High blood pressure (hypertension) - Treatment 

You can take effective steps to lower your blood pressure with changes to your lifestyle and by taking medication.

Your choice of treatment will depend on your blood pressure level and your risk of developing a cardiovascular disease, such as a heart attack or stroke.

• If your blood pressure is slightly above 130/80mmHg but your risk of cardiovascular disease is low, you should be able to lower your blood pressure by making some changes to your lifestyle.
• If your blood pressure is moderately high (140/90mmHg or above) and you're at risk of cardiovascular disease in the next 10 years, treatment will involve medication and lifestyle adjustments.
• If your blood pressure is very high (180/110mmHg or above) you will need treatment soon, possibly with further tests, depending on your health.

Lifestyle changes

Below are some changes you could make to your lifestyle to reduce high blood pressure. Some of these will lower your blood pressure in a matter of weeks, others may take longer.

• Cut your salt intake to less than 6g (0.2oz) a day. Find out how you can reduce the amount of salt in your diet.
• Eat a healthy, low-fat, balanced diet, including plenty of fresh fruit and vegetables. Get tips on eating more healthily.
• Be active: being physically active is one of the most important things you can do to prevent or control high blood pressure. Get tips on being more active.
• Cut down on alcohol. Get tips on cutting down, download a drinks diary and keep track of your drinking.
• Stop smoking. Smoking greatly increases your chances of getting heart and lung diseases. Get help quitting.
• Lose weight. Find out what your ideal weight is using the BMI healthy weight calculator.
• Drink less coffee, tea or other caffeine-rich drinks such as cola. Drinking more than four cups of coffee a day may increase your blood pressure.
• Try relaxation therapies, such as yoga, meditation and stress management. These treatments are not normally provided by the NHS.

The more healthy habits you adopt, the greater effect there is likely to be on lowering your blood pressure.

In fact, some people find that, by sticking to a healthy lifestyle, they do not need to take any medicines at all. Find out more about preventing high blood pressure.

Medication

There is a wide range of blood-pressure-lowering medicines to choose from. You may need to take more than one type of medication because a combination of drugs is sometimes needed to treat high blood pressure.

In some cases, you may need to take blood pressure-lowering medication for the rest of your life. However, if your blood pressure levels stay under control for several years, you might be able to stop your treatment.

Most medications used to treat high blood pressure can produce side effects but the large choice of blood pressure medicines means that these can often be resolved by changing treatments.

Let your GP know if you have any of the following common side effects while taking medication for high blood pressure:

• feeling drowsy
• pain around your kidney area (on the side of your lower back)
• a dry cough
• dizziness, faintness or light-headedness
• a skin rash

Below are the most widely used medications for treating high blood pressure. Different high blood pressure treatments work better for different ethnic groups. Your GP will consider your ethnic background when making a treatment plan.

ACE inhibitors

Angiotensin-converting enzyme (ACE) inhibitors reduce blood pressure by relaxing your blood vessels. The most common side effect is a persistent dry cough. If side effects become particularly troublesome, a medication that works in a similar way to ACE inhibitors, known as an angiotensin-2 receptor antagonist, may be recommended.

ACE inhibitors can cause unpredictable effects if taken with other medications, including some over-the-counter ones. Check with your GP or pharmacist before taking anything in combination with this medication.

Find out more about ACE inhibitors.

Calcium channel blockers

Calcium channel blockers keep calcium from entering the muscle cells of the heart and blood vessels. This widens your arteries (large blood vessels) and reduces your blood pressure.

Drinking grapefruit juice while taking some types of calcium blockers can increase your risk of side effects. You can discuss the possible risks with your GP or pharmacist.

Find out more about calcium channel blockers.

Diuretics

Sometimes known as water pills, diuretics work by flushing excess water and salt from the body through urine.

Find out more about thiazide diuretics.

Beta-blockers

Beta-blockers work by making your heart beat more slowly and with less force, thereby reducing blood pressure.

Beta-blockers used to be a popular treatment for high blood pressure but now they only tend to be used when other treatments have not worked. This is because beta-blockers are considered to be less effective than the other medications used to treat high blood pressure.

Find out more about beta-blockers.

Beta-blockers can also interact with other medications, causing possible side effects. Check with your GP or pharmacist before taking other medications in combination with beta-blockers.

Don't suddenly stop taking beta-blockers without first consulting your GP. Stopping suddenly will lead to serious side effects, such as a rise in blood pressure or an angina attack.

Alpha-blockers

Alpha-blockers are not usually recommended as a first choice for lowering high blood pressure unless other treatments have not worked. Alpha-blockers work by relaxing your blood vessels, making it much easier for blood to flow through them.

Common side effects of alpha-blockers include:

• fainting spells when you first start the treatment
• dizziness
• headache
• swollen ankles
• tiredness

Find out about the health risks of not treating high blood pressure.