^ Jump up to: a b c Members, Authors/Task Force; Mancia, Giuseppe; Fagard, Robert; Narkiewicz, Krzysztof; Redon, Josep; Zanchetti, Alberto; Böhm, Michael; Christiaens, Thierry; Cifkova, Renata (13 June 2013). "2013 ESH/ESC Guidelines for the management of arterial hypertension". European Heart Journal. 34 (28): 2159–219. doi:10.1093/eurheartj/eht151. hdl:1854/LU-4127523. ISSN 0195-668X. PMID 23771844. Archived from the original on 27 January 2015.
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.
“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.
Medicines are available if these changes do not help control your blood pressure within 3 to 6 months. Diuretics help rid your body of water and sodium. ACE inhibitors block the enzyme that raises your blood pressure. Other types of medicines— beta blockers, calcium channel blockers, and other vasodilators—work in different ways, but their overall effect is to help relax and widen your blood vessels and reduce the pressure inside the vessel. [See also the free government publication “Medicines to Help You: High Blood Pressure” (PDF) from the US Food and Drug Administration.]
This cruciferous veggie is a good source of the blood pressure-regulating minerals magnesium, calcium, and potassium. In fact, high amounts of those three minerals is a telltale sign of many foods to lower blood pressure. Previous research in animals has found that a diet high in broccoli sprouts may help reduce blood pressure, cardiovascular disease, and stroke. Broccoli sprouts are high in compounds that may help reduce damage to arteries, which may play a role in high blood pressure.
A 2015 review of several studies found that restoring blood vitamin D levels by using supplements (more than 1,000 IU per day) reduced blood pressure in hypertensive individuals when they had existing vitamin D deficiency. The results also demonstrated a correlation of chronically low vitamin D levels with a higher chance of becoming hypertensive. Supplementation with vitamin D over 18 months in normotensive individuals with vitamin D deficiency did not significantly affect blood pressure.
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.
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.
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).