Blood pressure or arterial blood pressure is the pressure exerted by the blood on the walls of the blood vessels.  High blood pressure or hypertension means high pressure (tension) in the arteries. High blood pressure is generally defined as a level exceeding 140/90 mm Hg that has been confirmed on multiple occasions.  Blood pressure is generally felt to be abnormally high at a level of 140/90, and some sort of definitive therapy and follow-up should be started at this level.

Some people may only need lifestyle changes to control their high blood pressure, while others need medication as well

Either way, treating high blood pressure usually is a lifelong process. A diet that is lower in fat and high in fruits, vegetables and low-fat dairy foods significantly and quickly lowers blood pressure. Also, reducing salt (sodium) intake often lowers blood pressure because sodium intake promotes water retention, which can add to the blood volume and as a result raise blood pressure.  And another risk factor, smoking, is probably the greatest risk factor for developing coronary heart disease.

Promoters of medications claim that the following medications will aid in the reduction of high blood pressure:  diuretics, beta-blockers, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), or alpha blockers.  The mere appearance of the words is enough to cause one’s heart to race.  But which of these medications will actually do what they claim?  Which are mere placebos with a fancy name and packaging?

Studies have shown that diuretics should be the first medications used when treating high blood pressure or should be used in combination with other drugs to lower high blood pressure.  Beta blockers reduce the heart rate and the output of blood by counteracting hormones called adrenaline and noradrenaline.

Medications such as Hydralazine, Minoxidil, Diazoxide, or Nitroprusside may be required if the blood pressure is very high. Angiotensin converting enzyme (ACE) inhibitors interfere with the production of angiotensin II, which causes arteries to constrict and increases salt retention. By blocking the angiotensin receptor found in many tissues, primarily in vascular smooth muscle, angiotensin II inhibitors work similarly to ACE inhibitors.

Another medication, calcium channel blockers, work by relaxing the blood vessels and reducing the heart rate. Vasodilators in these blockers cause the vessel walls to dilate, thus relaxing their walls and lowering blood pressure.

All in all, Treatment of primary high blood pressure, especially moderate or severe high blood pressure, decreases the risk of heart failure, coronary artery disease, heart attack, abnormal heartbeats, stroke, and kidney disease, and reduces the risk of death from these conditions.