Bring It Down

You go to the doctor for a regular checkup or because of some minor complaint, and they take your blood pressure. That’s a pretty regular thing. But this time, they tell you it’s too high. What should you do now?

The doctor tells you need to bring your blood pressure down. This seems a bit strange to you, as you haven’t experienced any symptoms, but they explain how hypertension (to give it its proper name) can increase your risk of all kinds of serious conditions, including heart attacks and strokes.

First, your doctor is going to recommend lifestyle changes, which will be enough for most people. It’s all the type of thing you expect a doctor to say – less salt, more healthy food, less alcohol, more exercise, no smoking. Unfortunately, for some people, that’s not enough, in which case you may need to start taking medication. This can be a lifelong thing.

There are several different medications associated with the management of hypertension. Diuretics, particularly thiazide diuretics, are likely to be one of the first you try. These actually work on the kidneys, but they help your blood pressure because one thing the kidneys do is help clear your blood of excessive amounts of salt (remember, too much salt is a contributor to hypertension).

Then there are calcium channel blockers, which you probably won’t be surprised to know block the channels that calcium uses to enter your cells. This, in turn, reduces contractions of the heart and arteries, slows the heartbeat and lowers aldosterone production. Beta blockers, best known for treating abnormalities in the heart’s rhythm, have also been used to treat high blood pressure.

ACE inhibitors restrict what’s called angiotensin-converting enzyme (ACE), which can contribute to blood vessels narrowing. Less-constricted blood vessels and greater blood volume means your blood pressure should lower. Alternatively, angiotensin II receptor blockers (ARBs, formerly known as angiotensin II receptor antagonists) stop angiotensin II from narrowing your blood pressure.

It might sound like a lot to get your head around, but if you do have hypertension, your doctor will talk through all your options so you can figure out the best management plan for you. Some of these medications have side effects and react differently with different people. Hopefully, you’ll be one of the lucky people who can control their blood pressure through lifestyle changes.

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