What Medications Are Used To Treat High Blood Pressure
Four classes of high blood pressure medications are considered first line when starting treatment. Sometimes other medications are coupled with these first-line drugs to better control your high blood pressure. First-line, pressure-lowering medications are:
- Angiotensin-converting enzyme inhibitors block the production of the angiotensin II hormone, which the body naturally uses to control blood pressure. When angiotensin II is blocked, your blood vessels dont narrow. Examples: lisinopril , enalapril or captopril.
- Angiotensin II receptor blockers block this same hormone from binding with receptors in the blood vessels. ARBs work the same way as ACE inhibitors to keep blood vessels from narrowing. Examples: metoprolol , valsartan or losartan.
- Calcium channel blockers prevent calcium from entering the muscle cells of your heart and blood vessels, allowing these vessels to relax. Examples: amlodipine , nifedipine , diltiazem .
- Diuretics flush excess sodium from your body, reducing the amount of fluid in your blood. Diuretics are often used with other high blood pressure medicines, sometimes in one combined pill. Examples: indapamide, hydrochlorothiazide or chlorothiazide.
Hypertension Level In Office
Systolic Blood Pressure Equal to or greater than 140 mm Hg
and/or
Diastolic Blood Pressure Equal to or greater than 90 mm Hg
2. Unattended Automated Office Blood Pressure:
Systolic Blood Pressure Equal to or greater than 135 mm Hg
and/or
Diastolic Blood Pressure Equal to or greater than 85 mm Hg
How To Treat The Different Stages Of Hypertension
5 MINUTES
The American Heart Association released an updated hypertension guideline in 2017 that discussed new blood pressure targets and treatment recommendations for patients with high blood pressure.
In the new hypertension guideline, the definition of hypertension was altered to reflect new targets for systolic and diastolic blood pressure measurements. These blood pressure targets help guide clinical decision making by categorizing hypertension: normal BP, elevated BP, stage 1, and stage 2.1
Previously, high blood pressure was defined as a systolic blood pressure measurement of 140 mmHg or higher or a diastolic blood pressure measurement of 90 mmHg or higher.1 The updated guideline redefined hypertension as a systolic blood pressure measurement of 130 mmHg and greater or diastolic blood pressure measurement of 80 mmHg and beyond.1 As a result, patients with systolic BP measurements greater than or equal to 140/90 mmHg are now considered to have stage 2 hypertension.1
There are more hypertensive patients than ever beforethis widespread condition is projected to increase 8% between 2013 and 2030.2 Therefore, the hypertension guideline provided new treatment recommendations that included both lifestyle changes and pharmacological strategies to help manage this condition.1 It is key for healthcare providers to have a comprehensive understanding of how to effectively treat the various stages of hypertension to help prevent its dangerous effects.
You May Like: Does Viagra Raise Blood Pressure
Set Weight Loss Goals
If your doctor has recommended you lose weight, talk with them about an optimal weight loss goal for you. The Centers for Disease Control and Prevention recommends a weight loss goal of one to two pounds a week. This can be achieved through a more nutritious diet and increased physical exercise.
Employing the help of a trainer or fitness app, and possibly even a dietician, are all methods to help you learn how to make the best choices for your body and your lifestyle.
Aging And Pulse Pressure
Systolic blood pressure and diastolic blood pressure both are important in case of hypertension. Systolic blood pressure rises progressively with age. So it is seen that when one lives long enough, almost greater than 90% of people will develop hypertension.
It is also seen that in developed countries, diastolic blood pressure rises until the age of 50 years and thereafter decreases, so produces a progressive rise of pulse pressure .
It is seen that people who develops hypertension before the age of 50 years typically have combined systolic and diastolic hypertension. It means these people have systolic blood pressure 140 mm Hg or higher and diastolic blood pressure is 90 mm Hg or higher.
But majority of patients who develop hypertension above 50 years of age have isolated systolic hypertension. It means these people have systolic blood pressure 140 mm Hg or higher. But diastolic blood pressure remains lower than 90 mm Hg.
Don’t Miss: How Do I Lower My Blood Pressure Naturally
Toxicity And Side Effect Management
Side effects are generally mild and resolve promptly upon decreasing the dosage or discontinuing the drug for short intervals.
Patients should be frequently monitored for side effects, more so in the early initiation phase of therapy when they are much frequent. Side effects are usually self-limited and include hypotension and ACEi/ ARBs), electrolyte imbalances, pedal edema and renal dysfunction. Renal dysfunction and electrolyte imbalance especially hyponatremia and hyperkalemia are frequent with ACEi and ARBs and need to be monitored periodically until the achievement of static levels of Cr, K, and Na.
For patients with severe side effects like symptomatic hyperkalemia or hyponatremia, syncope and acute kidney injury , treatment needs to be discontinued, and in-patient management is advised. Nephrologist and cardiologist opinions also need to be sought in such cases. Once the issues settle, treatment needs to be re-instituted gradually and cautiously with careful monitoring and frequent follow-ups.
Angioedema has been a potentially life-threatening side effect of ACEi and ARBs in susceptible individuals and warrants prompt discontinuation and is also a lifelong contra-indication for ACEi/ ARB usage.
Stroke And Brain Problems
High blood pressure can cause the arteries that supply blood and oxygen to the brain to burst or be blocked, causing a stroke. Brain cells die during a stroke because they do not get enough oxygen. Stroke can cause serious disabilities in speech, movement, and other basic activities. A stroke can also kill you.
Having high blood pressure, especially in midlife, is linked to having poorer cognitive function and dementia later in life. Learn more about the link between high blood pressure and dementia from the National Institutes of Healths Mind Your Risks®external icon campaign.
Read Also: Do Onions Lower Blood Pressure
Pertinent Studies And Ongoing Trials
The SYST-EUR trial, HYVET and SHEP studies were amongst the large RCTs that formed the basis for recommendations from the 8th report of JNC.
The SPRINT trial, HOPE-3 trial, Gubbio population study, Framingham heart study along with other RCTs, formed the basis for recommendations from ACC and ESC/ESH guidelines.
Can High Blood Pressure Affect Pregnancy
High blood pressure complicates about 10% of all pregnancies. There are several different types of high blood pressure during pregnancy and they range from mild to serious. The forms of high blood pressure during pregnancy include:
Chronic hypertension: High blood pressure which is present before pregnancy.
Gestational hypertension: High blood pressure in the latter part of pregnancy.
Preeclampsia: This is a dangerous condition that typically develops in the latter half of pregnancy and results in hypertension, protein in the urine and generalized swelling in the pregnant person. It can affect other organs in the body and cause seizures .
Chronic hypertension with superimposed preeclampsia: Pregnant people who have chronic hypertension are at increased risk for developing preeclampsia.
Your provider will check your blood pressure regularly during prenatal appointments, but if you have concerns about your blood pressure, be sure to talk with your provider.
You May Like: What Cough Medicine Can I Take With High Blood Pressure
Enhancing Healthcare Team Outcomes
Often hypertension is picked up by nurses charting the patients in ERs and out-patient setting, where prompt recognition and referral to a physician is essential as most of these hypertensive patients might be unaware of their disease, hence the name “silent killer.”
Inter-professional communication is of prime importance especially in picking up cases of resistant or difficult to treat hypertension where referral and inter-specialty approach will benefit a patient the most. Effective communication in an interprofessional team approach including nursing staff and nurse practitioner, primary referring physician, cardiologist, nephrologist and pharmacist is essential for ensuring blood pressure control. This team can also monitor for adequate patient compliance as well as potential toxicities and adverse effects, all of which will result in minimizing future complications and reducing health care costs as well as improving patient outcomes.
How Blood Pressure Is Measured
Blood pressure is measured with an instrument called a sphygmomanometer, through which the user listens for the sound of the force of blood in the patients arteries when the heart beats . Measured in millimeters of mercury , systolic pressure is the top number in your blood pressure reading. The second, or bottom number, is the pressure in the arteries of the heart at rest the diastolic pressure. Generally, as an adult, you are considered to have high blood pressure if your systolic pressure reading is greater than or equal to 140 mm Hg or if your diastolic pressure is greater than or equal to 90 mm Hg. But for every 20 mm Hg your systolic pressure raises above 115, and for every 10 mm Hg your diastolic pressure rises over 75, your risk of cardiovascular disease doubles so lower pressures are generally better.
Don’t Miss: How To Take Blood Pressure Readings
What Is Stage 1 High Blood Pressure
Stage 1 high blood pressure is the early, milder stage of high blood pressure. It is defined as persistent blood pressure of 130 to 139 mm Hg systolic OR 80 to 89 mm Hg diastolic 130/80 mm Hg to 139/89 mm Hg. This means if either the top number or bottom number falls within the range, you may have Stage 1 high blood pressure.
Table 1: Stage 1 High Blood Pressure Definition from the 2017 ACC/AHA Hypertension Guidelines
Your doctor will measure your blood pressure on several days or visits to find out if your blood pressure stays high over time. Your doctor may also ask you to take and track your blood pressure at home. If the average numbers are 130 to 139 mm Hg systolic OR 80 to 89 mm Hg diastolic , you may have Stage 1 high blood pressure.
Finding out you have high blood pressure early lets you start lowering your high blood pressure early. Lowering your blood pressure can help prevent damage to the blood vessels, heart, brain, and kidneys. It can prevent serious disease.
Less pressure, more health!
Also Check: What To Eat For High Blood Pressure
If Your Hypertension Is Resistant
It may take time for you and your doctor to work out a successful lifestyle and medication plan to lower your blood pressure.
Its very likely that youll find a combination of drugs that works, especially since new medications are always under development.
If your hypertension is resistant, its important that you keep working with your doctor and stick with your medication plan.
Read Also: How To Measure Blood Pressure With Apple Watch
What If Lifestyle Changes Dont Help Lower My Blood Pressure
If diet, exercise and other lifestyle changes dont work to lower your blood pressure, your healthcare provider will prescribe medications to help lower your blood pressure. Your provider will take into account other conditions you may have, such as heart or kidney disease and other drugs youre taking when prescribing medications to treat your high blood pressure. Be sure to follow your providers dosing directions exactly.
Healthy And Unhealthy Blood Pressure Ranges
Learn whats considered normal, as recommended by the American Heart Association.
| SYSTOLIC mm Hg | and/or | DIASTOLIC mm Hg | |
|---|---|---|---|
| NORMAL | |||
| HIGH BLOOD PRESSURE STAGE 1 | 130 139 | ||
| HIGH BLOOD PRESSURE STAGE 2 | 140 OR HIGHER | ||
| HYPERTENSIVE CRISIS | HIGHER THAN 180 | and/or | HIGHER THAN 120 |
Note: A diagnosis of high blood pressure must be confirmed with a medical professional. A doctor should also evaluate any unusually low blood pressure readings.
The five blood pressure ranges as recognized by the American Heart Association are:
Read Also: Can Depression Cause High Blood Pressure
Which Number On The Blood Pressure Reading Is More Important
So know that you know what the blood pressure readings mean. You are asking yourself which of those two numbers is more important to look out for.
Mostly, you should keep an eye on systolic blood pressure. As its the main risk factor for cardiovascular diseases for most people over the age of 50. Usually, this type of pressure rises over the years, due to the increase in stiffness of arteries, and buildup of plaque.
But you should know that an elevated state of either one of those two pressures is enough to get a diagnosis of hypertension. Studies confirmed that the risk of death from Ischemic heart disease and stroke is directly connected to the increase in them. Usually, that doubles with every 20 mm Hg for systolic or 10 mm Hg for diastolic pressure.
Managing High Blood Pressure Stage 1 Is A Commitment
If you have High Blood Pressure Stage 1 its vital to listen to the doctor. Remember you are a part of your healthcare team. You and your doctor are partners. Educate yourself about high blood pressure and learn how to monitor your blood pressure at home.
Armed with this information, you can commit to living heart healthy.
You May Like: Normal Blood Pressure Ranges For Adults
High Blood Pressure Overview
Both numbers in a blood pressure test are important, but for people who are 50 or older, systolic blood pressure gives the most accurate diagnosis of hypertension. Systolic is the top number in a blood pressure reading. It is considering as high if it is 140 mmHg or above.
Globally, hypertension is a greater concern with blood pressure causing deaths accounts for 13.5%.
What Is Blood Pressure
Blood pressure is the amount of pressure or force the blood exerts against the walls of your blood vessels when the heart beats.
Blood pressure is measured with two numbers. Systolic blood pressure measures the amount of pressure in your arteries when your heart contracts and pumps blood out. Diaslotic blood pressure measures the amount of pressure in your arteries when your heart rests and fills will blood.
For adults, a normal blood pressure reading is a systolic pressure of lower than 120 and a diastolic pressure of lower than 80.
Recommended Reading: How To Manage Blood Pressure
Diagnosis Of High Blood Pressure
The best way to diagnose HBP is to have it measured. A blood pressure reading, given in millimeters of mercury , has two numbers.
- Systolic blood pressure indicates how much pressure your blood is exerting against your artery walls during heartbeats.
- Diastolic blood pressure indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats.
Blood pressure measurements fall into four general categories. The American Heart Associations guidelines are as follow:
- Normal blood pressure: A reading of less than 120 and 80
- Elevated blood pressure: A reading ranging from 120 to 129 and below 80
- Stage 1 hypertension: A reading ranging from 130 to 139 or 80 to 89
- Stage 2 hypertension: A reading ranging from 140 or higher or 90
- Hypertensive crisis : A reading higher than 180 and/or 120
*If you have an electronic blood pressure machine and would like to measure your blood pressure at home, please follow The American Heart Associations guidelines:
What Are The Causes Of Hypertension
Each type of hypertension has different causes.
Primary high blood pressure usually develops gradually and in most cases, there is no known cause.
Secondary hypertension is caused by an underlying condition and generally appears suddenly, causing higher blood pressure than primary hypertension. Some conditions which may lead to secondary hypertension include:
- Obstructive sleep apnoea
- Alcohol abuse or chronic alcohol use
Recommended Reading: Is Turmeric Good For Blood Pressure
How Can I Tell If I Have High Blood Pressure
High blood pressure usually has no symptoms. In fact, many people have high blood pressure for years without knowing it. Thats why its called the silent killer. In 90-95 percent of cases, the cause of high blood pressure is unknown.
A single elevated blood pressure reading doesnt mean you have high blood pressure, but its a sign that further observation is required. The only way to find out if you have high blood pressure is to have your blood pressure checked.
The Effect Of Stress On Blood Pressure
During a stressful situation, our bodies release stress hormones like adrenaline and cortisol as part of our fight-or-flight response. This causes our heart rate to increase and blood vessels to constrict as we react to the stressor. Our blood pressure will rise because our heart is pumping faster and our arteries are narrower.
When the stressful situation is over and our bodies relax, our blood pressure will return to normal and the other effects will disappear.
There isnt conclusive proof that chronic stress directly causes long-term high blood pressure. However, a 2021 study showed preliminary results that linked urinary stress hormones, hypertension and cardiovascular events.
The researchers measured stress hormones in urine samples of 412 participants who did not have high blood pressure at the baseline. After a follow-up of a median of 11.2 years, it showed that higher urinary stress hormone levels were associated with an increased risk of hypertension. In addition, when cortisol levels were doubled, it was associated with a higher risk of incident cardiovascular events.
The study concluded that the relationship between chronic stress and blood pressure isnt completely clear and still needs to be further investigated. However, if stress isnt managed appropriately, it can indirectly cause hypertension.
Read Also: How Does Stress Affect Blood Pressure
The 4 Stages Of Hypertension
What is hypertension? Hypertension, or high blood pressure, occurs when your blood moves through your arteries at a higher pressure than usual. This pressure depends upon the resistance of the blood vessels and how hard the heart has to work. Hypertension can lead to severe health complications and will increase the risk of heart disease, stroke, heart failure, and/or kidney disease. Almost half of all adults in the United States have high blood pressure. Many of these adults are not even aware of their hypertension.