Treatment Options
High blood pressure is very treatable. At the Mount Sinai Hypertension Center, our goal is not simply to lower blood pressure but to prevent additional health issues. We treat high blood pressure with lifestyle changes and, when necessary, medications.
Lifestyle Modifications
If you have hypertension, changes to your lifestyle—large or small—can help you lower your blood pressure. These include:
- Maintaining a healthy body weight
- Reducing dietary sodium intake to no more than 2,000 mg of sodium per day (ideally < 1,500 mg daily)
- Engaging in regular aerobic physical activity such as brisk walking (at least 30 minutes a day, on five or more days a week)
- Limiting alcohol consumption
- Eating a diet rich in fruit and vegetables
- Not smoking
- Managing your stress
Medication
If changes in lifestyle do not lower your blood pressure enough, medication might be the next step. Antihypertensive medications treat your high blood pressure but do not cure it. As soon as you stop taking the medicine, your blood pressure will go up again. These medicines can include:
- Angiotensin receptor blockers and angiotensin-converting enzyme inhibitors: Known as ARBs and ACE inhibitors, these help relax blood vessels, which lowers blood pressure.
- Beta-blockers: They lower the heart rate and block renin, a key hormone that is involved with the mechanisms that lead to blood pressure elevation.
- Calcium channel blockers: These drugs relax the blood vessels, which makes blood pressure go down.
- Central sympatholytic drugs: These reduce blood pressure by stimulating areas in the brain and spinal cord called central alpha2‐adrenergic receptors.
- Diuretics: These medications help the body get rid of excess fluid and sodium; we sometimes call them water pills, although they actually help the body eliminate salt.
- Dual endothelin receptor antagonist: This newly approved drug works on resistant hypertension, along with other approaches.
- Mineralocorticoid receptor antagonists: These block the effects of the hormone aldosterone, which brings blood pressure down. They come in steroidal and nonsteroidal forms.
- Vasodilator drugs: These medications can relax the arterial wall and widen the arteries. This makes it easier for the blood to flow, lowering hypertension.
Most medications may have side effects. These can include dizziness, headaches, fatigue, rashes, coughing, and blurred vision. If you experience any side effects from your medication, you should discuss it with your doctor. We may be able to try different types of medicines to find the one that works best and has the fewest side effects. We can also perform renal denervation, a FDA-approved procedure, to lower blood pressure in patients with uncontrolled or resistant hypertension.