High blood pressure

The goal of treatment is to reduce blood pressure to a level where there is decreased risk of complications. Treatment may occur at home with close supervision by the health care provider, or may occur in the hospital.

Medications may include diuretics, beta-blockers, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), or alpha blockers. Medications such as hydralazine, minoxidil, diazoxide, or nitroprusside may be required if the blood pressure is very high.

Have your blood pressure checked at regular intervals (as often as recommended by your doctor.)

Lifestyle changes may reduce high blood pressure, including weight loss, exercise, and dietary adjustments (see "Prevention").

Hypertension is controllable with treatment. It requires lifelong monitoring, and the treatment may require adjustments periodically.

• hypertensive heart disease
• heart attacks
• congestive heart failure
• blood vessel damage (arteriosclerosis)
• aortic dissection
• kidney damage
• kidney failure
• stroke
• brain damage
• loss of vision

Even if you have not been diagnosed with high blood pressure, it is important to have your blood pressure checked at annual exams, especially if you have a history of high blood pressure in your family.

If you have high blood pressure, you will have regularly scheduled appointments with your doctor.

In between appointments, if you have any of the symptoms listed below or your blood pressure remains high even with treatment (this assumes the use of a home blood pressure monitor), then call your doctor right away.

• Severe headache
• Excessive tiredness
• Confusion
• Visual changes
• Nausea and vomiting
• Chest pain
• Shortness of breath
• Significant sweating

Wang Y, Wang QJ. The prevalence of prehypertension and hypertension among US adults according to the new joint national committee guidelines: new challenges of the old problem. Arch Intern Med. 2004;164(19):2126-34.

Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). Rockville, Md. National Heart, Lung, and Blood Institute, US Department of Health and Human Services; August 2004. National Institutes of Health Publication No. 04-5230. 

Eyre H, Kahn R, Robertson RM, et al. Preventing cancer, cardiovascular disease, and diabetes: A common agenda for the American Cancer Society, the American Diabetes Association, and the American Heart Association. Circulation. 2004;109(25):3244-55.

Whelton PK, He J, Appel LJ, et al. Primary prevention of hypertension: Clinical and public health advisory from The National High Blood Pressure Education Program. JAMA. 2002;288(15):1882-8.