Hypertension (High Blood Pressure) Treatment

Often, hypertension can improve with lifestyle changes.

Hypertension treatment can involve lifestyle modifications, medications, and natural remedies. Most people with hypertension experience improvement with prescription treatment such as diuretics, ACE inhibitors, beta-blockers, or other options, though some may require more than one prescription medication to reach optimal blood pressure. If your hypertension has a medical cause (secondary hypertension), you may also need treatment for medical issues that are contributing to your high blood pressure.

natural hypertension treatment
Illustration by Joshua Seong. © Verywell, 2018 

Home Remedies and Lifestyle Changes

Often, hypertension can improve with lifestyle changes. In some cases, high blood pressure can go down to normal levels with only lifestyle modifications, particularly if you have stage 1 hypertension (systolic blood pressure of 130 mmHg to 139 mmHg, or diastolic blood pressure 80 mmHg to 89 mmHg), or if you have elevated blood pressure (systolic blood of 120 mmHg to 129 mmHg and diastolic less than 80 mmHg).

If you have extremely high blood pressure, lifestyle modifications can be effective as a hypertension treatment, though it may not be enough to lower your blood pressure to an optimal level.

Smoking Cessation

Smoking is one of the leading factors that causes and worsens hypertension. If you smoke and have hypertension, you may experience a substantial improvement in your blood pressure if you quit.

Weight Loss

If you are overweight, losing weight can help reduce your blood pressure. With some persistence, most people can do so using a combination of diet and exercise. Bariatric surgery, which may be necessary for some individuals, has also been shown to improve hypertension. 

Dietary Modification

Foods that are high in water content, such as fresh fruits and vegetables, help maintain fluid and electrolyte balance, which can help keep blood pressure at ideal levels. Fruits and veggies also contain antioxidants, which help prevent damage to your blood vessels and related vascular disease, which often presents with hypertension. 

The Dietary Approaches to Stop Hypertension (DASH) diet is low in saturated fat, cholesterol, red meat, and sugar, and is considered to be a good dietary approach to maintaining your optimal blood pressure. This diet emphasizes vegetables, fruits, low-fat dairy, whole grains, lean protein, nuts, and legumes.

Exercise

Regular physical activity can help maintain optimal blood pressure, even if you do not need to exercise for weight loss. The cardiovascular, hormonal, and cholesterol changes that result from exercise are all believed to contribute to maintaining healthy blood pressure. 

Low Salt

A diet that is low in sodium can help lower your blood pressure. Excess salt has been shown to increase blood pressure for some people, but not for everyone.

It's best to get advice from a dietician regarding your salt intake. Some people need to have a moderate salt intake, while some need to consume a very low-salt diet to keep blood pressure from getting too high. 

Prescriptions

There are many prescription medications used for hypertension treatment. These medications fall into categories based on their different mechanisms of action. 

Treatment Goals

According to the American College of Cardiology and the American Heart Association, the goal of hypertension treatment is to attain a blood pressure reading that's less than 130/80 mmHg systolic and less than 80mmHg diastolic. In general, if you have hypertension, it is likely that you will need to be treated for the duration of your life to maintain this target blood pressure. 

Diuretics

Diuretics also referred to as water pills, increase the amount of fluid excreted in the urine. They are believed to lower blood pressure by reducing the volume of fluid circulating in the blood vessels.

Side effects of this hypertension treatment include low potassium levels, frequent urination, and worsening of gout. Examples of these drugs include:

  • Thalitone, Tenoretic, and Clorpres (chlorthalidone) 
  • HydroDiuril, Microzide, and Esidrix (hydrochlorothiazide) 
  • Lozol (indapamide)
  • Zaroxolyn, Mykrox (metolazone) 

Angiotensin-Converting Enzyme (ACE) Inhibitors

ACE inhibitors reduce blood pressure by dilating (widening) the arteries. Side effects include cough, decreased sense of taste, and elevated potassium levels. Examples of ACE inhibitors include:

  • Lotensin (benazepril) 
  • Capoten (captopril)
  • Vasotec, Vaseretic (enalapril) 
  • Monopril (fosinopril)
  • Prinivil, Zestril (lisinopril)
  • Univasc (moexipril) 
  • Accupril (quinapril)
  • Altace (ramipril)
  • Mavik (trandolapril)

Calcium Channel Blockers

Calcium channel blockers reduce blood pressure by dilating the arteries and reducing the force of the heart's contractions. Side effects include constipation, leg swelling, and headaches. Examples include:

  • Norvasc, Caduet, and Lotrel (amlodipine)
  • Cardizem, Dilacor, and Tiazac (diltiazem)
  • Plendil (felodipine)
  • DynaCirc (isradipine)
  • Cardene (nicardipine) 
  • Procardia XL, Adalat (nifedipine) 
  • Sular (nisoldipine) 
  • Isoptin, Calan, Verelan, and Covera (verapamil hydrochloride)

Beta Blockers

Beta blockers decrease the effect of adrenaline on the cardiovascular system, slow the heart rate, and reduce stress on the heart and the arteries. Side effects include worsening shortness of breath if you have chronic obstructive pulmonary disease or asthma; sexual dysfunction; fatigue; depression; and worsening of symptoms if you have peripheral artery disease. Beta-blocker examples include:

  • Sectral (acebutolol) 
  • Tenormin (atenolol)
  • Kerlone (betaxolol)
  • Zebeta, Ziac (bisoprolol)
  • Cartrol (carteolol) 
  • Coreg (carvedilol) 
  • Normodyne, Trandate (labetalol)
  • Lopressor, Toprol (metoprolol)
  • Corgard (nadolol)
  • Levatol (penbutolol)
  • Inderal, Inderal LA (propranolol)
  • Blocadren (timolol)

Angiotensin II Receptor Blockers (ARBs)

ARBs reduce blood pressure by dilating the arteries. Side effects include allergic reactions, dizziness, and high potassium levels. ARBs include:

  • Atacand (candesartan)
  • Avapro (irbesartan) 
  • Cozaar (losartan)
  • Micardis (telmisartan)
  • Diovan (valsartan)

Lotensin (Minoxidil)

Lotensin is a vasodilator. It works by causing blood vessels to relax and widen, which lowers the pressure necessary to push blood through them. Minoxidil doesn't act directly on the blood vessels. It stimulates the action of an enzyme to produce chemicals that facilitate the relaxation of blood vessels.

Side effects include swelling, low blood pressure, dizziness, nausea, loss of appetite, and unwanted hair growth.

Monotherapy and Combination Therapy

Use of a single antihypertensive medication is referred to as monotherapy. If one medication is not effective for hypertension treatment, or if it causes intolerable side effects, your healthcare provider may switch to another monotherapy, and then to a third, if necessary. 

If three or more attempts at monotherapy do not lower your blood pressure without causing adverse side effects, the next step is combination therapy with two or more prescription antihypertensives. Sometimes, combining medications that have a different mechanism of action can enhance the therapeutic effects without exacerbating the side effects. 

Resistant Hypertension

Resistant hypertension is defined as blood pressure that remains well above the target goals despite the use of optimal, three-drug therapy. 

There are a few things that can cause resistant hypertension:

  • Not taking medications as prescribed
  • Secondary hypertension
  • Fluid retention, often the result of kidney failure

If you have resistant hypertension, your healthcare provider will ask about whether you are taking your medications as prescribed; options and/or doses may be adjusted.

You may also or instead need medical treatment for another condition that could be causing your high blood pressure, such as sleep apneachronic kidney disease, or aldosteronism (excess hormone production in the adrenal glands). 

Complementary Medicine (CAM)

There are some natural remedies that may lower blood pressure, particularly if you have pre-hypertension. Hypertension natural remedies include:

  • Garlic: Garlic has long been thought to be a hypertension natural remedy. Studies show that garlic extract may lower blood pressure, although the optimal dose, frequency, and form are not well established. Garlic may produce this effect by acting directly on the kidneys to eliminate excess salt. It is considered a safe spice to consume, although it can cause some stomach upset. 
  • Magnesium: Magnesium, which is present in nuts, seeds, avocado, and green leafy vegetables, has also been proposed as a natural hypertension treatment. Supplements are also available in pill form. Studies show that higher levels of magnesium are associated with lower blood pressure, but it is still not completely clear whether there is a cause-and-effect relationship. 
  • Fish oil: Eating fish regularly is associated with lower blood pressure. The use of fish oil pills has also been studied as a hypertension treatment, though it is not clear whether consuming pills has the same effect as consuming fish. 
  • Stress control and relaxation: Stress and anxiety raise blood pressure temporarily. Methods of stress control are believed to modestly lower blood pressure in the short term, though more research is needed to address long-term benefits. 

While some of the numerous herbal remedies out there may be effective for hypertension treatment, some can actually raise blood pressure. If you are using herbal remedies, be sure to familiarize yourself with side effects and medication interactions and discuss them with your healthcare provider.

Hypertension Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Old Man

Over-the-Counter Therapies

There are no over-the-counter medications for lowering your blood pressure. However, there are a number of options that can actually cause high blood pressure as a side effect. Though this doesn't happen to everyone who uses these medications, this may be a concern for you, especially if you are taking a drug for the first time.

The most common types of OTC medications that can cause high blood pressure include:

  • Non-steroidal anti-inflammatories (NSAIDs): Medications such as Ibuprofen and aspirin can raise blood pressure for some people.
  • Decongestants: Some decongestants contain pseudoephedrine or phenylephrine, stimulants that raise blood pressure.
  • Weight loss supplements/appetite suppressants: Many of these over-the-counter products contain stimulants and/or caffeine, both of which raise blood pressure.
  • Caffeine-containing stimulants/energy pills: Pills used to maintain alertness or to stay awake typically contain caffeine as the active ingredient.

Frequently Asked Questions

  • How long does it take to lower your blood pressure?

    Blood pressure medications like Toprol (metoprolol) can start working the first day you take them. Some dietary changes may lower blood pressure within weeks. A 2017 study found that the DASH diet lowered blood pressure in one week by an average of 4 mm Hg for systolic blood pressure and 1 mm Hg for diastolic blood pressure. A low-sodium diet decreased blood pressure consistently over a period of four weeks.

  • How can you lower blood pressure during pregnancy?

    Talk to your healthcare provider about whether you should take medication. They'll help you to find one that's safe to take during pregnancy. You can also manage your blood pressure by eating healthy foods, keeping active when possible, checking your blood pressure at home, avoiding smoking, and going to all your prenatal appointments.

  • What is the first line of treatment for hypertension?

    The first step to managing hypertension is changing life style. That includes eating a healthy diet, exercising regularly, losing weight, and quitting smoking. When lifestyle changes are not enough, antihypertensive drugs are recommended, such as thiazide diuretics, beta‐blockers, and angiotensin converting enzyme (ACE) inhibitors.

  • What is the fastest way to lower blood pressure naturally?

    The fastest way to lower blood pressure naturally is to eat a healthy lifestyle, exercise for at least 30 minutes per day, lose weight, reduce your salt intake, quit smoking, and avoid drinking alcohol in excess.

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12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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