High Blood Pressure Treatment

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Your provider may use a risk calculator to estimate your risk of having a stroke or heart attack or dying from a heart or blood vessel disease. This information can help you both choose the best treatment to prevent long-term complications.

For example, the Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimator considers your cholesterol levels, age, sex, race, and blood pressure. It also factors in if you smoke or take medicines to manage high blood pressure or cholesterol.

Keep in mind that your cholesterol numbers and your risk score are only part of the story. You should talk to your provider to learn what the numbers mean for you. Also, the ASCVD Risk Estimator Plus isn’t the only type of risk calculator — and that’s a good thing, because no single risk calculator is right for everyone. For example, your provider might use the Predicting Risk of cardiovascular disease EVENTs (PREVENTTM) app to help assess your risk for serious complication. Studies show that some calculators overestimate risk for certain groups, while others may underestimate risk. Talk with your provider about your personal risk level. 

If you have high blood pressure, your provider may recommend that you adopt a heart-healthy lifestyle to help lower and control high blood pressure.

• Choose heart-healthy foods such as those in the DASH eating plan. NHLBI-funded research has shown that DASH combined with a low-salt eating plan can be as effective as medicines in lowering high blood pressure. Living With the DASH Eating Plan and Tips to Reduce Salt and Sodium offer more information.
• Avoid or limit alcohol. Talk to your provider about how much alcohol you drink. You may need to limit it or stop drinking. Resources and support are available at the Alcohol Treatment Navigator from the National Institute on Alcohol Abuse and Alcoholism.
• Get regular physical activity. There are many health benefits to getting the recommended amount of physical activity each week. Studies have shown that physical activity can help lower and control high blood pressure levels. Even a small amount of physical activity may help, like walking for 10 minutes each day. Reducing the amount of time you sit each day can also help you achieve your blood pressure goal. Before starting any exercise program, ask your provider what level of activity is right for you.
• Aim for a healthy weight. If you are an adult who is living with overweight or obesity, losing 5% to 10% of your weight over 6 months can improve your health. Even losing just 3% to 5% of your weight can improve blood pressure.
• Quit smoking. The Tips to Quit Smoking Fact Sheet has information about how to quit smoking. For free help and support to quit smoking, you can call the National Cancer Institute’s Smoking Quitline at 1-877-44U-QUIT (1-877-448-7848).
• Manage stress. Learning how to manage stress and cope with problems can improve your mental and physical health. Relaxation techniques, talking to a counselor, and finding a support group can all help.
• Get enough good-quality sleep. The recommended amount for adults is 7 to 9 hours of sleep per day. Develop healthy sleep habits by going to sleep and getting up at regular times, following a calming bedtime routine, and keeping your bedroom cool and dark.

Changing habits can be hard. To help make heart-healthy changes that last a lifetime, try making one change at a time. Add another change when you feel comfortable with the previous one. Practice a few healthy lifestyle habits together. When you can keep them up over time, you’re more likely to manage your blood pressure well.

When healthy lifestyle changes alone do not control or lower high blood pressure, your provider may prescribe blood pressure medicines. These medicines act in different ways to lower blood pressure. When prescribing medicines, your provider also considers their effects on other conditions you may have, such as heart or kidney disease.

Keep up your healthy lifestyle changes while taking these medicines. The combination of medicines and heart-healthy lifestyle changes can help control and lower your high blood pressure and prevent heart disease.

Talk to your provider if you have any concerns about side effects from the medicines. Your provider may change the dose or give you a new medicine. To manage high blood pressure, many people need to take two or more medicines. 

There are several common high blood pressure medicines your provider can prescribe:

• Angiotensin-converting enzyme inhibitors keep your blood vessels from narrowing as much.
• Angiotensin II receptor blockers also keep blood vessels from narrowing.
• Calcium channel blockers prevent calcium from entering the muscle cells of your heart and blood vessels. This allows blood vessels to relax.
• Diuretics remove extra water and sodium (salt) from your body, lowering the amount of fluid in your blood. The main diuretic for high blood pressure treatment is thiazide. Diuretics are often used with other high blood pressure medicines, sometimes in one combined pill.

If you are planning to get pregnant or are pregnant, talk with your provider about medicines you’re taking to lower your blood pressure. Not all medicines are safe during pregnancy, but some are. Controlling your blood pressure while you’re pregnant can lower your risk of pregnancy complications.