ACE (angiotensin converting enzyme) inhibitors are another class of antihypertensive drugs. They reduce the body's levels of angiotensin II, a substance that narrows blood vessels. This means that arteries are more open (dilated) and the blood pressure is lower. ACE inhibitors can be used alone, or with other medications such as diuretics. Side effects of ACE inhibitors can include skin rash, dry cough, dizziness, and elevated potassium levels. Women who are pregnant, planning to get pregnant, or breastfeeding should not take ACE inhibitors.
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.
Being overweight increases the risk of getting hypertension and increases the workload required of your heart. Diets designed to control blood pressure are often designed to reduce calories as well. Most of these diets require decreasing consumption of fatty foods and sugars while increasing your intake of lean protein, fiber, fruits, and vegetables. A weight loss of just 10 pounds can make a significant difference in your blood pressure.
Not only the degree of obesity is important, but also the manner in which the body accumulates extra fat. Some people gain weight around their belly (central obesity or "apple-shaped" people), while others store fat around their hips and thighs ("pear-shaped" people). "Apple-shaped" people tend to have greater health risks for high blood pressure than "pear-shaped" people.
Vasovagal syncope can be treated with several types of drugs such as beta blockers, for example, propanolol (Inderal, Inderal LA) and selective serotonin reuptake inhibitors such as fluoxetine (Prozac), escitalopram oxalate (Lexapro), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa), and fluvoxamine (Luvox). Fludrocortisone (Florinef) (a drug that prevents dehydration by causing the kidney(s) to retain water) also may be used. A pacemaker can also be helpful when a patient fails drug therapy.
Historically the treatment for what was called the "hard pulse disease" consisted in reducing the quantity of blood by bloodletting or the application of leeches. This was advocated by The Yellow Emperor of China, Cornelius Celsus, Galen, and Hippocrates. The therapeutic approach for the treatment of hard pulse disease included changes in lifestyle (staying away from anger and sexual intercourse) and dietary program for patients (avoiding the consumption of wine, meat, and pastries, reducing the volume of food in a meal, maintaining a low-energy diet and the dietary usage of spinach and vinegar).
The NHLBI is part of the U.S. Department of Health and Human Services’ National Institutes of Health (NIH)—the Nation’s biomedical research agency that makes important scientific discovery to improve health and save lives. We are committed to advancing science and translating discoveries into clinical practice to promote the prevention and treatment of heart, lung, blood, and sleep disorders, including high blood pressure. Learn about the current and future NHLBI efforts to improve health through research and scientific discovery.
There are even more medication types that can lower blood pressure. Some of these are alpha blockers, vasodilators, and central alpha agonists. Your doctor may prescribe these medications if other medications have been ineffective or if you have another condition along with hypertension. Side effects can include fast pulse, palpitations, dizziness, diarrhea, or headaches.
Lastly, we conduct statewide outreach to health care organizations. We make and distribute a suite of materials available to encourage accurate and consistent blood pressure self-management in English, Spanish, Russian, Chinese and Vietnamese. We also work closely with Washington Information Network 211 so people can call or search online for places to get their blood pressure checked nearby.
In the 19th and 20th centuries, before effective pharmacological treatment for hypertension became possible, three treatment modalities were used, all with numerous side-effects: strict sodium restriction (for example the rice diet), sympathectomy (surgical ablation of parts of the sympathetic nervous system), and pyrogen therapy (injection of substances that caused a fever, indirectly reducing blood pressure).
For example, a 2015 study known as the SPRINT trial found that patients who lowered their systolic blood pressure to around 120 mm Hg were 27 percent less likely to die during the study period, compared with those whose treatment target was to lower their blood pressure to less than 140 mm Hg. (The SPRINT study made headlines in 2015 when the trial was abruptly cut short because the findings were so significant.)
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When blood pressure is measured, there are two numbers for each reading: for example, "120 over 80" is written as 120/80. This is because each heartbeat sends a pressure wave through the bloodstream. The higher number (systolic blood pressure) is the peak of the wave, when your heart contracts (the loud "thump" when you listen to your heartbeat). The lower number (diastolic blood pressure) is the lower "dip" or trough of the wave, when your heart relaxes.