The goal of treatment is to lower your high blood pressure. This will help prevent stroke and damage to organs and blood vessels throughout the body.
First, your doctor will recommend that you make changes to your lifestyle. The severity of your high blood pressure will determine whether or not you need to take medication in addition to making lifestyle changes.
Based on the results of your medical examination, lab tests, and the severity of your high blood pressure, your doctor can determine the best treatment plan for you.
Lifestyle change is the first step
Lifestyle changes may be enough to lower your blood pressure if carried out with commitment and determination. This includes eating healthier foods, exercising, and controlling your weight.
If lifestyle changes alone do not bring your blood pressure down low enough, your doctor will then add medication. If you have any of the following risk factors, your doctor will likely start you on medication sooner:
- High total cholesterol
- High LDL ("bad") cholesterol
- Low HDL ("good") cholesterol
- Men over 35
- Women after menopause
- Family history of early cardiovascular disease (father, grandfather, or brother under age 55; mother, grandmother, or sister under age 65)
Finally, if you have any of the following medical conditions, your doctor will probably start you on medication right away:
- Heart disease (Chest pain due to heart disease, prior heart attack, prior surgery on coronary arteries, heart failure, enlargement of left ventricle)
- Kidney damage
- Disorders of the retina (eye)
- Other artery disease
Again, lifestyle changes continue to be necessary even if you are taking blood pressure medication.
If you are like most people with high blood pressure, you will need medication to bring your blood pressure under control. In fact, two or more drugs are often needed. It is important to remember, however, that medications do not work well if you don't make the necessary lifestyle changes to your diet, weight, and exercise routine. In addition, medications are only effective if they are taken at the prescribed amount and frequency. Compliance with medication is critical in the long-term management of high blood pressure.
Patients with diabetes
If you have diabetes, the goal for your blood pressure is less than 130/80. The goal is lower because diabetes and hypertension are a very dangerous combination that can quickly lead to organ damage and early death. Like anyone with high blood pressure, you will be followed closely and treated with lifestyle changes initially. However, drug treatment is generally started earlier than for someone without diabetes if diet and exercise alone don't bring your blood pressure down.
Steven Kang, MD, Division of Cardiac Pacing and Electrophysiology, East Bay Arrhythmia, Cardiovascular Consultants Medical Group, Oakland, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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