Women who are taking ACE inhibitors or ARBs for high blood pressure should not become pregnant while on this class of drugs. If you're taking an ACE inhibitor or an ARB and think you might be pregnant, see your doctor immediately. These drugs have been shown to be dangerous to both mother and baby during pregnancy. They can cause low blood pressure, severe kidney failure, excess potassium (hyperkalemia) and even death of the newborn.
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.
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.
In Europe hypertension occurs in about 30-45% of people as of 2013. In 1995 it was estimated that 43 million people (24% of the population) in the United States had hypertension or were taking antihypertensive medication. By 2004 this had increased to 29% and further to 32% (76 million US adults) by 2017. In 2017, with the change in definitions for hypertension, 46% of people in the United States are affected. African-American adults in the United States have among the highest rates of hypertension in the world at 44%. It is also more common in Filipino Americans and less common in US whites and Mexican Americans. Differences in hypertension rates are multifactorial and under study.
Many blood pressure medications, known as antihypertensives, are available by prescription to lower high blood pressure (HBP or hypertension). There are a variety of classes of high blood pressure medications and they include a number of different drugs. In the widget below, you will find an overview of the classes of blood pressure medication. To expand the information on a type of medication, simply click on the subject tab.
Hypertension is diagnosed on the basis of a persistently high resting blood pressure. The American Heart Association recommends at least three resting measurements on at least two separate health care visits. The UK National Institute for Health and Care Excellence recommends ambulatory blood pressure monitoring to confirm the diagnosis of hypertension if a clinic blood pressure is 140/90 mmHg or higher.
When your heart contracts and squeezes blood out into your network of arteries, the pressure inside those blood vessels is at its highest. This is called systolic pressure and it’s the top number on your blood pressure reading. In between beats, the heart relaxes and the pressure drops. This is your diastolic blood pressure, and it’s the reading’s bottom number.
^ Ostchega Y, Dillon CF, Hughes JP, Carroll M, Yoon S (July 2007). "Trends in hypertension prevalence, awareness, treatment, and control in older U.S. adults: data from the National Health and Nutrition Examination Survey 1988 to 2004". Journal of the American Geriatrics Society. 55 (7): 1056–65. doi:10.1111/j.1532-5415.2007.01215.x. PMID 17608879.
NHLBI Expert Panel on Cardiovascular Health and Risk Reduction in Children and Adolescents. We have supported the development of guidelines based on up-to-date research to evaluate and manage risk of heart disease in children and adolescents, including high blood pressure. Visit Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents for more information.
Serum creatinine is measured to assess for the presence of kidney disease, which can be either the cause or the result of hypertension. Serum creatinine alone may overestimate glomerular filtration rate and recent guidelines advocate the use of predictive equations such as the Modification of Diet in Renal Disease (MDRD) formula to estimate glomerular filtration rate (eGFR). eGFR can also provide a baseline measurement of kidney function that can be used to monitor for side effects of certain anti-hypertensive drugs on kidney function. Additionally, testing of urine samples for protein is used as a secondary indicator of kidney disease. Electrocardiogram (EKG/ECG) testing is done to check for evidence that the heart is under strain from high blood pressure. It may also show whether there is thickening of the heart muscle (left ventricular hypertrophy) or whether the heart has experienced a prior minor disturbance such as a silent heart attack. A chest X-ray or an echocardiogram may also be performed to look for signs of heart enlargement or damage to the heart.
Methyldopa, formerly known under the brand name Aldomet, is one of the oldest blood pressure medications still in use. It was first introduced more than 50 years ago. Methyldopa works in the central nervous system to lower blood pressure. While its general use has declined over the years, methyldopa is considered the first-line of treatment for high blood pressure that develops during pregnancy.
Be proactive and follow all medical advice received about how to manage hypertension. It is crucial to continue on any prescriptions given to treat hypertension. It is very dangerous to stop taking a medication for hypertension just because the symptoms seem to have lessened. Have frequent medical checkups and stay in touch with the doctor if any new symptoms arise.
^ Jump up to: a b Brook RD, Appel LJ, Rubenfire M, Ogedegbe G, Bisognano JD, Elliott WJ, Fuchs FD, Hughes JW, Lackland DT, Staffileno BA, Townsend RR, Rajagopalan S, American Heart Association Professional Education Committee of the Council for High Blood Pressure Research, Council on Cardiovascular and Stroke Nursing, Council on Epidemiology and Prevention, and Council on Nutrition, Physical, Activity (Jun 2013). "Beyond medications and diet: alternative approaches to lowering blood pressure: a scientific statement from the American Heart Association". Hypertension. 61 (6): 1360–83. doi:10.1161/HYP.0b013e318293645f. PMID 23608661.
Often, hypertension can improve with lifestyle changes. In some cases, high blood pressure can go down to normal levels with only lifestyle modifications, particularly if you have stage 1 hypertension (systolic blood pressure of 130 mmHg to 159 mmHg, or diastolic blood pressure 80 mmHg to 99 mmHg), or if you have elevated blood pressure (systolic blood of 120 mmHg to 129 mmHg and diastolic less than 80 mmHg).
Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71(19):e127-e248. PMID: 29146535 www.ncbi.nlm.nih.gov/pubmed/29146535.
^ Jump up to: a b Semlitsch, T; Jeitler, K; Berghold, A; Horvath, K; Posch, N; Poggenburg, S; Siebenhofer, A (2 March 2016). "Long-term effects of weight-reducing diets in people with hypertension". The Cochrane Database of Systematic Reviews. 3: CD008274. doi:10.1002/14651858.CD008274.pub3. PMID 26934541. Archived from the original on 23 March 2016. Retrieved 9 March 2016.
Recurrent headaches: Headaches are fairly common among people with or without hypertension. Some people with hypertension notice changes or worsening of headaches when medications are skipped or when the blood pressure becomes higher than usual. Headaches associated with hypertension can be mild, moderate, or severe and can be of a throbbing nature.
Physical changes: If something in your body changes, you may begin experiencing issues throughout your body. High blood pressure may be one of those issues. For example, it’s thought that changes in your kidney function due to aging may upset the body’s natural balance of salts and fluid. This change may cause your body’s blood pressure to increase.
Primary (or essential) hypertension is when the cause is unknown. The majority of hypertension cases are primary. When there is an underlying problem such as kidney disease or hormonal disorders that can cause hypertension, it is called secondary hypertension. When it is possible to correct the underlying cause, high blood pressure usually improves and may even return to normal.
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.
Hypertension is often considered a men’s health problem, but that’s a myth. Men and women in their 40s, 50s, and 60s have a similar level of risk for developing high blood pressure. But after the onset of menopause, women actually face higher risks than men of developing high blood pressure. Prior to age 45, men are slightly more likely to develop high blood pressure, but certain female health issues can change these odds.
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.
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.
Much of the disease burden of high blood pressure is experienced by people who are not labeled as hypertensive. Consequently, population strategies are required to reduce the consequences of high blood pressure and reduce the need for antihypertensive medications. Lifestyle changes are recommended to lower blood pressure, before starting medications. The 2004 British Hypertension Society guidelines proposed lifestyle changes consistent with those outlined by the US National High BP Education Program in 2002 for the primary prevention of hypertension: