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Hypertension

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Prevention and Treatment

Lifestyle changes can help lower the risk of developing hypertension. For many people 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.  Risks associated with sex (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 high blood pressure.

There are several classes of drugs available to treat hypertension; each works differently, targeting a specific aspect of blood pressure regulation. Frequently, someone will need to take a couple of different medications together to achieve blood pressure control. Your health practitioner will work with you to select the appropriate combinations and dosages. (See How High Blood Pressure is Treated? on the NHLBI website.)

With secondary hypertension, if the condition causing the high blood pressure can be resolved (by removing an adrenal tumor or stopping a medication) or controlled (by controlling diabetes or 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 hypertension will be controlled with a combination of medications and the person will be monitored closely to help maintain organ function and address acute problems as they arise.

Hypertensive urgencies, where asymptomatic blood pressure is more than 180/110 mm Hg, without organ damage, and emergencies, where organs are damaged and blood pressure measurements can be higher than 180/120 mm Hg, must be treated immediately. They may require hospitalization so that intravenous medications can be given and monitored because, if untreated, they can quickly result in organ damage.

Pregnant women with preeclampsia or toxemia require rest, close monitoring, and frequent visits to their healthcare provider's office. The only real resolution for preeclampsia is delivery, but postponing delivery as long as possible allows the developing baby 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.

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