can’t eliminate stress, but you can minimize its impact. Research shows yoga and meditation create effective strategies to manage stress and blood pressure. If those aren’t your thing, consider other stress-relieving tactics including deep breathing or practicing mindfulness.
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 discussing blood pressure issues, the healthcare professional may ask questions about past medical history, family history, and medication use, including prescriptions, over-the-counter medications, herbal remedies, and food additives. Other questions may include lifestyle habits, including activity levels, smoking, alcohol consumption, and illegal drug use.
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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.
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. 
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.
Guanadrel (Hylorel)* or guanethidine (Ismelin)* may cause some diarrhea, which may persist in some people. This side effect usually becomes less of a problem if you continue treatment. These drugs reduce blood pressure more when you stand. Consequently, you may get dizzy and lightheaded and feel weak when you get out of bed in the morning or stand up suddenly. If you notice any of these reactions and if they persist for more than a minute or two, contact your doctor. He/she may instruct you to reduce or omit the next dose of the medication.
Exercise could be just as effective in lowering high blood pressure as prescribed medication. Researchers pooled data from nearly 400 trials and found that for people with high blood pressure, activity such as walking, swimming and simple weight training seemed to be just as good as most drugs used to treat it. However, the team warns people should not stop taking their medication until further studies are carried out.
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Another important step is to lose weight and maintain a healthy weight. Being overweight elevates your risk for high blood pressure and many other diseases and conditions. Losing just 5 percent of your body weight can have a significant positive impact on your blood pressure. Studies have shown that the combination of exercising and losing weight improves blood pressure numbers even more than either one alone. It may seem daunting to lose weight, but it is possible. Talk to your doctor about how other people have done it. And consider seeing a weight loss counselor too. You can do this! And after only a few pounds of healthy weight loss, you should start seeing your blood pressure numbers drop.
About This Image: Person receiving a blood pressure test. Medical research shows that as we age blood pressure rises slightly to accommodate an increased demand of oxygen and nutrients. It is completely natural for the first number (systolic) to be 100 plus our age. A recent study by a group of UCLA researchers came very close to corroborating Dr. Piette's guide for blood pressure of 100 plus your age for men, subtracting 10 for women, and this is after this rule had been in use for five or more decades. Are we now being taught that Dr. Piette's guide for blood pressure is wrong merely for drug company profit?
Exercise every day. Moderate exercise can lower your risk of high blood pressure. Set some goals so you can exercise safely and work your way up to exercising at least 30 minutes a day most days of the week. Check with your doctor before starting an exercise plan if you have any health problems that are not being treated. You can find more information about exercise and physical activity at Go4Life.
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.

“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.”

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.


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.
While the words “blood pressure-lowering diet” may conjure images of unseasoned egg whites and limp steamed veggies, getting your blood pressure into a healthy range is more than just doable —it can be downright delicious. Start by adding the Eat This, Not That!-approved list of blood pressure-lowering foods into your regular routine and watch your numbers go from scary to stellar in no time.
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.
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.

Reduce sodium in your diet. One easy way to reduce your sodium intake is to limit or avoid processed foods, such lunch meats, hot dogs, bacon, frozen dinners, canned vegetables with added salt, and that sort of thing. Most packaged convenience foods, like macaroni and cheese, soups, side dishes, pizzas, and other multi-ingredient foods have a lot of added sodium. Start reading labels and pay attention to the sodium content. You should aim for 1500mg or less every day.


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.
Do not attempt to lower extremely elevated blood pressure in yourself or someone else. While the goal is to reduce blood pressure before additional complications develop, blood pressure should be reduced over the course of hours to days, depending on severity. It is important not to lower blood pressure too quickly, because rapid blood pressure reductions can cut off the supply of blood to the brain, leading to brain damage or death.
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.
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.
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.

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. 

Up to 40% of patients taking clonidine (Catapres) will experience dry mouth and about a third will have drowsiness, headache, and sleepiness. Other common side effects include constipation, dizziness, and local skin reactions with use of the Catapres-TTS skin patch. Reserpine use is linked with possible side effects including nightmares, stuffy nose, depression, and an inability to fall asleep. Diarrhea and heartburn are also possible. Guanadrel and guanethidine can cause diarrhea and other gastrointestinal issues – as well as dizziness and drowsiness.

“Beware of the American Heart Association’s (AHA) 'Salty Six' — six popular foods that can add high levels of sodium to your diet,” says Rachel Johnson, PhD, a professor of nutrition at the University of Vermont in Burlington and the former chair of the AHA’s nutrition committee. The Salty Six include breads and rolls, cold cuts and cured meats, sandwiches, pizza, soup, and chicken.


Physical examination may include listening to the heart and lungs, feeling for pulse in the wrist and ankles, and feeling and listening to the abdomen looking for signs of an enlarged aorta. The examiner may also listen in the neck for carotid bruits (sounds made by a narrowed artery in the neck) and in the abdomen for bruits made by an abdominal aortic aneurysm.

Preeclampsia is a condition that affects about 5 to 8 percent of pregnant women. In the women it affects, it usually develops after 20 weeks of pregnancy. Rarely, this condition can occur earlier in pregnancy or even postpartum. The symptoms include high blood pressure, headaches, possible liver or kidney problems, and sometimes sudden weight gain and swelling.
Hi I am currently 9 months pregnant and today I got very hot and felt weak and had excessive sweating. My mom has a digital blood pressure cuff and during this I took it , which was 94/55 with a pulse of 90. It kind of freaked me out so I took another one a couple minutes later which was 105/50 with a pulse of 93. And last one I took was 107/55 with a pulse of 81. Does this sound normal for someone whose pregnant? I always thought high blood pressure was the issue not low. Just very curious, thanks.
There was a time when the high blood pressure medication list was very short indeed. In the 1950s, reserpine was one of the few products on the market to treat hypertension. It is rarely used due to its numerous side effects and drug interactions. The peripheral adrenergic inhibitors work in the brain to block signals that tell blood vessels to constrict. They are mostly used when other high blood pressure medications fail to solve the problem. Guanadrel (Hylorel), guanethidine monosulfate (Ismelin), and reserpine (Serpasil) are peripheral adrenergic inhibitors.
Not enough info for you? Geek out on blood pressure and hypertension with these studies and stats from the most trusted sources on the interwebs. And if you have any questions or you think we missed something important, leave a comment or book a consultation with me or one of these trained medical professionals and we’ll answer your questions and concerns in no time.

Most commonly high blood pressure causes no symptoms at all. This means that people with high blood pressure can be having damage occur to their heart, kidneys, eyes, and circulation without feeling badly! It is very important, therefore, to have blood pressure testing as part of the routine physical examination. However, in people with uncomplicated high blood pressure, they may experience
Half of American adults have this life-threatening condition, yet many are unaware or simply don’t take it seriously. But it doesn’t have to be that way. Hypertension is manageable and even preventable, but you have to know your risk factors and get your blood pressure checked (regularly!) to see if you’re at risk. Let’s take a closer look at what blood pressure actually is, how hypertension works, and how you can prevent the effects of high blood pressure to stave off heart disease.

Some of these drugs may decrease your body's supply of the mineral potassium. Symptoms such as weakness, leg cramps or being tired may result. Eating foods containing potassium may help prevent significant potassium loss. If your doctor recommends it, you could prevent potassium loss by taking a liquid or tablet that has potassium along with the diuretic. Diuretics such as amiloride (Midamar)*, spironolactone (Aldactone)* or triamterene (Dyrenium)* are called "potassium sparing" agents. They don't cause the body to lose potassium. They might be prescribed alone, but are usually used with another diuretic. Some of these combinations are Aldactazide*, Dyazide*, Maxzide* or Moduretic*.
7. Visit your chiropractor. A special chiropractic adjustment could significantly lower high blood pressure, a placebo-controlled study suggests. “This procedure has the effect of not one, but two blood–pressure medications given in combination,” study leader George Bakris, MD, told WebMD. Your chiropractor can create an effective protocol that helps normalize blood pressure without medication or other invasive procedures.
While a rising heart rate will increase blood flow through the body, it does not necessarily correspond with an increase in the pressure of that blood flow. This is because blood vessels can increase in size (dilate) to facilitate larger quantities of blood. Even if your heart rate were to double, your normal blood pressure & high pulse may only slightly increase blood pressure.

As you age, prevention becomes even more important. Systolic pressure tends to creep up once you’re older than 50, and it’s far more important in predicting the risk of coronary heart disease and other conditions. Certain health conditions, such as diabetes and kidney disease, may also play a role. Talk to your doctor about how you can manage your overall health to help prevent the onset of hypertension.
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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.
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.
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.
While medication can lower blood pressure, it may cause side effects such as leg cramps, dizziness, and insomnia. The good news is that most people can bring their numbers down naturally without drugs. “Lifestyle changes are an important part of prevention and treatment of high blood pressure,” says Brandie D. Williams, MD, FACC, a cardiologist at Texas Health Stephenville and Texas Health Physicians Group.
Partner with your doctor. Ask if there are any take steps you can take to lessen medication side effects. For example, to lessen the effects of low blood pressure, it may help to avoid standing for a long time in the sun. In some cases, side effects such as fatigue or diarrhea may subside with time. In other cases, your doctor may change the dosage or prescribe another high blood pressure medication. A combination of medications sometimes works better than one medication alone by not only improving high blood pressure control but also by reducing side effects.
It is well known that mean blood pressure levels tend to be low in non-westernized tribal peoples and that these levels tend to rise, particularly in the older age groups, among persons of the same origins who come into more contact with modern Western life-styles. That tendency can be attributed to many factors – increased salt intake, increased o...
‘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. 

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
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