Why treat hypertension

A comparison of outcomes with angiotensin-converting—enzyme inhibitors and diuretics for hypertension in the elderly. Staessen JA, et al. Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension.

Beckett NS, et al. Treatment of hypertension in patients 80 years of age or older. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension.

Musini VM, et al. Pharmacotherapy for hypertension in the elderly. Diao D, et al. Pharmacotherapy for mild hypertension. Sundstrom J, et al. Effects of blood pressure reduction in mild hypertension [published ahead of print December 23, ]. Ann Intern Med. Accessed January 6, Upadhyay A, et al. Systematic review: blood pressure target in chronic kidney disease and proteinuria as an effect modifier.

Lv J, et al. Effects of intensive blood pressure lowering on the progression of chronic kidney disease. Ninomiya T, et al. Blood pressure lowering and major cardiovascular events in people with and without chronic kidney disease. Wright JT Jr, et al. Effect of blood pressure lowering and antihypertensive drug class on progression of hypertensive kidney disease [published correction appears in JAMA. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes [published correction appears in BMJ.

Cushman WC, et al. Effects of intensive blood-pressure control in type 2 diabetes mellitus. Arguedas JA, et al. Blood pressure targets for hypertension in people with diabetes mellitus. Psaty BM, et al. Health outcomes associated with various antihypertensive therapies used as first-line agents. Dhalla IA, et al. Chlorthalidone versus hydrochlorothiazide for the treatment of hypertension in older adults.

Law MR, et al. Use of blood pressure lowering drugs in the prevention of cardiovascular disease. Turnbull F, et al. Effects of different regimens to lower blood pressure on major cardiovascular events in older and younger adults. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic [published corrections appear in JAMA.

Wiysonge CS, et al. Beta-blockers for hypertension. Weber MA, et al. Clinical practice guidelines for the management of hypertension in the community. J Clin Hypertens Greenwich. Mancia G, et al. Eur Heart J. This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.

Contact afpserv aafp. Want to use this article elsewhere? Get Permissions. Read the Issue. Sign Up Now. Feb 1, Issue. Author disclosure: No relevant financial affiliations. B 8 — 10 , 14 In patients older than 30 years, treatment of diastolic blood pressure to less than 90 mm Hg reduces rates of cardiovascular disease, stroke, and death.

A 19 — 22 Treatment of systolic blood pressure to less than mm Hg in patients without comorbid conditions who are older than 60 years reduces rates of cardiovascular disease, stroke, and death. A 23 — 26 Treatment of systolic blood pressure to less than mm Hg is recommended in adults 30 to 60 years of age who do not have comorbid conditions.

C 7 Treatment of black patients who have chronic kidney disease with an angiotensin-converting enzyme inhibitor reduces the decline in glomerular filtration rate compared with beta blockers or calcium channel blockers.

C 29 , 30 , 33 — 35 First-line pharmacologic treatment of hypertension for nonblack patients includes thiazide diuretics, calcium channel blockers, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers. B 36 , 38 , 39 First-line pharmacologic treatment of hypertension for black patients includes thiazide diuretics or calcium channel blockers. Enlarge Print Table 1. Table 1. Enlarge Print Table 2. Table 2. Enlarge Print Table 3.

Lifestyle Recommendations for Lowering Blood Pressure Consume a diet that emphasizes intake of vegetables, fruits, and whole grains; includes low-fat dairy products, poultry, fish, legumes, nontropical vegetable oils, and nuts; and limits intake of sweets, sugar-sweetened beverages, and red meat.

Combine the DASH diet with lower sodium intake. Table 3. Enlarge Print Table 4. Table 4. Enlarge Print Table 5. Table 5. More Information Blood pressure chart Blood pressure test. Beta blockers: How do they affect exercise? Blood pressure medications: Can they raise my triglycerides? Calcium supplements: Do they interfere with blood pressure drugs? Diuretics: A cause of low potassium?

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Can whole-grain foods lower blood pressure? High blood pressure and cold remedies: Which are safe? Resperate: Can it help reduce blood pressure? Weightlifting: Bad for your blood pressure? How to measure blood pressure using a manual monitor How to measure blood pressure using an automatic monitor What is blood pressure? More Information L-arginine: Does it lower blood pressure? Share on: Facebook Twitter. Show references High blood pressure. National Heart, Lung, and Blood Institute.

Accessed Dec. What is high blood pressure? American Heart Association. Hypertensive crisis: When you should call for high blood pressure. Hypertension in adults: Screening. Preventive Services Task Force. Thomas G, et al.

Blood pressure measurement in the diagnosis and treatment of hypertension in adults. Blood pressure monitoring kiosks aren't for everyone. Food and Drug Administration. Basile J, et al. Overview of hypertension in adults. Know your risk factors for high blood pressure. Rethinking drinking: Alcohol and your health. National Institute on Alcohol Abuse and Alcoholism. Bonow RO, et al. Systemic hypertension: Mechanisms and diagnosis.

Elsevier; Hypertension adult. Mayo Clinic; About metabolic syndrome. Understanding blood pressure readings. Whelton PK, et al. Monitoring your blood pressure at home. Mann JF. Choice of drug therapy in primary essential hypertension.

Agasthi P, et al. Renal denervation for resistant hypertension in the contemporary era: A systematic review and meta-analysis. Scientific Reports. Chernova I, et al. Resistant hypertension updated guidelines. Current Cardiology Reports. Forman JP, et al. Diet in the treatment and prevention of hypertension. Goldman L, et al. Alzheimer disease and other dementias. In: Goldman-Cecil Medicine.

Managing stress to control high blood pressure. Brenner J, et al. Mindfulness with paced breathing reduces blood pressure. Medical Hypothesis. Grundy SM, et al. Brook RD, et al. Beyond medications and diet: Alternative approaches to lowering blood pressure: A scientific statement from the American Heart Association. Natural medicines in the clinical management of hypertension. Natural Medicines.

Saper RB, et al. Overview of herbal medicine and dietary supplements. Lopez-Jimenez F expert opinion. Mayo Clinic. Department of Health and Human Services and U. Department of Agriculture. Accessed Jan. Physical activity and exercise lower blood pressure in individuals with hypertension: narrative review of 27 RCTs. British Journal of Sports Medicine. Your doctor will carry out some blood and urine tests, and ask questions about your health to determine your risk of other problems:.

There are some changes you could make to your lifestyle to reduce high blood pressure. Some of these will lower your blood pressure in a matter of weeks, while others may take longer. You can take these steps today, regardless of whether or not you're taking blood pressure medicines. In fact, by making these changes early on you may be able to avoid needing medicines. Get more advice about lifestyle changes to prevent and reduce high blood pressure. Several types of medicine can be used to help control high blood pressure.

You may need to take blood pressure medicine for the rest of your life. But your doctor might be able to reduce or stop your treatment if your blood pressure stays under control for several years. It's really important to take your medicine as directed. If you miss doses, it will not work as well. The medicine will not necessarily make you feel any different, but this does not mean it's not working. Medicines used to treat high blood pressure can have side effects, but most people do not get any.

If you do get side effects, do not stop taking your medicine. Talk to your doctor, who may advise changing your medicine. Angiotensin-converting enzyme ACE inhibitors reduce blood pressure by relaxing your blood vessels. Common examples are enalapril , lisinopril , perindopril and ramipril.