Simple lifestyle changes can help reduce high blood pressure. Some people may need to take medicine as well.
Your GP can tell you about changes you can make to your lifestyle. They will discuss with you if they think you'll also need medicine.
When treatment is recommended
Everyone with high blood pressure is advised to make healthy lifestyle changes.
To decide if you need medicine, your GP will look at your:
- blood pressure readings
- risk of developing problems such as heart attacks or strokes
Your GP will do some blood and urine tests. They will ask questions about your health to determine your risk of other problems.
If your blood pressure is consistently above:
- 140/90mmHg (or 135/85mmHg at home), but your risk of other problems is low – you'll be advised to make some changes to your lifestyle
- 140/90mmHg (or 135/85mmHg at home) and your risk of other problems is high – you'll be offered medicine to lower your blood pressure. This will be in addition to lifestyle changes
- 160/100mmHg – you'll be offered medicine to lower your blood pressure,. This will be in addition to lifestyle changes
There 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, while others may take longer.
- cut your salt intake to less than 6g (0.2oz) a day (about 1 teaspoon)
- eat a low-fat, balanced diet - include plenty of fresh fruit and vegetables
- be active
- cut down on alcohol
- lose weight – find out what your ideal weight is using the BMI healthy weight calculator
- drink less caffeine – found in coffee, tea and cola
- stop smoking
- get at least 6 hours of sleep a night
You can take these steps today, even if you already take blood pressure medicines.
By making these changes early on you may be able to avoid needing medicines.
Medicines for high blood pressure
Several types of medicine can be used to help control high blood pressure.
- An ACE inhibitor or an angiotensin-2 receptor blocker (ARB) will be offered if you're under 55 years of age
- a calcium channel blocker or an ACE inhibitor or a combination of both and other medicines will be offered if you're aged 55 or older
You may need to take blood pressure medicine for the rest of your life. Your GP might be able to reduce or stop your treatment if your blood pressure stays under control for several years.
It's really important to take your medicine as directed. If you miss doses, it will not work as well.
The medicine will not necessarily make you feel any different, but this does not mean it's not working.
Medicines used to treat high blood pressure can have side effects, but most people do not get any.
If you do get side effects, do not stop taking your medicine. Talk to your GP, who may advise changing your medicine.
Angiotensin-converting enzyme (ACE) inhibitors reduce blood pressure by relaxing your blood vessels.
Common examples are enalapril, lisinopril, perindopril and ramipril.
The most common side effect is a persistent dry cough. Other possible side effects include headaches, dizziness and a rash.
Angiotensin-2 receptor blockers (ARBs)
ARBs work in a similar way to ACE inhibitors. They're often recommended if ACE inhibitors cause troublesome side effects.
Common examples are candesartan, irbesartan, losartan, valsartan and olmesartan.
Possible side effects include dizziness, headaches, and cold or flu-like symptoms.
Calcium channel blockers
Calcium channel blockers reduce blood pressure by widening your blood vessels.
Common examples are amlodipine, felodipine and nifedipine. Other medicines, such as diltiazem and verapamil, are also available.
Possible side effects include headaches, swollen ankles and constipation.
Drinking grapefruit juice can increase your risk of side effects.
Diuretics work by flushing excess water and salt from the body through your pee. Diuretics are sometimes known as water pills.
They're often used if calcium channel blockers cause troublesome side effects.
Common examples are indapamide and bendroflumethiazide.
Possible side effects include dizziness when standing up, increased thirst, needing to go to the toilet frequently, and a rash.
You might also get low potassium and low sodium after long-term use.
Beta blockers can reduce blood pressure by making your heart beat more slowly and with less force.
They are used only when other treatments have not worked.
Beta blockers are considered less effective than other blood pressure medicines.
Common examples are atenolol and bisoprolol.
Possible side effects include dizziness, headaches, tiredness, and cold hands and feet.
High blood pressure in older people
The target blood pressure reading for people over 80 is below 150/90 mmHg when it's measured in the clinic or surgery. The target is below 145/85 mmHg for home readings.
There are definite benefits from taking medicines to reduce blood pressure if you're under the age of 80. It's less clear if they are useful if you're over 80.
If you're over 80, your GP will consider your other health risk factors when deciding to give you treatment for high blood pressure.