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.
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:
When blood pressure is higher than normal most of the time, it starts to damage the blood vessels, heart, and kidneys. This can lead to heart attack, stroke, and other problems.
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:
Things you can't change include:
High blood pressure usually can't be cured. But it can be controlled. The two types of treatment for high blood pressure are:
For most people, the goal is to get their blood pressure below 140/90. But a person's goal may be lower. Your doctor will give you a blood pressure goal that is based on your health. For example, your goal may be lower if you have other conditions such as diabetes, heart failure, coronary artery disease, or chronic kidney disease.
If your blood pressure is lower than 160/100 and your overall risk for heart disease is low, you may be able to lower your blood pressure to your goal with lifestyle changes without taking pills. Your doctor can help you know your risk for heart disease.
If healthy habits aren't enough to bring your blood pressure down to your goal, you may need to take pills.
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.
For most people, it takes time and patience to replace old habits with new ones. You may need to take blood pressure pills until you decide you are ready to make lifestyle changes.
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:
|Take medicine for high blood pressure||Try lifestyle changes first|
|What is usually involved?|
|What are the benefits?|
|What are the risks and side effects?|
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
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."
— Terrence, age 59
"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."
— Magda, age 45
"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."
— Paolo, age 51
"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."
— Hanh, age 64
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.
I'm not concerned about the side effects of blood pressure medicine.
I'm worried about the side effects of pills.
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.
My other important reasons:
My other important reasons:
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.
Trying lifestyle changes first
1. Is it true that you may need to start taking medicine right away based on your health?
2. Do you still need to make lifestyle changes if you are taking pills for high blood pressure?
3. If your risk of heart disease is low, can you lower your blood pressure without pills?
1. 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?
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
3. Use the following space to list questions, concerns, and next steps.
|Primary Medical Reviewer||E. Gregory Thompson, MD - Internal Medicine|
|Specialist Medical Reviewer||Robert A. Kloner, MD, PhD - Cardiology|