How to lower blood pressure
The regulation of blood pressure is a complex system with various feedback loops and control points where medications can act. For that reason, there are many different ways that drugs can lower blood pressure. Lifestyle changes always form the basis of treatment. Lifestyle changes may be enough to prevent or at least delay the need for medication in patients with mild hypertension (stage 1). Also, if blood pressure medications are still needed, their effects can be enhanced so that less medication is required.
The following measures are recommended:
- Quit smoking
- Reduce alcohol consumption to less than 14 units per week for men and 8 units per week for women (1 unit equals 125 ml of wine or 250 ml of beer).
- Lose weight if you are overweight
- Regular physical activity at least 30 minutes on 57 days per week.
- Reduce table salt intake to under five grams per day
- Increase your intake of vegetables, fruit, fish, nuts and unsaturated fats (such as olive oil). Also choose low-fat dairy products and limit red meat.
- Avoid binge drinking completely
A sufficient but not excessive intake of potassium from food (e.g., fruit, vegetables, legumes) can have a positive effect on blood pressure. However, before taking over-the-counter potassium effervescent tablets or similar products, please talk to your doctor to avoid side effects. This is especially important if you have kidney disease, because in that case you should not get too much potassium. Discussing this with your doctor is therefore essential.
For sufficiently high blood pressure values (stage 2 or 3 hypertension) or if additional risk factors are present (for example diabetes), drug therapy is started early.
Antihypertensives blood pressurelowering medications
For routine treatment, medications from five different drug classes are recommended; depending on other underlying conditions, these are largely considered equivalent. They are all suitable for both initial and long-term treatment of high blood pressure. These are
- Diuretics water pills
- Beta-blockers
- Calcium channel blockers (three groups are distinguished)
- ACE inhibitors
- Angiotensin receptor blockers (ARBs)
In most patients, treatment is started directly with a combination of two drug classes, preferably combined in a single pill.
Monotherapy, meaning treatment with only one drug class, should only be used for stage 1 hypertension or selected patients (e.g., very advanced age). As long as the target blood pressure is not reached, medication should be intensified. A triple combination therapy is also conceivable.
The final treatment decision is up to your doctor.
For more information, see our article on high blood pressure medications.
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Sources:
This article comes from BloodPressureDB – the leading app since 2011 that helps hundreds of thousands monitor their blood pressure every day.
Our content is based on carefully researched, evidence-based data and is continuously updated (as of 01/2024).
Author Dr. med. Christine Berchtold-Benchieb is a specialist in general medicine, studied at LMU Munich and has worked in hospitals as well as in several general and specialist practices. Her many years of daily care for patients with high blood pressure combine evidence-based expertise with practical experience and provide reliable recommendations.
Author Dr. med. Christine Berchtold-Benchieb is a specialist in general medicine, studied at LMU Munich and has worked in hospitals as well as in several general and specialist practices. Her many years of daily care for patients with high blood pressure combine evidence-based expertise with practical experience and provide reliable recommendations.
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