Hypertension Treatments

Although hypertension can be frightening because of its long-term health effects, and the lack of warning signs, it is very treatable. The dual goals of hypertension treatments are to lower the blood pressure to a normal level and to maintain that level. 

The first line of attack is lifestyle changes. Following a heart healthy diet loaded with vegetables, fruits, and legumes (peas and beans), but low in sodium and saturated fats, is the first step. Limit alcohol consumption to one drink per day for women, and two drinks per day for men. 

Adding regular exercise is the second, and just as important, step. Exercise has been shown to reduce blood pressure levels, and will also help reduce weight to acceptable levels. Being overweight is a contributing factor to hypertension. Thirty minutes of moderate daily exercise is the goal. Check with your physician before implementing any exercise program.

Smoking raises blood pressure significantly. If you are a smoker, it is vital to stop smoking as soon as possible. Your physician or other health care worker will be able to help you find a product or program to aid you in this goal.

Reduce stress as much as possible. Stress is a leading contributing factor to hypertension.

For many people, these changes are enough to bring their blood pressure into a normal range. For others, further hypertension treatments are necessary. There are many medications which your doctor can prescribe which will help reduce blood pressure. The medications your doctor prescribes depend on many factors: your individual health profile, weight, other existing health problems such as diabetes or kidney disease, and other medications you may be taking.

There are several classes of hypertension medications, each containing a number of drugs within it. These work in different ways and with different systems in the body to help lower blood pressure. Depending on your individual needs, your physician may prescribe one or more of these hypertension medications to work together. He or she will keep a careful eye on your blood pressure and on any side effects which may occur in order to ascertain the best combination of medications for you.

One of the most commonly prescribed medications is a diuretic, often called “water pills.” They help flush excess water and sodium from the system. While there are several types of diuretics, the thiazide diuretics are commonly utilized to help lower and regulate blood pressure. Examples of thiazide diuretics are Esidrix or Zaroxolyn. Side effects can include frequent urination, dizziness, blurred vision, muscle cramps and fatigue, dehydration, constipation, and nausea. Many of these side effects are associated with lack of potassium caused by the excretion of potassium with the excess fluid. Your physician may prescribe a potassium supplement along with the diuretic.

Beta-blockers help the heart to beat more lowly and with less force. Some of the most commonly prescribed are Tenormin (atenolol), Coreg (carvedilol) and Levatol (penbutolol) . Side effects of beta blockers can include dizziness, fatigue drowsiness, cold extremities, edema, sexual problems, slow heartbeat, depression, and breathing problems. Taking your medication with food can help lessen side effects.

Apha blockers reduce the nerve impulses which tighten the blood vessel walls. Alpha blockers work in a similar way to beta blockers, except that they affect alpha receptors. A sub-class called an alpha-1 blocker is useful for treating hypertension with high cholesterol. Side effects include dizziness or faintness upon standing, headaches and sinus congestion, heart palpitations, sexual problems, and dry mouth. 

ACE (Angiotensin converting enzyme) inhibitors prevent the body from manufacturing a hormone called angiotensin II. This hormone narrows and restricts artery walls, which increases pressure. By lowering the levels of angiotensin II, blood pressure is also lowered. ACE inhibitors also increase blood flow, so the heart does not have to work as hard. This also helps to prevent kidney damage. ACE inhibitors include Captopril, Lisinopril, Enalapril, and Benzapril. Some of the side effects of these medications are persistent dry cough, nausea or diarrhea, fever and chills, and trouble swallowing. 

There are also angiotensin II receptor blockers (ARBs) which, like the ACE inhibitors, prevent narrowing of the artery walls. They are usually prescribed for patients who cannot tolerate ACE inhibitors. Examples include Cozaar (losartan), Diovan (valsartan), Avapro ( irbesartan), and Atacand ( candesartan). Dizziness, muscle cramps or weakness, insomnia, back or leg pain, nausea or diarrhea, and confusion are side effects which may occur, but are not common. 

Vasodilators work to relax the walls of the arteries and other blood vessels. They are fast-acting, and frequently used in emergencies. Because they can cause increased heart rate as well as fluid retention, they are often prescribed in combination with a beta blocker, which slows the heart rate. Vasodilators include hydralazine and minoxidil. Besides the increased heart rate, side effects can include flushing, palpitations, nausea and weakness. Minoxidil can also cause increased blood sugar and increased hair growth.

Calcium channel blockers keep the blood vessels from absorbing calcium, thus resulting in the relaxation of the walls. Amlodipine, diltiazem, nifedipine, and verapamil are four common medications in this group. Dizziness, dry mouth, heart rhythm problems, edema, headache, low blood pressure, nausea, constipation and fatigue are potential side effects. Taking the medication with milk or food can help prevent some side effects.

Nervous system inhibitors, also called “peripheral nerve acting agents” or anti-adrenergics are not used as much anymore due to their side effects, and the many other medications available. These work in the brain rather than the circulatory system, to augment messages to the system to enlarge and relax the walls of the blood vessels. Side effects of Reserpine (Serpalan) can include nightmares, depression, congestion, and indigestion. Guanethidine (Ismelin) is often the cause of a slowed heart rate and hypotension (low blood pressure).

Hypertension treatments are simple to implement. Taking the hypertension medications prescribed by your physician and embracing a healthy lifestyle by not smoking, not drinking alcohol to excess, getting daily exercise, and good nutrition will help lower and maintain your blood pressure at healthy level.

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