High Blood Pressure
Alternate Names : Hypertension
What are the treatments for the condition?
Secondary high blood pressure can sometimes be controlled by treating the
underlying condition. Effective treatment of Cushing's syndrome may lower blood pressure. Open heart surgery to correct
coarctation of the aorta
can correct high blood pressure.
There are many types of medications used to treat high
blood pressure. The medications are classified as follows:
Angiotensin-converting enzyme inhibitors, or ACE inhibitors, block the production of a body chemical that constricts the arteries.
ACE inhibitors include benazepril hydrochloride, enalapril maleate, and
quinapril hydrochloride.
Angiotensin II receptor blockers block the effect of a body chemical
that constricts the arteries. This group of medications includes valsartan,
losartin potassium, and candesartan.
Beta-blockers lower the heart rate and increase the amount of blood
pumped with each heartbeat. Common beta-blockers include atenolol, propanolol
hydrochloride, and nadolol.
Calcium channel blockers lower the heart rate and relax the blood
vessels. Some common calcium channel blockers include amlodipine besylate,
diltiazem hydrochloride, nifedipine, and verapamil.
Diuretics, or water pills, help the body get rid of extra fluid and
sodium. Common diuretics
include furosemide, hydrochlorothiazide, and chlorthalidone.
Sympathetic nerve inhibitors keep the nervous system from
constricting arteries. This group includes clonidine hydrochloride, guanabenz
acetate, and alpha methyldopa.
Vasodilators relax the muscles in the blood vessel walls and allow
the vessels to dilate. Common vasodilators include isosorbide dinitrate and
hydralazine.
Calcium channel blockers have been used for more than 20
years to treat high blood pressure. However, the findings of two recent
studies have shown
that people who take a calcium channel blocker have a much higher incidence of
complications than people taking other medications for high blood pressure.
One study, for example, found that the risk of heart attack was 27%
greater. The risk of congestive heart failure was 26% higher. The
American
Heart Association recommends discussing the risks and benefits of the
medication with the healthcare provider.
The choice of medication varies depending on a person's medical history.
Beta-blockers
usually are avoided in someone with breathing problems such as asthma. ACE inhibitors and diuretics are especially useful for
people with kidney disease or
diabetes. A person who has high blood pressure may be on multiple
medications.
The goal of treatment is to keep the top number below 140 and the bottom number
below 90. In a person with diabetes, the goal is to keep the top number below
130 and the bottom number below 85. For an individual with heart
disease or
kidney
disease, the goal is to get the blood pressure as low as can be
tolerated.
What are the side effects of the treatments?
The side effects of treatment of high blood pressure vary according to the
medications used. Beta-blockers can worsen
asthma. Diuretics can cause
dehydration and salt
imbalance.
Calcium channel blockers can cause swelling of the legs, as well as a
higher risk of heart attack and congestive heart
failure. ACE inhibitors may lead to chronic dry
cough.
What happens after treatment for the condition?
A person who has high blood pressure needs to continue to take the prescribed
medications daily. Blood pressure may return to normal as a result of lifestyle changes. These changes include weight
loss, increased physical
activity,
reduction of
alcohol intake, and a
diet low in
sodium. In most cases,
a
person will need to continue to take blood pressure medications for life.
How is the condition monitored?
High blood pressure is monitored through frequent visits to a healthcare
professional. A person who has high blood pressure often records blood
pressure readings between
office
visits. Any new or worsening symptoms should be reported to the healthcare
provider.
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