Hypertension treatment: what really works and what to do now

High blood pressure quietly raises your risk for heart attack, stroke, and kidney damage. The good news: you can lower it with clear actions you control plus the right medicines. Below are practical, evidence-backed steps you can start today and discuss with your clinician.

Simple, quick actions you can take

Measure your blood pressure at home with an upper-arm cuff—don’t trust wrist gadgets. Record readings twice daily for a week to see your true pattern. Aim for a target most doctors use: systolic below 130 mmHg and diastolic below 80 mmHg, unless your doctor sets a different goal for you.

Four lifestyle moves make the biggest difference:

• Cut sodium: aim for under 2,000 mg of sodium daily (about 5 g salt). Swap processed foods for fresh produce.
• Eat the DASH way: more vegetables, fruits, whole grains, lean protein, and low-fat dairy.
• Move: 150 minutes a week of moderate activity (brisk walking) or 75 minutes of vigorous exercise.
• Lose weight and limit alcohol: losing 5–10% of body weight often lowers BP; men limit to 2 drinks/day, women 1.

Common medications and how they're used

When lifestyle changes aren’t enough, medicines are added. Here are common classes and quick notes so you know what to expect:

• ACE inhibitors (e.g., lisinopril): work well for many, protect kidneys in diabetes. Cough is a possible side effect.
• ARBs (e.g., losartan): similar to ACE inhibitors but without the cough; good alternative if ACE causes problems.
• Thiazide-type diuretics (e.g., chlorthalidone, hydrochlorothiazide): remove extra fluid and often used first-line.
• Calcium channel blockers (e.g., amlodipine): great for older adults and for controlling systolic pressure.
• Beta-blockers (e.g., metoprolol): useful with heart disease or arrhythmias; not always first choice for uncomplicated hypertension.

Many people need two drugs from different classes to reach targets. If BP stays high on three medicines (including a diuretic), your doctor will check for "resistant hypertension" and look for secondary causes like sleep apnea, kidney disease, or hormonal problems.

Check labs before and after starting drugs: electrolytes and kidney function matter. Keep a home BP log and bring it to visits. If your reading ever hits 180/120 mmHg with chest pain, shortness of breath, vision changes, or confusion, go to the emergency room right away.

Small, steady changes win. Track progress, keep taking meds as prescribed, and talk openly with your clinician about side effects or costs. With the right plan you can lower your risk and feel better—one step at a time.