How can blood pressure be lowered
The regulation of blood pressure is a complex system with various control circuits and "adjustments" that can be targeted with medication. Accordingly, the pharmacological influence on blood pressure reduction is also diverse. The basis of treatment is always the recommended lifestyle change. Lifestyle changes may be sufficient to prevent or at least delay the need for medication in patients with mild hypertension (Grade 1). Furthermore, if antihypertensive medications are still necessary, their effect can be enhanced, thus requiring less medication.
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 corresponds to 125 ml of wine or 250 ml of beer).
- Weight reduction in case of overweight
- Regular physical activity - at least 30 minutes on 5-7 days per week.
- Reduce salt consumption to under five grams per day
- Increase consumption of vegetables, fruits, fish, nuts, and unsaturated fatty acids (olive oil). Also, use low-fat dairy products and limit red meat.
- Avoid binge drinking completely
A sufficient, not excessive, potassium intake through food (e.g., fruits, vegetables, legumes) can positively affect blood pressure. However, before resorting to over-the-counter potassium effervescent tablets or similar, please consult your doctor to avoid side effects. This is especially important in cases of kidney disease, as too much potassium should not be supplied. Therefore, a conversation with the doctor is urgently necessary.
In cases of significantly high blood pressure values (Hypertension Grade II or III) or additional risk factors (such as diabetes), medication therapy is started early.
Antihypertensives - blood pressure-lowering medications
For routine treatment, medications from five different substance classes are recommended, which are largely considered equivalent (depending on other underlying conditions). They are suitable for both initial and long-term treatment of hypertension. These include
- Diuretics - water pills
- Beta-blockers
- Calcium antagonists (three groups can be distinguished here)
- ACE inhibitors
- Angiotensin receptor blockers (ARB)
In most patients, treatment is initiated directly with a combination of 2 substance classes, preferably combined in one tablet.
Monotherapy, meaning treatment with only one substance class, should only be done in cases of Hypertension Grade 1 or selected patients (e.g., very old age). As long as the target blood pressure is not reached, the medication therapy should be intensified. A triple combination therapy is also conceivable.
The final therapy decision lies with your treating physician.
For more information, please see our article on hypertension medications.
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Sources:
By Dr. med. Christine Berchtold-Benchieb.
This article is medically reviewed. Last updated by Sabine Croci (01/2024).
Information on the website and within the app cannot replace a consultation with a doctor, but can certainly complement it.
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