Treatment

Simple lifestyle changes can often help reduce high blood pressure (hypertension), although some people may need to take medication as well.

Your GP can advise you about changes you can make to your lifestyle and discuss whether they think you would benefit from medication.

This page covers:

When treatment is recommended

Lifestyle changes

Medication

Whentreatment is recommended

Everyone with high blood pressure is advised to make the healthy lifestyle changes outlined below.

Whether medication is recommended depends on your blood pressure reading and your risk of developing problems such as heart attacksor strokes.

Your doctorwill carry out some blood and urine tests, and ask questions about your health todetermine your risk ofother problems:

• ifyour blood pressure is consistently above 140/90mmHg (or 135/85mmHg at home) but your risk of other problems is low you'll be advised to make some changes to your lifestyle
• if your blood pressure is consistently above 140/90mmHg (or 135/85mmHg at home) andyour risk of other problems is high you'll be offered medication to lower your blood pressure, in addition to lifestyle changes
• if your blood pressure isconsistently above 160/100mmHg you'll be offered medication to lower your blood pressure,in addition to lifestyle changes

The various treatments forhigh blood pressureare outlined below. You can also read a summary of the pros and cons of the treatments for high blood pressure, allowing you to compare your treatment options.

Lifestylechanges

Below are some changes you could make to your lifestyle to reduce high blood pressure. Some of these will lower your blood pressure in a matter of weeks, while others may take longer.

These include:

• cutting your salt intake to less than 6g (0.2oz) a day find outhow you can reduce the amount of salt in your diet
• eating a low-fat, balanced diet including plenty of fresh fruit and vegetables; get tips oneatingmore healthily
• being active read some tipsabout getting more exercise
• cutting down on alcohol get tips oncutting down, including downloading a drinks diary and keeping track of your drinking
• losing weight find out what your ideal weight is using the BMI healthy weight calculatorand read advice aboutlosing weight if you're overweight
• drinking less caffeinefound in coffee, tea and cola
• stopping smoking get help quitting
• getting at least six hoursofsleep a night if you can read sometips for getting to sleep

You can take these steps today,regardless of whetheror not you're taking blood pressure medication. In fact, by making these changes early on you may be able to avoid needing medication.

Many people need to take a combination of different medicines.

The medication recommended for you at first will depend on your age and ethnicity:

• if you'reunder 55 years of age you'll usually be offered an ACE inhibitor or anangiotensin-2 receptor blocker (ARB)
• if you're aged 55 or older, or you're any age and of African or Caribbean origin you'll usually be offered a calcium channel blocker

You may need to take blood pressure medication for the rest of your life. Butyour doctor might be able to reduce or stop your treatment if your blood pressure stays under control for several years.

It's really importantto take your medications as directed. If you miss doses, it won't work as effectively. The medication won't necessarily make you feel any different, but this doesn't mean it's not working.

Medications used to treat high blood pressure can have side effects, but most people don't experience any. Ifyou do, changing medication will often help.

Common blood pressure medications are described below.

ACE inhibitors

Angiotensin-converting enzyme (ACE) inhibitors reduce blood pressure by relaxing your blood vessels.

Common examplesareenalapril, lisinopril, perindopril and ramipril.

The most common side effect is a persistent dry cough. Other possible side effects include headaches,dizziness and a rash.

Find out more aboutACE inhibitors.

Angiotensin-2 receptorblockers (ARBs)

ARBs work in a similar way to ACE inhibitors. They're often recommended if ACE inhibitors cause troublesome side effects.

Common examples are candesartan, irbesartan, losartan, valsartan and olmesartan.

Possible side effects includedizziness, headaches, andcold or flu-like symptoms.

Find out more aboutARBs.

Calcium channel blockers

Calcium channel blockers reduce blood pressure by widening your blood vessels.

Common examples are amlodipine, felodipine and nifedipine. Other medicines such as diltiazem and verapamil are also available.

Possible side effects include headaches, swollen ankles and constipation.

Drinking grapefruit juice while taking some calcium channel blockers can increase your risk of side effects.

Find out more aboutcalcium channel blockers.

Diuretics

Sometimes known as water pills, diuretics work by flushing excess water and salt from the body through urine. They're oftenused if calcium channel blockers cause troublesome side effects.

Common examples are indapamide and bendroflumethiazide.

Possible side effects include dizziness when standing up, increased thirst, needing to go to the toilet frequently, and a rash.

Low potassium level (hypokalaemia) and low sodium level (hyponatraemia) may also be seen after long-term use.

Find out more aboutthiazide diuretics.

Beta-blockers

Beta-blockers can reduce blood pressureby making your heart beat more slowly and with less force.

They used to be a popular treatment for high blood pressure, but now only tend to be used when other treatments haven't worked.

This is because beta-blockers are considered less effectivethan other blood pressure medications.

Common examplesareatenolol and bisoprolol.

Possible side effects include dizziness, headaches, tiredness, and cold hands and feet.

Find out more aboutbeta-blockers.

Angina

Angina is chest pain caused by a reduced flow of blood to the heart, typically resulting from heart disease.

Antihypertensive

Antihypertensive medicine reduce high blood pressure (hypertension).

Artery

Arteries are blood vessels that carry blood from the heart to the rest of the body. .

Cholesterol

Cholesterol is a fatty substance made by the body that lives in blood and tissue. It is used to make bile acid, hormones and vitamin D.

Chronic

Chronic usually means a condition that continues for a long time or keeps coming back.

Heart attack

A heart attack happens when there is a blockage in one of the arteries in the heart.

Platelets

Platelets are cells in the blood that control bleeding by plugging the broken blood vessel and helping the blood to clot.