Hypertension - Treatment

There is no cure for primary hypertension, but blood pressure can almost always be reduced with the correct treatment. The goal of this treatment is to prevent the complications of hypertension.

In cases of secondary hypertension, one approach is to treat the medical condition that causes hypertension. Efforts may be made at the same time to reduce the patient's blood pressure.

A program designed to reduce blood pressure usually has three parts: changes in diet, a plan of regular exercise, and antihypertensive medications. Some changes in lifestyle that can reduce blood pressure include the following:

The effects of hypertension on the heart and kidney. Hypertension has caused atrophy and scarring of the kidney (left) and left ventricular hypertrophy in the sectioned heart (right). (Photograph by

Dr. E. Walker

. Reproduced by permission of

Photo Researchers, Inc.

)

• Reducing salt intake
• Reducing fat intake
• Losing weight
• Getting regular exercise
• Quitting smoking
• Reducing alcohol consumption
• Learning how to manage stress

For patients with mild or moderate hypertension, these steps may be enough to bring their blood pressure into the normal or high normal range. For patients with more serious hypertension, medications may be prescribed. A variety of medications are available for the treatment of hypertension. They fall into the following categories:

• Diuretics help the kidneys eliminate excess salt and water. The loss of fluid from the kidneys causes arteries to expand and blood pressure to become lower.
• Beta-blockers cause the heart to beat more slowly and with less force.
• Calcium channel blockers help relax muscle cells, reducing the force with which they pump blood.
• Angiotensin converting enzyme (ACE) inhibitors are chemicals that prevent blood vessels from tightening up. As a result, the pressure exerted by blood in the blood vessels is reduced.
• Alpha-blockers act on the nervous system, causing arteries to expand and reduce the pressure exerted by the heart on blood flow.
• Vasodilators are chemicals that act directly on arteries, causing them to relax (dilate) so that blood can move more easily through them.
• Nervous system antagonists and agonists act on the nerves that control the size of arteries. They cause arteries to open and allow blood to flow through them more easily.