Hypertension increases your risk of heart attack and stroke. A variety of treatments can help you manage your blood pressure, including lifestyle changes and medications.

Treatment for high blood pressure typically involves a combination of medication and lifestyle changes. The goal is to get your blood pressure into its optimal range.

Elevated blood pressure doesn’t necessarily raise your risk of heart attack or stroke. But without attention, it can progress to high blood pressure — which definitely does raise your risk.

Read on to learn more about lifestyle changes and medication options for high blood pressure.

A healthy lifestyle is the first line of defense against high blood pressure. Habits that help manage blood pressure include:

  • A balanced diet: Eating a nutrient-dense, balanced diet can help manage blood pressure and improve health. You may want to try the DASH diet, which stands for Dietary Approaches to Stop Hypertension. It prioritizes fruits, vegetables, whole grains, lean meats, nuts, and legumes.
  • Physical activity: Staying physically active with regular cardiovascular exercise is good for your heart. Aim for 150 minutes of moderate intensity exercise per week.
  • Moderate weight: Maintaining a moderate weight can improve your blood pressure.
  • Avoid alcohol: If you drink, avoid heavy alcohol use. Experts recommend no more than one drink per day for women and two drinks per day for men.
  • Avoid smoking: You can improve your blood pressure by avoiding secondhand smoke and quitting smoking if applicable.
  • Manage stress: Stress can raise your blood pressure, so take steps to manage stress where you can. You can try guided breathing, meditation, yoga, or speaking with a therapist.
  • Reduce salt: Eating too much sodium can raise your blood pressure, so try to consume less salt. Aim to get no more than 2,300 milligrams (mg) per day.

Learn more lifestyle strategies and habits for lowering blood pressure.

Some people find that lifestyle changes alone are not enough to manage high blood pressure. In these cases, many types of blood pressure medications with different modes of action can help.

For some people, a combination of two or more drugs may be needed to manage their blood pressure. Your doctor can recommend the right medication protocol for you.

High blood pressure medications can be divided into the categories listed below, based on how they work. The drugs in each section are just a sampling of what’s available.

Diuretics

Diuretics, sometimes called water pills, help the kidneys get rid of excess water and salt. This reduces the volume of blood that needs to pass through the blood vessels, resulting in lower blood pressure.

There are four major types of diuretics defined by how they work. They include:

  • thiazide diuretics (chlorthalidone, Microzide, Diuril)
  • potassium-sparing diuretics (amiloride, Aldactone, Dyrenium)
  • loop diuretics (bumetanide, furosemide)
  • combination diuretics, which include more than one variety used together

Diuretics in the thiazide group generally have fewer side effects than the others, particularly when taken at low doses. If you have early stage high blood pressure, lower doses are recommended.

Beta-blockers

Beta-blockers help the heart beat with less speed and force. The heart pumps less blood through the blood vessels with each beat, so blood pressure decreases. Some examples of beta-blockers include:

Alpha-beta-blockers

Alpha-beta-blockers have a combined effect. They’re a subclass of beta-blockers that block the binding of catecholamine hormones to both alpha and beta receptors.

They can decrease the constriction of blood vessels like alpha-1 blockers, slowing the rate and force of the heartbeat like beta-blockers. Examples include:

  • carvedilol (Coreg)
  • labetalol hydrochloride (Normodyne)

Angiotensin-converting enzyme (ACE) inhibitors

ACE inhibitors help the body produce less of a hormone called angiotensin II, which causes blood vessels to narrow. These medications decrease blood pressure by helping blood vessels expand and let more blood through.

Some ACE inhibitors include:

  • benazepril hydrochloride (Lotensin)
  • captopril (Capoten)
  • enalapril maleate (Vasotec)
  • fosinopril sodium (Monopril)
  • lisinopril (Prinivil, Zestril)

Angiotensin II receptor blockers (ARBs)

ARBs block the action of angiotensin II directly on the blood vessels. It attaches at the receptor site on the blood vessels and keeps them from narrowing. This causes blood pressure to fall.

Some examples include:

  • candesartan (Atacand)
  • eprosartan mesylate (Teveten)
  • irbesartan (Avapro)
  • losartan potassium (Cozaar)
  • telmisartan (Micardis)
  • valsartan (Diovan)

Calcium channel blockers

Calcium channel blockers limit calcium from entering the smooth muscle cells of the heart and blood vessels. This makes the heart beat less forcefully with each beat and helps blood vessels relax, lowering blood pressure.

Examples of these medications include:

  • amlodipine besylate (Norvasc, Lotrel)
  • felodipine (Plendil)
  • diltiazem (Cardizem)
  • isradipine (DynaCirc, DynaCirc CR)
  • verapamil hydrochloride (Calan SR, Covera-HS, Isoptin SR, Verelan)

Alpha-1 blockers

Your body produces types of hormones called catecholamines when it experiences stress. Catecholamines, such as norepinephrine and epinephrine, cause the heart to beat faster and with more force. They also constrict blood vessels, raising blood pressure.

The muscles around some blood vessels have alpha-1 or alpha-adrenergic receptors. When a catecholamine binds to an alpha-1 receptor, the muscle contracts, the blood vessel narrows, and blood pressure rises.

Alpha-1 blockers bind to alpha-1 receptors, blocking catecholamines from attaching. This keeps them from narrowing blood vessels so blood is able to flow through the blood vessels more freely, and blood pressure falls.

Examples of these drugs include:

  • doxazosin mesylate (Cardura)
  • prazosin hydrochloride (Minipress)
  • terazosin hydrochloride (Hytrin)

Alpha-2 receptor agonists (central agonists)

When an alpha-2 receptor is activated, the production of norepinephrine is blocked. This decreases the amount of norepinephrine produced. Less norepinephrine means less constriction of blood vessels and lower blood pressure.

Since alpha-2 receptor agonists can work in the brain and central nervous system, they’re also known as central agonists. This makes these medications useful for treating a large range of health conditions beyond high blood pressure.

Examples include:

Vasodilators

Vasodilators relax the muscles in the walls of blood vessels, especially small arteries, called arterioles. This widens the blood vessels and allows blood to flow through them more easily. Blood pressure falls as a result.

Examples include:

Treatment for high blood pressure includes ongoing care as well as individual treatments tailored for specific situations and younger age groups.

Ongoing medical care

To make the most of your treatment, it’s vital to get regular medical checkups and blood pressure tests. Regular checkups allow your doctor to monitor how well your treatment is going and make any necessary adjustments to your treatment plan.

If your blood pressure starts inching back up, your doctor can respond promptly. Doctors’ visits also give you an opportunity to ask questions and bring up any concerns.

Treatment for specific situations

Additional treatment options may be needed in certain situations, like resistant hypertension or secondary hypertension.

Resistant hypertension refers to blood pressure that remains high after trying at least three different types of blood pressure medications. Someone whose high blood pressure is controlled by taking four different kinds of medication is considered to have resistant hypertension.

Even such hard-to-treat cases can often be managed successfully. Your doctor might prescribe a different medication, dose, drug combination, or more aggressive lifestyle changes.

Secondary hypertension is high blood pressure that’s directly caused by another health condition or drug side effect. Blood pressure often drops substantially or even goes back to normal once doctors diagnose and treat the root cause.

Treatment options for children and teens

The first line of treatment for children and teens with high blood pressure is a healthy lifestyle. This includes:

Children may take the same blood pressure medications as adults when necessary. For children with secondary hypertension, blood pressure often returns to normal once the underlying condition is treated.

High blood pressure treatment usually involves a combination of lifestyle changes and medication. Sometimes, lifestyle changes are enough to return your blood pressure to normal levels. These changes may include diet, exercise, and weight loss.

If your high blood pressure continues, be sure to consult a doctor who can prescribe the appropriate medication.