Treatments
Lifestyle changes can help lower the risk of developing hypertension. In many patients with mild high blood pressure, reaching and maintaining a healthy weight, exercising regularly, limiting alcohol and salt, and stopping smoking can decrease blood pressure levels to normal and may be the only “treatment” required. The risks associated with gender, race, and increasing age, however, do not disappear with lifestyle changes and, in many cases, a treatment plan that includes medications is necessary to control persistent high blood pressure.
There are several classes of drugs available to treat hypertension. Each class works differently, targeting a specific aspect of blood pressure regulation. Frequently, a patient will need to take a couple of different medications together to achieve blood pressure control. Your doctor will work with you to select the combinations and dosages that are right for you. Classes that are available include:
Diuretics – a commonly used group of drugs that increase the excretion of salt and water by the kidneys. This reduces the volume of fluid in circulation, which lowers the blood pressure.
Adrenergic blockers (alpha blockers, beta blockers, alpha-beta blockers) – work to help inhibit the nervous system from responding as rapidly to physical and emotional stressors.
ACE (angiotensin-converting enzyme) inhibitors and ARBs (Antiotensin II receptor blockers) – help prevent the constriction of arterioles (small arteries) by blocking the formation and/or action of angiotensin II, an enzyme that the body produces to constrict blood vessels and increase blood pressure.
Calcium channel blockers – dilate arterioles by decreasing the amount of calcium that enters into the blood vessels and the heart muscles.
Vasodilators – work directly on blood vessels to relax the muscles that constrict and dilate the arteries.
With secondary hypertension, if the condition causing the high blood pressure can be resolved (such as by removing an adrenal tumor or stopping a medication) or controlled (such as diabetes and thyroid disease), then blood pressure levels may fall to normal or near normal levels. When a cure is not possible and control of the underlying condition consists of minimizing further damage (as may occur with kidney disease), then the hypertension will be controlled with a combination of medications, and the patient will be monitored closely over time to help maintain organ function and address acute problems as they arise.
Hypertension urgencies (an asymptomatic blood pressure of more than 180/110 mm Hg) and emergencies (seen with malignant hypertension – a severe form of high blood pressure, measurements can be higher than 210/120 mm Hg) must be treated immediately and may require hospitalization so that intravenous medications can be given and monitored.
Pregnant women with pre-eclampsia require rest, close monitoring, and frequent visits to their doctor’s office. The only real resolution for pre-eclampsia is delivery, but postponing delivery as long as possible allows the fetus more time to mature. This time delay must be balanced against the increasing danger of seizures and organ damage in the mother, emergency conditions that can be lethal to both the baby and the mother.
On This Site