Many different types of medicine can be used to treat high blood pressure (see the box below). These are called antihypertensive medicines.

The goal of treatment is to reduce your blood pressure to normal levels with medicine that’s easy to take and has few, if any, side effects. This goal can almost always be met.

If your blood pressure can only be controlled with medicine, you’ll need to take the medicine for the rest of your life. Don’t stop taking the medicine without talking with your family doctor or you may increase your risk of having a stroke or heart attack.

Types of antihypertensive drugs

* Diuretics: These drugs help your body get rid of extra sodium and fluid so that your blood vessels don’t have to hold so much fluid.

* Beta-blockers: These drugs block the effects of adrenaline.

* Alpha-blockers: These drugs help your blood vessels stay open.

* ACE inhibitors: These drugs prevent your blood vessels from constricting by blocking your body from making angiotensin II. Angiotensin II is a chemical that constricts blood vessels.

* Calcium channel blockers: These drugs help prevent your blood vessels from constricting by blocking calcium from entering your cells.

* Combinations: These drugs combine an ACE inhibitor with a calcium channel blocker.

Different drugs have different side effects for different people. Side effects of antihypertensive drugs can include feeling dizzy when you stand up after lying down or sitting, lowered levels of potassium in your blood, problems sleeping, drowsiness, dry mouth, headaches, bloating, constipation and depression. In men, some antihypertensive drugs can cause problems with having an erection.
Talk to your family doctor about any changes you notice. If one medicine doesn’t work for you or causes side effects, you have other options. Let your doctor help you find the right medicine for you.

Imagine that your arteries are pipes that carry blood from your heart to the rest of your body. High blood pressure (also called hypertension) occurs when your blood moves through your arteries at a higher pressure than normal.

Blood pressure is really two measurements, separated by a slash when written down, such as 120/80. You may also hear someone say a blood pressure is “120 over 80.”

The first number is the systolic blood pressure. This is the peak blood pressure when your heart is squeezing blood out. The second number is the diastolic blood pressure. It’s the pressure when your heart is filling with blood–relaxing between beats.

A normal blood pressure is 120/80 or lower. High blood pressure is 140/90 or higher. If your blood pressure is between 120/80 and 140/90, you have something called “prehypertension.”

Blood pressure is measured by putting a blood pressure cuff around your arm, inflating the cuff and listening for the flow of blood. Your doctor will measure your blood pressure at more than one visit to see if you have high blood pressure.

Treatment begins with changes you can make to your lifestyle to help lower your blood pressure and reduce your risk of heart disease (see the box below). If these changes don’t work, you may also need to take medicine.

Even if you must take medicine, making some changes in your lifestyle can help reduce the amount of medicine you must take.

Lifestyle changes

* Don’t smoke cigarettes or use any tobacco product.

* Lose weight if you’re overweight.

* Exercise regularly.

* Eat a healthy diet that includes lots of fruits and vegetables and is low in fat.

* Limit your sodium, alcohol and caffeine intake.

* Try relaxation techniques or biofeedback.

The nicotine in cigarettes and other tobacco products causes your blood vessels to constrict and your heart to beat faster, which temporarily raises your blood pressure. If you quit smoking or using other tobacco products, you can significantly lower your risk of heart disease and heart attack, as well as help lower your blood pressure.

If you’re overweight, losing weight usually helps lower blood pressure. Regular exercise is a good way to lose weight. It also seems to lower high blood pressure by itself.

In some people, alcohol causes blood pressure to rise quite a lot. In other people, it doesn’t. If you drink alcohol, limit it to no more than 1 or 2 drinks per day. One drink is a can of beer, a glass of wine or 1 jigger of liquor. If your blood pressure increases with alcohol, it’s best not to drink any alcohol.

For both men and women, the biggest factors that contribute to heart disease are smoking, high blood pressure, high cholesterol, family history and age. Take a moment to look at your lifestyle, family history and your general health. With this information, you and your family doctor can assess your risk and make a plan to avoid potential problems. Although you can’t do much about your family history or your age, you can make lifestyle changes to avoid many of the other risk factors (see below).

Don’t smoke. Smoking is a major risk factor for heart disease in women. More than half of the heart attacks in women under 50 are related to smoking. If you stop smoking, you can lower your risk of heart attack by one third within 2 years. Women who smoke and use birth control pills increase their risk even more. There are a variety of products to help you quit smoking. You may want to try using nicotine skin patches or nicotine gum: these types of medicines are available over the counter. There are also prescription medicines available that can help you stop smoking. Talk to your doctor about the best way for you to quit smoking. Breathing smoke from someone else’s cigarettes is also bad for your heart and lungs. If you live with someone who smokes, encourage him or her to quit.

Control your blood pressure. Treating high blood pressure can lower your risk of heart attack and stroke. Losing weight, exercising regularly and eating a healthy diet are all ways to help control high blood pressure. Reducing how much salt you consume can also help. If these steps don’t lower your blood pressure, your doctor may recommend medicine for you to take.

Control your cholesterol level. If you don’t know your level, ask your doctor to check it. Diet is a key part of lowering high cholesterol levels. However, some people may need to take medicine in addition to diet and exercise.

Maintain a healthy weight. Extra weight puts strain on your heart and arteries. Exercise and a low-fat diet can help you lose weight. Being overweight means you have a higher risk for many other health problems, especially diabetes, high blood pressure and heart disease. If you’re overweight, talk to your doctor about a safe and effective way to lose weight.

Exercise regularly. Remember, your heart is a muscle. It needs regular exercise to stay in shape. Aerobic exercise, such as brisk walking, swimming, jogging or biking, gives your heart the best workout. You can also use fitness equipment like exercise bicycles, treadmills and ski machines when exercising indoors. Finding an exercise partner may make it easier and safer for you to exercise often. You should exercise at least 30 to 60 minutes, 4 to 6 times a week. Talk to your doctor before starting an exercise program.

Eat a low-fat diet. Keep fat calories to 30% or less of the total calories you eat during a day and avoid saturated fat (the fat in meats and coconut oil). Information is available to help you make healthy choices. For example, food labels list nutrition information, including fat calories, many cookbooks have heart-healthy recipes, and some restaurants serve low-fat dishes.

Take care of diabetes. If you have diabetes, regular exercise, weight control, a low-fat diet and regular doctor visits are important. If you need to take medicine for diabetes, be sure to take it exactly as your doctor tells you to.

Be aware of chest pain. Be sure to contact your doctor immediately if you suffer from pain in your chest, shoulder, neck or jaw. Also notify your doctor if you experience shortness of breath or nausea that comes on quickly. If you are having a heart attack, the faster you can get to the hospital, the less damage will happen to your heart. Every second counts.

Know your family history. Having a father or brother with heart disease before age 55, or a mother or sister with heart disease before age 65, are factors that contribute to heart disease. Inform your doctor about your family history.

Women are at risk for heart disease and heart attacks, just like men. In fact, heart disease is the leading cause of death among women over 65. American women are 4 to 6 times more likely to die of heart disease than of breast cancer. Heart disease kills more women over 65 than all cancers combined. Women develop heart problems later in life than men — typically 7 or 8 years later. However, by about age 65, a woman’s risk is almost the same as a man’s.

Cholesterol-lowering medicines lower the risk of heart attacks in men. However, there is not enough evidence to show that these medicines work as well in women who have never had a heart attack. If you have already had a heart attack, cholesterol-lowering medicines can lower your risk of another attack.

Taking an aspirin every day may lower your risk of problems if you have coronary artery disease, a heart attack or angina. Aspirin makes your blood thinner, so it is less likely to make a blood clot. However, aspirin can cause gastrointestinal bleeding and other problems. Talk to your doctor about your risk factors for heart disease and whether you should consider taking aspirin.

Angina is chest pain caused by a sudden decrease in the blood supply to the heart. Medicines called statins, beta-blockers and ACE inhibitors may also help if you have heart problems. Ask your doctor if any of these medicines are right for you.

Estrogen replacement therapy, also called hormone replacement therapy, can help minimize the symptoms of menopause (such as hot flashes) and to reduce the risk of osteoporosis (weakening of the bones). It was once thought that HRT could also help protect against heart disease. New studies have shown that when it comes to heart health, HRT actually does more harm than good. If you’re taking HRT to help prevent heart disease, talk to your doctor about whether you should stop.