Simple Methods for Controlling High Blood Pressure

The normal blood pressure of the normal human being is 120/80 mmHg.when the blood pressure is more than 140/90 it is known as high blood pressure. The one on the top is known as systolic pressure and the one on the bottom is diastolic pressure. We should always keep in mind that high blood pressure is usually present for many years before its complications develop.

The idea is to treat hypertension early, before it damages critical organs in the body. Hence increased public awareness and screening programs to detect uncomplicated hypertension are the keys to successful treatment. By treating high blood pressure successfully early enough, we can significantly decrease the risk of stroke, heart attack, and kidney failure. The goal for patients with combined systolic and diastolic hypertension is to attain a blood pressure of 140/85 mm Hg. Bringing the blood pressure down lower to this may be desirable in African American patients, and patients with diabetes or chronic kidney disease. Life style changes in pre-hypertensive patients are desirable. It is not well established that treatment with medication of patients with pre-hypertension is beneficial.

Blood pressure that is persistently higher than 140/ 90 mm Hg usually is treated with lifestyle modifications and medication. If the diastolic pressure remains at a borderline level i.e. fewer than 90 mm Hg, and persistently above 85, more aggressive treatment may be started in certain circumstances. These circumstances include borderline diastolic pressures in association with end-organ damage, systolic hypertension, or factors that increase the risk of cardiovascular disease, such as age [65 years and above], African American decent, smoking, hyperlipemia or diabetes.

Any one of the several classes of medications may be started, except the alpha-blocker medications. The alpha-blockers are used only in combination with another anti-hypertensive medication in specific medical situations. In some situations, certain classes of anti-hypertensive drugs are preferable to others as the first line drugs. For example, angiotensin converting enzyme inhibitors or angiotensin receptor blocking drugs is the drugs of choice in patients with heart failure, chronic kidney failure or heart attack that weakens the heart muscle. Also, beta-blockers are sometimes the preferred treatment in hypertensive patients with a resting tachycardia i.e. racing heartbeat when resting or an acute heart attack.

Furthermore, patients with hypertension may sometimes have a co-existing, second medical condition. In such cases, a particular class of anti-hypertensive medication or combination of drugs may be chosen as the first line drugs. The idea is to control the hypertension while also benefiting the second condition. For example, beta-blockers may treat chronic anxiety or migraine headache as well as the hypertension. The combination of an ACE inhibitor and an ARB drug can be used to treat certain diseases of the heart muscle known better as cardiomyopathies and certain kidney diseases where reduction in proteinuria would be beneficial.

In some other situations, certain classes of anti-hypertensive medications should not be used as they are contraindicated. Dihydropyridine calcium channel blockers used alone may cause problems for patients with chronic renal disease by increasing proteinuria. However, an ACE inhibitor will stop this effect. Furthermore, the non-dihydropyridine type of calcium channel blockers should not be used in patients with heart failure or certain abnormal heart rates or rhythms called as arrhythmias. These drugs may be beneficial in treating certain other arrhythmias. Few drugs, such as minoxidil, since it is so powerful, usually are relegated to second line choice for treatment. Clonidine is a good drug. But it has side effects such as fatigue, sleepiness, and dry month. This makes it a second or third line choice. It is used only after all of the first and second line drugs have been tried without success.

Diuretics are among the oldest known medications for treating hypertension. They work in the tiny tubes of the kidneys to remove salt from the body. Water also may be removed along with the salt. Diuretics may be used as single drug treatment for hypertension. More frequently, low doses of diuretics are used in combination with other anti-hypertensive medications to enhance the effect of the other medications. The diuretic hydrochlorothiazide works in the far end part of the kidney tubules to increase the amount of salt that is removed from the body in the urine. In a low dose of 12.5 to 25 mg per day, this diuretic may improve the blood pressure-lowering effects of other anti-hypertensive drugs.





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