A class of drugs called angiotensin receptor blockers (ARBs) is commonly used to lower high blood pressure. This class includes drugs such as losartan (brand name: Cozaar), candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), telmisartan (Micardis) and valsartan (Diovan). We asked how much this class of drugs lowers blood pressure and whether there is a difference between individual drugs within the class. The available scientific literature was searched to find all trials that had assessed these questions.

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.


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.
Eat potassium- and magnesium-rich foods. Potassium can help regulate your heart rate and can reduce the effect that sodium has on your blood pressure. Foods like bananas, melons, oranges, apricots, avocados, dairy, leafy green vegetables, tomatoes, potatoes, sweet potatoes, tuna, salmon, beans, nuts, and seeds have lots of potassium.  Magnesium is thought to help blood vessels relax, making it easier for blood to pass through. Foods rich in magnesium include vegetables, dairy, chicken, legumes, and whole grains. It’s better to get vitamins and minerals from food, and a heart-healthy diet like the one we described above is a good way to ensure you get plenty of nutrients. However, you may want to talk to your doctor about whether taking certain supplements might help your blood pressure.
The fact that there are so many drugs to choose from means at least two things. First, it means there is no “best” drug for hypertension, that is, there is no drug that works well for almost everyone without causing unacceptable adverse effects. If there were, drug companies would have stopped their efforts to develop new antihypertensive drugs long ago—and the list of approved drugs would be much shorter.
Consider once again the analogy of the garden hose. If you turn on the water “harder,” there is more pressure in the hose. Excessive salt in the diet can result in excessive fluid volume in the blood, which results in elevated blood pressure. This cause, too, is reversible, as a plant-based diet of whole, natural foods, devoid of added salt, is naturally low in sodium chloride.
Peter, I’ve been using a blood pressure meter for nearly 30 years, so my response is based on my personal experience and information I’ve acquired over the years. First, I suggest that you take your meter to the doctor and have them check several readings of your meter against theirs. For example, If your meter consistently shows it’s 10 points lower than the doctor’s, just delete the 10 points from your meter reading (have them check both numbers so you can adjust both as necessary). Also, it’s common that many doctor’s offices take your blood pressure incorrectly (you should actually sit still for 5 minutes, with your feet on the floor and the cuff at the same level as your heart) . Some of us have”white coat” hypertension, so you may always be elevated at the doctor’s office. If you are a large man, you (and your doctor’s office) may need to use a larger cuff as the wrong size of cuff can affect your reading. Also, I spoke with customer service at one of the companies that makes many of the home & professional meters, and she told me that the automated machines are not very accurate if you have kidney disease or heart failure (I have both). Ask the doctor’s staff to always use the manual system and it will be more accurate than those noisy automatic ones.
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.  
Start your day with a round of zesty pink grapefruit and see your blood pressure numbers shoot into a healthy range in no time. In addition to being an excellent source of blood pressure-lowering, immune-boosting vitamin C, pink grapefruit is a good source of lycopene, which multiple studies have deemed effective at reducing blood pressure. In fact, a Finnish study published in Neurology reveals that study subjects with the highest concentrations of lycopene in their blood decreased their risk of stroke by 55 percent.
Daily exercise: Being fit is a key part of blood pressure control. All kids with hypertension should exercise and play sports for 1 hour each day — with some activity (like jogging) most days and higher levels of activity (like running) 3 times a week. Usually, exercise is restricted only when hypertension is very severe. Kids with severe hypertension should not do any weight- or power-lifting, bodybuilding, or strength training until their blood pressure is under control and a doctor says it's OK.
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.

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. 


Anyone can develop hypotension, but certain groups of people are more likely to experience it, and there are different types. For instance, orthostatic (positional) hypotension, which occurs when you stand up after sitting or lying down, is more common in older adults. Typically, “your body has certain compensatory mechanisms to prevent your blood pressure from falling when you stand up,” explains Willie Lawrence, MD, an interventional cardiologist at Research Medical Center in Kansas City, Missouri, and a spokesperson for the American Heart Association. But, he adds, “orthostatic hypotension is a problem for some people because these reflexes that should occur, don’t occur.”
4. Cut down on processed food. Just about all processed foods contain huge amounts of fructose, particularly fruit drinks or any fruit-flavored products. Fructose is hidden all over the supermarket, even in the most unlikely places: processed meats, breads, pasta sauces and dressings. Fast food chains love fructose. The only thing they love more is vegetable oil.
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