How to Treat Hypertension

Most people who have high blood pressure will need lifelong treatment to help ward off or delay serious health problems brought on by the condition.

Treatment for adults is usually aimed at getting to and keeping blood pressure below 130/80 millimeters of mercury (mmHg). (1)

Options to treat high blood pressure may include eating a healthy diet with less salt and taking medication, as well as incorporating additional lifestyle changes.

An important part of a high blood pressure treatment plan is to stick to a healthy diet, including limiting sodium intake. The U.S. government’s 2020–2025 Dietary Guidelines for Americans recommend consuming less than 2,300 milligrams (mg) of sodium per day. (2) People with high blood pressure may need to restrict sodium intake even more. The American Heart Association (AHA) recommends an ideal limit of no more than 1,500 mg per day for adults with hypertension. (3)

It’s important to pay attention to food labels and choose options that are low-sodium and “no salt added” at the grocery store and while cooking. (4)

Your doctor may recommend the Dietary Approaches to Stop Hypertension (DASH) diet, which focuses on fruits, vegetables, and whole grains, as well as fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils. The DASH plan also limits foods high in saturated fats, including fatty meats, full-fat dairy products, and tropical oils, like coconut and palm oils, as well as sugary drinks and other sweets. (5)

A 2017 study of more than 400 adults with stage 1 high blood pressure found that combining a low-salt diet with the DASH eating plan was as effective as certain drugs in lowering systolic blood pressure. (6)

RELATED: DASH Diet Linked to a Lower Risk of Depression in Older Adults

Additional lifestyle changes can also help you lower and manage blood pressure. These include:

Keeping a Healthy Weight Maintaining a healthy weight can help you control high blood pressure and keep other complications at bay.

Moreover, reducing your weight by just 3 to 5 percent can help lower your risk of health problems related to high blood pressure. (4)

While a body mass index (BMI) — which measures your weight in relation to your height and gives an estimate of your total body fat — of less than 25 is the goal for controlling blood pressure, your doctor can help you determine your specific weight goals. (4)

Exercise Regular exercise can keep your weight under control, as well as help lower your blood pressure.

The AHA recommends an average of 40 minutes of moderate-to-vigorous intensity aerobic activity three or four times a week to lower blood pressure. (7)

Limiting Alcohol Consumption Alcohol can raise your blood pressure, even if you don’t have hypertension, so everyone should monitor alcoholic intake.

Healthy women of all ages and men older than 65 should stick to drinking up to one drink a day, while men 65 and younger should stay within up to two drinks a day. (4)

Not Smoking While smoking is a proven risk factor for heart problems like heart attack and stroke, researchers are still trying to understand its connection to high blood pressure. Both smoking and secondhand exposure to tobacco smoke increase the risk of plaque inside the arteries, a condition known as atherosclerosis, which high blood pressure accelerates.

Smoking also causes a temporary increase in blood pressure. (8)

Ask your doctor for tips to quit smoking, and investigate smoking-cessation medication and devices to help you break your addiction to nicotine.

Managing Stress The relationship between stress and high blood pressure is still being studied, but stress is known to contribute to risk factors for hypertension, such as poor diet and excessive alcohol use.

Additionally, stress hormones adrenaline and cortisol make the heart beat faster and constrict blood vessels in preparation for the fight-or-flight response. This raises blood pressure temporarily, but researchers are still studying if chronic stress may impact blood pressure over time. (9)

Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health.

The following ways may help you better manage your stress:

• Practicing relaxation techniques, such as yoga, deep breathing, and meditation, which not only help you relax but also temporarily reduce your blood pressure
• Getting enough sleep (aim for seven to nine hours per night)
• Exercising
• Listening to music or focusing on something calm and peaceful (4)

Sometimes diet and lifestyle changes may not be enough to manage high blood pressure and medication is needed. There are a variety of blood pressure drugs, known as antihypertensives, available by prescription. Some of the most common ones include:

• Diuretics These help the body get rid of excess salt and water and help control blood pressure.
• Beta-Blockers These reduce heart rate and the heart’s workload, which in turn lowers blood pressure.
• ACE Inhibitors Also known as angiotensin-converting enzyme inhibitors, these help the body produce less of the chemical angiotensin, which causes the arteries to narrow. These drugs help the blood vessels relax and open up, which lowers blood pressure.
• Calcium Channel Blockers These prevent calcium from entering the muscle cells of the heart and arteries. This also helps the blood vessels relax and open up, thus lowering blood pressure.
• Alpha Blockers These reduce the arteries’ resistance and relax the muscle tone of the vascular walls.
• Central Agonists These help decrease sympathetic nervous system activity and the blood vessels’ ability to tense up and contract, thereby helping to lower blood pressure. (10)

Some of these drugs may be taken in combination to treat hypertension. Your doctor will work with you to find a treatment plan that is best for you.

For many people, taking more than one medication in low doses can be more effective in treating high blood pressure than taking larger doses of one single drug.

Sometimes your doctor may need to try different combinations of drugs in order to determine which is best for you. It is important to follow recommendations carefully and report any side effects to your healthcare provider. (11)

Additional reporting by Ashley Welch.