Stephen J. Schueler, M.D.

Primary Hypertension Treatment

Treatment for hypertension often includes a low salt diet, avoiding smoking and secondary smoke, regular exercise, weight reduction for obesity, and medications to control blood pressure. Rarely, surgery may be required to treat some less common causes of hypertension.

Treatment options for hypertension include:

  • Diet for high blood pressure:
  • Limit alcohol use to no more than 2 drinks per day for men and 1 for women
  • Lifestyle changes for high blood pressure
  • Medications for high blood pressure
  • Surgery for high blood pressure:
    • For rare causes for high blood pressure
  • Encourage self monitoring of blood pressure

Many types of medications are used to treat hypertension. Classes of medication used to treat hypertension include:

Primary Hypertension Diet

A diet for the treatment of hypertension includes:

  • Low cholesterol diet
  • Low fat diet
    • Limit intake of fat to 25% of your total calories.
    • 10% to 15% of your total calories should be in the form of monounsaturated fats, such as olive oil, canola oil and peanut oil.
  • Low salt diet for hypertension
    • Reduce salt intake to no more than 1,500 mg (1.5 grams) per day
    • One teaspoon of salt contains about 2,300 mg of sodium.
    • Avoid cooking with salt.
    • Avoid fast food.
    • Avoid salty foods, such as pickles, cured meats, salty snacks, and canned soup.
    • Avoid seasonings that contain sodium, such as soy sauce, steak sauce, garlic and onion salt, and monosodium glutamate.
    • Do not add salt to your food at the dinner table.
    • Read food labels and buy foods that are low in salt.
    • When eating out, ask that your food be prepared without added salt.
  • High fiber diet

Primary Hypertension Drugs

Many types of medications are used to treat hypertension.

General directions for taking hypertension medication include:

  • Take medications as directed.
  • Do not miss doses of medication.
  • Do not stop taking medication without talking to your doctor.

Types of medication used to treat hypertension include:

Primary Hypertension ACE Inhibitors

ACE inhibitors lower blood pressure by dilating arteries in the body. ACE inhibitors also reduce the risk of heart attack and help prevent heart failure, especially in those with diabetes.

Side effects include dizziness, sedation, fatigue, impotence, and depression. Rarely, ACE inhibitors cause swelling of the mouth or tongue, called angioedema.

ACE inhibitors for hypertension:

Primary Hypertension Alpha Blockers

Alpha-adrenergic blockers (alpha blockers) block the action of hormones in the bloodstream that cause narrowing of the arteries. These medications reduce the blood pressure by dilating the blood vessels.

Alpha-adrenergic blockers for hypertension:

Primary Hypertension AR2 Blockers

Angiotensin receptor blockers (AR2 blockers) block the action of a hormone, called angiotensin II, which constricts blood vessels and stimulates the body to retain fluid. These medications reduce the blood pressure by dilating the blood vessels and reducing fluid in the bloodstream.

Angiotensin receptor blockers for hypertension:

Primary Hypertension Beta-Blockers

Beta-blockers slow the heart rate, reduce the work done by the heart and reduce the blood pressure. Beta-blockers can reduce angina and reduce the risk for death in those who have had a heart attack.

Beta-blockers for hypertension:

Primary Hypertension Calcium Blockers

Calcium channel blockers reduce the blood pressure by dilating the blood vessels. Calcium channel blockers also slow the heart rate, and reduce the work done by the heart.

Calcium channel blockers for hypertension:

Some calcium channel blockers are available in combination with other drugs:

Primary Hypertension Diuretics

Diuretics stimulate the kidneys to remove water and salt from the body. This lowers the blood pressure and reduces strain on the heart.

Diuretics for hypertension:

Primary Hypertension Rx Combinations

Combination therapy involves treatment with two or more types of blood pressure medication. Some manufacturers combine two types of medication into one tablet.

Combination medications for high blood pressure:

Primary Hypertension Sympatholytics

Central sympatholytics medications stimulate the brain to dilate the blood vessels, which reduces the blood pressure.

Central sympatholytics for hypertension:

Primary Hypertension Vasodilators

Direct vasodilators stimulate the blood vessels to dilate, which lowers blood pressure.

Vasodilators for hypertension:

Primary Hypertension Lifestyle

Important lifestyle factors for those with hypertension:

  • Alcohol: Consume alcohol in moderation (if at all); No more than 1 glass of wine or beer per day in women; no more than 2 glasses of wine or beer in men.
  • Caffeine: Avoid caffeine-containing beverages such as coffee, tea, chocolate, and some cola.
  • Exercise: Discuss an exercise plan with your doctor to gradually raise your level of activity. Aerobic activity such as walking, running, swimming, or biking can lower blood pressure. Keep in mind isometric exercises such as bodybuilding, weight lifting, or push-ups can raise blood pressure. Never start an exercise regime without first consulting your physician.
  • Maintain a normal weight: Weight loss is a cornerstone of blood pressure treatment, with many studies showing that a loss of 10 to 20 pounds can lower blood pressure significantly.
  • Smoking: Stop smoking and avoid exposure to secondary smoke.
  • Stress Reduction: Plan a strategy to reduce stress. Some popular stress reducing activities include mediation, reading, painting, and gardening. Some people benefit from biofeedback programs. Anything that can reduce the stress in your daily life is worthwhile.

Primary Hypertension National Guidelines

National High Blood Pressure Education Program Recommendations

AssessmentGuidelineRecommended Action
Normal Blood PressureSBP < 120 and DBP <80None
Pre-hypertensionSBP 120-139 or DBP 80-89reduce weight, diet, exercise
Stage 1 hypertensionSBP 140-159 or DBP 90-99single medication
Stage 2 hypertensionSBP >160 or DBP >100two medications

Primary Hypertension Pregnancy

Facts about hypertension during pregnancy:

Primary Hypertension Questions For Doctor

The following are some important questions to ask before and after the treatment of hypertension.

Questions to ask before treatment:

  • What are my treatment options?
  • What are the risks associated with treatment?
  • Do I need to stay in the hospital?
    • How long will I be in the hospital?
  • What are the complications I should watch for?
  • How long will I be on medication?
  • What are the potential side effects of my medication?
  • Does my medication interact with nonprescription medicines or supplements?
  • Should I take my medication with food?

Questions to ask after treatment:
  • Do I need to change my diet?
  • When can I resume my normal activities?
  • When can I return to work?
  • Do I need a special exercise program?
  • What else can I do to reduce my blood pressure?
  • How often will I need to see my doctor for checkups?
  • What local support and other resources are available?

Primary Hypertension Specialist

Physicians from the following specialties evaluate and treat hypertension:

Primary Hypertension Surgery

Rare causes of hypertension that may require treatment with surgery include:

Continue to Primary Hypertension Home Care

Last Updated: Dec 16, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Primary Hypertension References
  1. Aronow WS. Treatment of hypertension in the elderly. Geriatrics. 2008 Oct;63(10):21-5. Review. [18828653]
  2. Kearney PM, Whelton M, Reynolds K, Whelton PK, He J. Worldwide prevalence of hypertension: a systematic review. J Hypertens. 2004 Jan;22(1):11-9. [15106785]
  3. Then KL, Rankin JA. Hypertension: a review for clinicians. Nurs Clin North Am. 2004 Dec;39(4):793-814. [15561162]
  4. Toto RD. Hypertension and kidney literature review 2000. Clin Nephrol. 2002 Oct;58(4):253-9. [12400839]
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