High blood pressure can be easily reduced and controlled by making some lifestyle changes. However, if this is not possible, medication may be required to lower blood pressure. Talk to your doctor about the best blood pressure control method for you and make the right decision.
When should high blood pressure be treated?
Everyone with high blood pressure is advised to make some healthy lifestyle changes. Along with that, the doctor determines the need for medication by considering some factors.
Among the factors are high blood pressure levels and long-term risk of certain serious diseases (eg: heart attack and brain stroke). The table below illustrates the relationship of these two factors with the treatment of hypertension—
| Measured pressure at the doctor | Pressure measured at home | Risk of long-term and serious health problems | treatment |
| 140/90 or higher | 135/85 or higher | less | Making healthy lifestyle changes is enough |
| 140/90 or higher | 135/85 or higher | more | Medicines should be taken along with lifestyle changes |
| 160/100 or more | 160/100 or more | more or less | Medication is important along with lifestyle changes |
Various tests are done on the patient's blood and urine to determine the risk of various long-term health problems. Also important medical decisions are made by asking some questions about the patient's health status.
Treatment of hypertension in the elderly
Blood pressure targets for those over 80 years of age are:
- At home: caught under 145/85
- In clinic or hospital: below 150/90 is considered
Although antihypertensive drugs are effective in people under 80 years of age, the effectiveness of drugs after this age is unclear. So till the age of 80 a patient if—
- Medicines are taken without any side effects
- High blood pressure is controlled by medication
Then the medicine is considered safe for him to continue for the rest of his life. But if high blood pressure is diagnosed for the first time after the age of 80, medication will be advised only after considering other health risks.
Lifestyle changes
Some healthy changes in daily lifestyle should be made to lower blood pressure. Some of these changes can help lower blood pressure within a few weeks. However, some changes may take longer to have an effect.
- Try to limit the amount of salt in your diet to 6 grams (about one teaspoon) per day. The salt used in cooked food and the raw salt of leaves should be kept in this amount.
- Eat healthy and balanced food. Try to include enough fresh fruits and vegetables in your diet. Cut down on fat and high calorie foods.
- Develop an exercise habit. Gradually increase the amount of daily physical activity.
- If the weight is more than normal, reduce it. You can use a BMI calculator to find out the ideal weight.
- Try to cut down on caffeinated beverages like tea, coffee, and coke.
- Quit smoking.
- If you have a habit of drinking alcohol, reduce it.
These habits should be followed even if you are already taking high blood pressure medication. Developing these habits over time can reduce the need for medication. So practice these habits from today.
High blood pressure medication
A variety of medications are used to control high blood pressure. Medicines are usually available in tablet form and are taken once a day. However, if necessary, it may be recommended to eat twice a day.
Generally—
- ACE inhibitors or angiotensin II receptor blockers are recommended for patients under 55 years of age .
- If the patient is 55 years or older, calcium channel blockers are usually recommended.
A high blood pressure patient may need to take these medications for life. If necessary, the doctor may add other medicines to control blood pressure. Again, if one drug does not work, another drug may be suggested instead.
However, if the blood pressure has been under control for several years, the doctor may reduce the dose of the medicine. If necessary, he can advise you to stop taking medicines and simply follow a healthy lifestyle.
The dosage of the medicine should not be changed or stopped without the doctor's advice. It is very important to take the medicine exactly as directed. Missing the prescribed dose of the medicine for the day will reduce the effectiveness of the medicine.
You may not feel much of a difference after taking the medicine. But that doesn't mean the medicine isn't working.
A combination of two or more medications may be needed to control high blood pressure.
Never do that
Many people stop taking the medicine, or reduce the dose on their own, when they feel physically healthy. This action is totally inappropriate. As a result of this, the blood pressure may increase and lead to various complex and life-threatening health problems including stroke, kidney disease, blindness. Therefore, the medicine should be taken regularly in the correct dosage. In addition to taking medication, it will be much easier to control blood pressure by making healthy changes in lifestyle such as balanced and moderate food, exercise habits, smoking cessation.
How do high blood pressure medications work?
The mechanisms of action and common side effects of drugs used to treat high blood pressure are discussed here.
ACE inhibitors
(ACE Inhibitor=Angiotensin Converting Enzyme Inhibitor)
Medicines in this group—
- Lowers blood pressure by relaxing the blood vessels of the body
- The most commonly used are: Enalapril, Lisinopril, Perindopril and Ramipril.
Side Effects: The most common side effect is a prolonged dry cough. Other side effects include—headache, dizziness, red welts or rash.
Angiotensin II receptor blockers
Medicines in this group—
- Lowers blood pressure by relaxing the body's blood vessels—that is, works like the ACE inhibitor group. If any side effects occur due to taking medicines of ACE inhibitor group, taking medicines of this group is recommended.
- The most commonly used are: Candesartan, Irbesartan, Valsartan and Olmesartan.
Side effects: Common side effects include—headache, dizziness, chills, flu-like symptoms.
Calcium channel blockers
Medicines in this group—
- Dilates blood vessels in the body and lowers blood pressure
- The most commonly used are: Amlodipine, Felodipine and Nifedipine, Diltiazem and Verapamil.
Side effects: Common side effects include—headache, ankle swelling, constipation.
Consuming excessive amounts of grapefruit or grapefruit juice while taking calcium channel blockers may increase side effects.
Diuretics
Medicines in this group—
- Removes excess water and salt from the body through urine.
Diuretics are recommended if side effects occur after taking calcium channel blockers.
- Most commonly used are: Indapamide and Bendroflumethiazide.
Side effects: Common side effects include— dizziness on standing up suddenly, excessive thirst, frequent urination, red welts or rash.
Taking such medicine for a long time can cause deficiency of important salts called potassium and sodium in the body.
Beta blockers
A few days ago, beta blockers were the most popular drug in the treatment of high blood pressure. However, this group of drugs is recommended only if other drugs do not work. Because beta blockers are less effective than other blood pressure lowering medications.
Medicines in this group—
- Lowers blood pressure by reducing the speed and intensity of the heartbeat
- Most commonly used are: Atenolol, Bisoprolol, Metoprolol, Labetalol, Carvedilol
Side Effects: Common side effects include—headache, dizziness, feeling tired, cold hands and feet.
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