High Blood Pressure: Should I Take Medicine?
High Blood Pressure: Should I Take Medicine?Skip to the navigationYou may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. High Blood Pressure: Should I Take Medicine?Get the factsYour options- Start taking medicine for high blood pressure.
- Try lifestyle changes first.
If your
blood pressure is very high-higher than 160/100,
or when either number is higher-you don't have a decision to make. You
definitely need medicine to lower your blood pressure. Key points to remember- For some people, lifestyle changes may be enough to lower their blood pressure. Whether this is an option for you depends on how high your blood pressure is, whether you have other health problems, such as diabetes, and whether any of your organs have already been damaged. Your doctor may also consider how likely you are to develop other diseases, especially heart disease.
- Lifestyle changes are as important as medicine
in lowering blood pressure and lowering the risk for heart attack and stroke. Lifestyle changes include losing weight, eating healthy, being active, limiting sodium and alcohol, and not smoking.
- If healthy habits aren't enough to bring your blood pressure
down to your goal, you may need to take pills.
- Most people who take pills for
high blood pressure need to take two or more kinds of pills that work
together.
- Even with pills, you will need healthy habits for the
rest of your life to lower your risk for heart attack and stroke.
FAQs
Blood pressure is a measure of how hard the blood
pushes against the walls of your arteries as it moves through your body. It's
normal for blood pressure to go up and down during the day. But if it stays up
when you are resting, you have high blood pressure. Adult blood
pressure is sorted into four types: - Ideal blood pressure-less than 120/80 (say
"120 over 80")
- Prehypertension-120/80 or higher, but less than
140/90
- Stage 1 high blood pressure-140/90 to
159/99
- Stage 2 high blood pressure-160/100 or higher
The top and bottom numbers are both important. High blood pressure means the top number is 140 or higher or the bottom number is 90 or higher, or both.
High blood pressure can damage the blood vessels, heart, and kidneys. This can lead to heart attack,
stroke, and other problems. The goal of treating high blood pressure is to lower your risk of health problems that are caused by, or made worse by, high blood pressure. Your doctor can help you know your risk of health problems like heart attack and stroke. Anything that increases your risk for
a disease or problem is called a risk factor. High blood pressure is just one
of several risk factors that make heart attack and stroke more likely. If you
have high blood pressure plus another risk factor, heart attack and stroke are
even more likely. Some risk factors are things you can change. Others you
can't. Risk factors for heart attack and stroke that you can
change include: - Having high blood pressure.
- Smoking.
- Having high cholesterol.
- Being
overweight.
- Not exercising.
- Having
diabetes that isn't under control.
Things you can't change include: - Having a parent, sister, or brother with
early heart disease (before age 55 for men or before age 65 for
women).
- Your age. People older than age 65 are more likely to have heart disease.
High blood pressure
usually can't be cured. But it can be
controlled. The two types of treatment for high blood pressure
are: - Lifestyle changes.
- Daily
medicines.
Your doctor will give you a blood pressure goal. An example of a goal is to keep blood pressure below 140/90. Your goal may be lower or higher based on your health and age. Your blood pressure goal can help you prevent problems caused by high blood pressure. If your blood pressure is lower than 160/100
and your overall risk for health problems, such as heart disease, is low, you may choose to try to lower your
blood pressure with lifestyle changes without taking pills. Your doctor can help you know your risk for health problems caused by high blood pressure. If healthy habits aren't enough to bring your blood pressure
down to your goal, you may need to take pills. Why are lifestyle changes so helpful? Changes
in lifestyle can help control high blood pressure. You may be able to avoid
taking pills. If you are already taking blood pressure medicine, making some
lifestyle changes may let you take a lower dose. The combination of lifestyle changes and medicine will have the biggest effect on lowering your risk of heart
attack or stroke. - Losing as little as 10 lb (4.5 kg) can help
lower blood pressure.
- Physical activity lowers blood pressure,
especially if you have been inactive until now. Exercise also helps you manage
your weight, but it can lower your blood pressure even if you don't lose
weight. Ask your doctor what level of activity is safe for you. To lower blood pressure, your doctor might recommend that you try to do
moderate exercise at least 2½ hours a week. Or try to do
vigorous activity at least 1¼ hours a week.
- Reducing salt in your diet can help control high blood
pressure. Try to limit the amount of sodium you eat to less than 1,500 mg a day.
- Eating heart-healthy foods can help lower blood pressure. The DASH (Dietary Approaches to Stop Hypertension) eating plan includes fruits, vegetables, and low-fat or nonfat dairy foods.
- Drinking more than 3 alcohol drinks a day may raise
your blood pressure. It can also interfere with some blood pressure medicines.
Limiting alcohol to 2 drinks a day for men and 1 drink a day for women may help
lower blood pressure.
- Quitting smoking is important to reduce the risk of heart
attack and stroke. Nicotine in tobacco briefly increases blood pressure and
heart rate with each use.
If you decide to try lifestyle changes first,
you and your doctor may want to set a deadline. For example, you might decide
that you will try lifestyle changes for 3 to 6 months. Then, if your blood
pressure does not come down enough in that time, you may decide to start taking pills.
Your doctor may advise you to take medicine for high
blood pressure if: - Your blood pressure is 160/100 or
higher.
- You have
organ damage or other health problems such as heart failure, coronary artery disease, diabetes, or kidney
disease.
- You have one or more risk factors for heart attack or stroke.
- Lifestyle changes have not lowered your blood pressure
to your goal.
Compare your options | |
|---|
What is usually involved? |
| |
|---|
What are the benefits? |
| |
|---|
What are the risks and side effects? |
| |
|---|
Take medicine for high
blood pressure Take medicine for high
blood pressure - You take medicine every
day.
- You may have to take more than one medicine to find the right mix
to lower your blood pressure.
- You will still need to make lifestyle
changes to lower your risk of heart attack and stroke.
- Medicines help control your blood
pressure and lower your risk of heart attack and stroke.
- Some pills cause dry
mouth, weakness or dizziness, or a cough.
- Blood pressure medicine may be expensive if your insurance
doesn't pay for it.
Try lifestyle changes
first Try lifestyle changes
first - You make lifestyle
changes such as eating better, exercising, drinking less alcohol, and quitting
smoking to lower your high blood pressure.
- Lifestyle changes help control your blood
pressure and your risk of heart attack and stroke.
- You avoid the side effects of blood
pressure pills.
- You avoid the cost of blood pressure pills.
- If
these changes don't lower your blood pressure enough, you may still need
medicine.
After my
doctor told me my blood pressure was too high, she suggested I try to bring it
down by changing some of my habits. I quit smoking, went on a diet, and started
a walking program. That made me feel healthier, but it didn't bring my blood
pressure down very much. Now I take two kinds of blood pressure medicine as
well as keeping up with my lifestyle changes. Everything is under control.
I just found out I have high blood
pressure. I want to try to make some lifestyle changes before I start taking
medicine. I know I need to start out by making small changes and sticking with
them. I'm going to start by walking 15 minutes 5 days a week and cutting down
on salt by looking for other ways to season my food. After 2 weeks of that,
I'll add some more goals and walk a little longer. I really think I can do
this. My doctor thinks I might be able to control my blood pressure
by losing weight and getting more exercise. I started a diet but I wasn't sure I'd be able to lose weight. And I worry about having a heart attack because of my family history. So I decided to start taking medicine right away. I'll also try to eat healthier and start walking. About 6 years ago I found out my blood
pressure was a little too high. I was a little overweight, and I didn't get much
exercise. So I went on a diet and started going to the gym regularly. I was
very motivated, because I did not want to have to take medicine if I could
avoid it. It worked. My blood pressure came down and has stayed down.
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take medicines for high blood pressure Reasons to try lifestyle changes first I've tried being more active and making other lifestyle changes, but it has not lowered my blood pressure enough. I feel confident that I can succeed at making lifestyle changes. More important Equally important More important I'm not concerned about the side effects of blood pressure medicine. I'm worried about the side effects of pills. More important Equally important More important I want to do everything I can to prevent a heart attack or stroke. I don't want to take medicine, even if it might lower my risk of heart attack and stroke. More important Equally important More important My other important reasons: My other important reasons: More important Equally important More important Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking medicine Trying lifestyle changes first Leaning toward Undecided Leaning toward What else do you need to make your decision?1.
How sure do you feel right now about your decision? Not sure at all Somewhat sure Very sure Your SummaryHere's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. Next stepsWhich way you're leaningHow sure you areYour commentsKey concepts that you understoodKey concepts that may need reviewCredits | Author | Healthwise Staff |
|---|
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
|---|
| Primary Medical Reviewer | Martin J. Gabica, MD - Family Medicine |
|---|
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
|---|
| Specialist Medical Reviewer | Robert A. Kloner, MD, PhD - Cardiology |
|---|
References Other Works Consulted - Diao D, et al. (2012). Pharmacotherapy for mild hypertension. Cochrane Database of Systematic Reviews (8).
- Eckel RH, et al. (2013). 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. http://circ.ahajournals.org/content/early/2013/11/11/01.cir.0000437740.48606.d1.citation. Accessed December 5, 2013.
- Go AS, et al. (2013). An effective approach to high blood pressure control: A scientific advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension. DOI: 10.1161/HYP.0000000000000003. Accessed December 30, 2013.
- James PA, et al. (2013). 2014 Evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the Eighth Joint National Committee (JNC 8). Journal of the American Medical Association. DOI: 10.1001/jama.2013.284427. Accessed December 18, 2013.
- Smith SC, et al. (2011). AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: A guideline from the American Heart Association and American College of Cardiology Foundation. Circulation, 124(22): 2458-2473. Also available online: http://circ.ahajournals.org/content/124/22/2458.full.
- Weber MA, et al. (2013). Clinical practice guidelines for the management of hypertension in the community. Journal of Clinical Hypertension. DOI: 10.1111/jch.12237. Accessed December 19, 2013.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. High Blood Pressure: Should I Take Medicine?Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. - Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the FactsYour options- Start taking medicine for high blood pressure.
- Try lifestyle changes first.
If your
blood pressure is very high-higher than 160/100,
or when either number is higher-you don't have a decision to make. You
definitely need medicine to lower your blood pressure. Key points to remember- For some people, lifestyle changes may be enough to lower their blood pressure. Whether this is an option for you depends on how high your blood pressure is, whether you have other health problems, such as diabetes, and whether any of your organs have already been damaged. Your doctor may also consider how likely you are to develop other diseases, especially heart disease.
- Lifestyle changes are as important as medicine
in lowering blood pressure and lowering the risk for heart attack and stroke. Lifestyle changes include losing weight, eating healthy, being active, limiting sodium and alcohol, and not smoking.
- If healthy habits aren't enough to bring your blood pressure
down to your goal, you may need to take pills.
- Most people who take pills for
high blood pressure need to take two or more kinds of pills that work
together.
- Even with pills, you will need healthy habits for the
rest of your life to lower your risk for heart attack and stroke.
FAQs What is high blood pressure?
Blood pressure is a measure of how hard the blood
pushes against the walls of your arteries as it moves through your body. It's
normal for blood pressure to go up and down during the day. But if it stays up
when you are resting, you have high blood pressure. Adult blood
pressure is sorted into four types: - Ideal blood pressure-less than 120/80 (say
"120 over 80")
- Prehypertension-120/80 or higher, but less than
140/90
- Stage 1 high blood pressure-140/90 to
159/99
- Stage 2 high blood pressure-160/100 or higher
The top and bottom numbers are both important. High blood pressure means the top number is 140 or higher or the bottom number is 90 or higher, or both. What are the risks of not lowering your blood pressure?
High blood pressure can damage the blood vessels, heart, and kidneys. This can lead to heart attack,
stroke, and other problems. The goal of treating high blood pressure is to lower your risk of health problems that are caused by, or made worse by, high blood pressure. Your doctor can help you know your risk of health problems like heart attack and stroke. Anything that increases your risk for
a disease or problem is called a risk factor. High blood pressure is just one
of several risk factors that make heart attack and stroke more likely. If you
have high blood pressure plus another risk factor, heart attack and stroke are
even more likely. Some risk factors are things you can change. Others you
can't. Risk factors for heart attack and stroke that you can
change include: - Having high blood pressure.
- Smoking.
- Having high cholesterol.
- Being
overweight.
- Not exercising.
- Having
diabetes that isn't under control.
Things you can't change include: - Having a parent, sister, or brother with
early heart disease (before age 55 for men or before age 65 for
women).
- Your age. People older than age 65 are more likely to have heart disease.
What is the treatment for high blood pressure?High blood pressure
usually can't be cured. But it can be
controlled. The two types of treatment for high blood pressure
are: - Lifestyle changes.
- Daily
medicines.
Your doctor will give you a blood pressure goal. An example of a goal is to keep blood pressure below 140/90. Your goal may be lower or higher based on your health and age. Your blood pressure goal can help you prevent problems caused by high blood pressure. If your blood pressure is lower than 160/100
and your overall risk for health problems, such as heart disease, is low, you may choose to try to lower your
blood pressure with lifestyle changes without taking pills. Your doctor can help you know your risk for health problems caused by high blood pressure. If healthy habits aren't enough to bring your blood pressure
down to your goal, you may need to take pills. Why are lifestyle changes so helpful? Changes
in lifestyle can help control high blood pressure. You may be able to avoid
taking pills. If you are already taking blood pressure medicine, making some
lifestyle changes may let you take a lower dose. The combination of lifestyle changes and medicine will have the biggest effect on lowering your risk of heart
attack or stroke. - Losing as little as 10 lb (4.5 kg) can help
lower blood pressure.
- Physical activity lowers blood pressure,
especially if you have been inactive until now. Exercise also helps you manage
your weight, but it can lower your blood pressure even if you don't lose
weight. Ask your doctor what level of activity is safe for you. To lower blood pressure, your doctor might recommend that you try to do
moderate exercise at least 2½ hours a week. Or try to do
vigorous activity at least 1¼ hours a week.
- Reducing salt in your diet can help control high blood
pressure. Try to limit the amount of sodium you eat to less than 1,500 mg a day.
- Eating heart-healthy foods can help lower blood pressure. The DASH (Dietary Approaches to Stop Hypertension) eating plan includes fruits, vegetables, and low-fat or nonfat dairy foods.
- Drinking more than 3 alcohol drinks a day may raise
your blood pressure. It can also interfere with some blood pressure medicines.
Limiting alcohol to 2 drinks a day for men and 1 drink a day for women may help
lower blood pressure.
- Quitting smoking is important to reduce the risk of heart
attack and stroke. Nicotine in tobacco briefly increases blood pressure and
heart rate with each use.
If you decide to try lifestyle changes first,
you and your doctor may want to set a deadline. For example, you might decide
that you will try lifestyle changes for 3 to 6 months. Then, if your blood
pressure does not come down enough in that time, you may decide to start taking pills.
Why might your doctor recommend taking medicine for high blood pressure?Your doctor may advise you to take medicine for high
blood pressure if: - Your blood pressure is 160/100 or
higher.
- You have
organ damage or other health problems such as heart failure, coronary artery disease, diabetes, or kidney
disease.
- You have one or more risk factors for heart attack or stroke.
- Lifestyle changes have not lowered your blood pressure
to your goal.
2. Compare your options| | Take medicine for high
blood pressure | Try lifestyle changes
first |
|---|
| What is usually involved? | - You take medicine every
day.
- You may have to take more than one medicine to find the right mix
to lower your blood pressure.
- You will still need to make lifestyle
changes to lower your risk of heart attack and stroke.
| - You make lifestyle
changes such as eating better, exercising, drinking less alcohol, and quitting
smoking to lower your high blood pressure.
|
|---|
| What are the benefits? | - Medicines help control your blood
pressure and lower your risk of heart attack and stroke.
| - Lifestyle changes help control your blood
pressure and your risk of heart attack and stroke.
- You avoid the side effects of blood
pressure pills.
- You avoid the cost of blood pressure pills.
|
|---|
| What are the risks and side effects? | - Some pills cause dry
mouth, weakness or dizziness, or a cough.
- Blood pressure medicine may be expensive if your insurance
doesn't pay for it.
| - If
these changes don't lower your blood pressure enough, you may still need
medicine.
|
|---|
Personal storiesPersonal stories about taking medicine for high blood pressure
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"After my doctor told me my blood pressure was too high, she suggested I try to bring it down by changing some of my habits. I quit smoking, went on a diet, and started a walking program. That made me feel healthier, but it didn't bring my blood pressure down very much. Now I take two kinds of blood pressure medicine as well as keeping up with my lifestyle changes. Everything is under control." "I just found out I have high blood pressure. I want to try to make some lifestyle changes before I start taking medicine. I know I need to start out by making small changes and sticking with them. I'm going to start by walking 15 minutes 5 days a week and cutting down on salt by looking for other ways to season my food. After 2 weeks of that, I'll add some more goals and walk a little longer. I really think I can do this." "My doctor thinks I might be able to control my blood pressure by losing weight and getting more exercise. I started a diet but I wasn't sure I'd be able to lose weight. And I worry about having a heart attack because of my family history. So I decided to start taking medicine right away. I'll also try to eat healthier and start walking." "About 6 years ago I found out my blood pressure was a little too high. I was a little overweight, and I didn't get much exercise. So I went on a diet and started going to the gym regularly. I was very motivated, because I did not want to have to take medicine if I could avoid it. It worked. My blood pressure came down and has stayed down." 3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take medicines for high blood pressure Reasons to try lifestyle changes first I've tried being more active and making other lifestyle changes, but it has not lowered my blood pressure enough. I feel confident that I can succeed at making lifestyle changes. More important Equally important More important I'm not concerned about the side effects of blood pressure medicine. I'm worried about the side effects of pills. More important Equally important More important I want to do everything I can to prevent a heart attack or stroke. I don't want to take medicine, even if it might lower my risk of heart attack and stroke. More important Equally important More important My other important reasons: My other important reasons: More important Equally important More important 4. Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking medicine Trying lifestyle changes first Leaning toward Undecided Leaning toward 5. What else do you need to make your decision?
Check the facts
1.
Is it true that you may need to start taking medicine right away based on your health? You're right. Your doctor might recommend that you take medicine right away if you have very high blood pressure or if you have organ damage or other health problems such as diabetes. 2.
Do you still need to make lifestyle changes if you are taking pills for high blood pressure? You're right. Even with pills, you will need healthy habits for the rest of your life to lower your risk for heart attack and stroke. 3.
Do lifestyle changes lower blood pressure for everyone? You are right. Lifestyle changes can help everyone lower blood pressure. But some people cannot lower their blood pressure enough with lifestyle changes alone. They need to take medicine too. Decide what's next1.
Do you understand the options available to you? 2.
Are you clear about which benefits and side effects matter most to you? 3.
Do you have enough support and advice from others to make a choice? Certainty1.
How sure do you feel right now about your decision? Not sure at all Somewhat sure Very sure 2.
Check what you need to do before you make this decision. Credits | By | Healthwise Staff |
|---|
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
|---|
| Primary Medical Reviewer | Martin J. Gabica, MD - Family Medicine |
|---|
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
|---|
| Specialist Medical Reviewer | Robert A. Kloner, MD, PhD - Cardiology |
|---|
References Other Works Consulted - Diao D, et al. (2012). Pharmacotherapy for mild hypertension. Cochrane Database of Systematic Reviews (8).
- Eckel RH, et al. (2013). 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. http://circ.ahajournals.org/content/early/2013/11/11/01.cir.0000437740.48606.d1.citation. Accessed December 5, 2013.
- Go AS, et al. (2013). An effective approach to high blood pressure control: A scientific advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension. DOI: 10.1161/HYP.0000000000000003. Accessed December 30, 2013.
- James PA, et al. (2013). 2014 Evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the Eighth Joint National Committee (JNC 8). Journal of the American Medical Association. DOI: 10.1001/jama.2013.284427. Accessed December 18, 2013.
- Smith SC, et al. (2011). AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: A guideline from the American Heart Association and American College of Cardiology Foundation. Circulation, 124(22): 2458-2473. Also available online: http://circ.ahajournals.org/content/124/22/2458.full.
- Weber MA, et al. (2013). Clinical practice guidelines for the management of hypertension in the community. Journal of Clinical Hypertension. DOI: 10.1111/jch.12237. Accessed December 19, 2013.
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.Current as of:
April 3, 2017 Last modified on: 8 September 2017
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