High Blood Pressure Treatment (cont.)
John P. Cunha, DO, FACOEP
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Jay W. Marks, MD
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
In this Article
- What is high blood pressure (hypertension)?
- Which lifestyle modifications are beneficial in treating high blood pressure?
- Alcohol
- Smoking
- Coffee and caffeinated beverages
- Salt
- Other dietary considerations
- Obesity
- Exercise and stress reduction
- How is high blood pressure treated?
- Starting treatment for high blood pressure
- Treatment with combinations of drugs for high blood pressure
- Emergency treatment for high blood pressure
- Treatment during pregnancy
- Which medications are used to treat high blood pressure
- Angiotensin converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers
- Beta blockers
- Diuretics
- Calcium channel blockers (CCBs)
- Alpha blockers
- Clonidine
- Minoxidil
- Renin inhibitors
- Aldosterone blockers
- Combining agents
- What about the patient's compliance with medication regimens?
- Is alternative medicine used to treat high blood pressure?
- What are the complications of high blood pressure?
- Can high blood pressure be prevented?
- What's new in high blood pressure?
- Find a local Internist in your town
Other dietary considerations
It is beneficial to add potassium to the diet. Studies show that people who consume more potassium have lower blood pressures. Good sources of potassium include:
- bananas,
- melons,
- oranges,
- spinach and
- zucchini.
Along with lowering salt in the diet, a balanced eating plan that also reduces cholesterol intake and fatty foods is recommended. The TLC Diet (Therapeutic Lifestyle Changes) often is recommended to lower blood cholesterol.
Some supplements, such as garlic and flaxseed have been shown in studies to lower blood pressure. Some small-scale studies have shown Coenzyme Q10 (CoQ10) may lower blood pressure, but further studies are needed. Garlic may react with some prescription medications such as blood thinners, so consult a physician before taking any supplements. Other home remedies, such as calcium, magnesium, and fish oil have been shown in studies to lower blood pressure, but patients should consult with their physician before taking any supplements.
Obesity
Being overweight can increase the risk for high blood pressure. Obesity is common among hypertensive patients, and its prevalence, especially in aging patients, can contribute to hypertension in several ways. In obese people the heart has to pump more blood to supply the excess tissue. The increased cardiac output can then raise the blood pressure. In addition, obese hypertensive individuals have a greater stiffness (resistance) in their peripheral arteries throughout the body. Insulin resistance and the metabolic syndrome, which are associated with hypertension, also occur more frequently in the obese. Finally, obesity may be associated with a tendency for the kidneys to retain salt. Weight loss may help reverse obesity-related problems and may lower blood pressure. Losing as little as 10 to 20 pounds can help lower blood pressure and the risk of heart disease.
The American Journal of Clinical Nutrition reported in 2005 that waist size, a measure of central body obesity, was a better predictor of a person's blood pressure than body mass index (BMI), a measure of overall obesity. Men should strive for a waist size of 35 inches or under and women 33 inches or under.
Some very obese people have a syndrome called sleep apnea, which is characterized by periodic interruption of normal breathing during sleep. Sleep apnea may contribute to the development of hypertension in this subgroup of obese individuals. Repeated episodes of apnea cause a lack of oxygen (hypoxia), causing the adrenal gland to release adrenaline and related substances which cause a rise in the blood pressure.
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