|1. Lifestyle Modification
Lifestyle modification is important for prevention of hypertension and can be used as treatment for people with high normal blood pressure or people with stage 1 hypertension who have a low risk for heart disease. Lifestyle changes include weight reduction; if the person is overweight, alcohol intake should be limited to no more than 720 ml of beer, 300 ml of wine, or 60 ml of 100 proof whisky per day. For women and people without a weight problem the numbers should be halved. In addition, regular aerobic physical activity such as walking briskly for 30 to 45 minutes several times a week helps reduce blood pressure. Limiting sodium or table salt to 2.4 grams per days can also help reduce blood pressure.
Cigarette smoking increases the risk for cardiac disease. Blood pressure rises with each cigarette that is smoked. Quitting smoking can significantly reduce blood pressure. Having healthy eating habits can reduce your risk for heart disease, and if you need to be on medication, eating a well-balanced diet will help keep your medication dose low.
Lifestyle modification should be attempted for at least 6 to 12 months. After that, drug therapy with medications may be initiated if goals are not met. In some cases, medications may be initiated first, and depending upon how high the blood pressure is, additional risk factors for cardiovascular disease and the presence of other organ damage. For example, the target blood pressure level for people with diabetes is 130/80 mm Hg.
|3. Self-measurement of blood pressure
Measuring your own blood pressure at home could give an accurate blood pressure reading as some people become very anxious when they visit the health care professional and their blood pressure is elevated because of the stress. This is known as "white coat hypertension." If you are on medication, measuring your own blood pressure can help determine your response to the medication. This will let you know whether your dose is appropriate or if it needs adjustment. Although the sphygmomanometer is the most reliable method for measuring blood pressure, there are many personal home monitors that make measuring blood pressure convenient . It is important to follow the manufacturer's instructions for optimal results. The blood pressure cuff should be of appropriate size and the batteries should be checked frequently. Although home monitors can be of valuable assistance, it is still most important to see your physician for appropriate follow-up.
Controlling blood pressure with medications clearly decreases your risk of heart disease, kidney disease and stroke. Many kinds of medication are available now, and most of these agents can be taken once a day to help control blood pressure. Initially, the drug should be started at the lowest dose possible to help prevent adverse effects such as too abrupt a reduction in blood pressure. Adjustments are usually made every one to two months depending upon tolerability and response because there are certain side effects that occur quickly and can be serious. It is important to remember to take your medication at the same time each day because this minimizes the fluctuation of blood pressure. There are times, however, when one or more agents must be used to control your blood pressure. Some of these agents have undesirable side effects. Be sure to tell your doctor if any side effects occur because he or she may be able to choose another medication for you. It is important to take medication consistently even if you are feeling well.
||Calcium channel blockers
||Angiotensin receptor blockers
|| Alpha adrenergic blockers
||Central alpha agonists
Diuretics are also known as "water pills." Diuretics work in the kidneys and remove excess water and sodium from the body. This reduces the amount of fluid from the blood. Diuretics can be used alone or with another blood pressure lowering medication.
Beta-blockers cause nerve impulses to the heart and blood vessels to decrease, and prompts the heart to beat slower and with less force. This action lowers your blood pressure and helps the heart work less hard.
ACE Inhibitors work by preventing the formation of a hormone called Angiotensin II that normally causes blood vessels to narrow. Ace inhibitors cause the vessels to relax thereby reducing blood pressure.
Calcium channel blockers prevent calcium from entering the muscle cells of the heart and blood vessels. This causes the blood vessels to relax and lowers the blood pressure.
Angiotensin receptor blockers shield blood vessels from angiotensin II. The blood vessels become wider thereby causing blood pressure to decrease.
Alpha adrenergic blockers reduce nerve impulses to blood vessels, which allow blood to pass more easily and cause blood pressure to decrease.
Central alpha agonists relax blood vessels by controlling nerve impulses. This causes the blood vessels to become wider and the blood pressure to go down.
Vasodilators directly open blood vessels by relaxing the vessel walls and reducing blood pressure.
Click here to see a list of common medications is shown in Table (2)
Hypertension Treatment Facts and Myths