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
Exercise and stress reduction
A regular exercise program may help lower blood pressure over the long term. Activities such as jogging, bicycle riding, power walking, or swimming for 30 to 45 minutes daily may lower blood pressure by as much as 5 to15 mm Hg. There also appears to be a relationship between the amount of exercise and the degree to which the blood pressure is lowered. So the more one exercises (up to a point), the more they lower their blood pressure. This beneficial response occurs only with aerobic (vigorous and sustained) exercise programs. Any exercise program should be recommended or approved by a physician.
Stress reduction can also help lower blood pressure. Stress can be limited by determining priorities, using time management skills, saying "no," living by values, setting realistic goals, and improving self-esteem. Relaxation methods to reduce stress include deep breathing, progressive muscle relaxation, mental imagery relaxation, relaxing to music, yoga, meditation, and biofeedback.
It is important for patients to keep logs of their blood pressure through the day. Physicians may have patients chart their blood pressure in a daily log to see if stressful factors during the day cause blood pressure to go up.
Patients should be sure to get adequate sleep in order to relax their minds and bodies. Naps may be necessary.
How is high blood pressure treated?
Goals of treatment
High blood pressure usually is present for years before its complications develop. Ideally, hypertension is treated early before it damages critical organs in the body. Increased public awareness and screening programs to detect early, uncomplicated hypertension are keys to successful treatment. Successful early treatment of high blood pressure can significantly decrease the risk of stroke, heart attack, and kidney failure.
The goal for patients with combined systolic and diastolic hypertension is to attain a blood pressure of 140/85 mm Hg. Bringing the blood pressure down even lower may be desirable in African American patients and patients with diabetes or chronic kidney disease. Although lifestyle changes in prehypertensive patients are appropriate, it is not well established that treatment with medication of patients with prehypertension is beneficial.
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