Managing High Blood Pressure: Self-Care and Diuretics. Adopting a healthy diet with less salt, engaging in regular exercise, and taking medications can help lower blood pressure.

The primary goal of high blood pressure treatment is to prolong the patient’s life free from complications. The aim is to reduce the likelihood of suffering a stroke, a heart attack, or heart or kidney failure. To achieve this, treatment should reach and maintain figures below 140/90 mmHg (“less than 14 systolic and 9 diastolic”).

If diagnosed with high blood pressure, your doctor will recommend a treatment plan. They’ll likely advise you to make healthy lifestyle changes. You might also need to take medications. The treatment’s goal is to lower your blood pressure enough to prevent more serious problems.

Dr. Paul Whelton, an expert in hypertension and kidney disease from Tulane University

Non-pharmacological Treatment of High Blood Pressure

The treatment of hypertension is not solely about medication intake; lifestyle change is equally, if not more, important. It is recommended to:

Quit smoking emphatically. Reduce the excessive intake of salt in the diet to about 5 g/day. Limit alcohol consumption to 20 g/day (half for women). This is equivalent to a glass of wine or a beer with a meal. Reduce overweight, if present. Engage in regular moderate physical activity. Healthy Eating

Low in fats (limit sausages, cheese, pork, beef, whole milk, pastries). Moderate in carbohydrates (pasta, rice, potato). High in fiber (fruit, vegetables, legumes, whole grains). Decrease the consumption of high-salt foods (sausages, canned goods, pre-cooked foods). A moderate reduction in salt intake lowers blood pressure figures, aids in weight loss, and reduces the need for antihypertensive medications. Increase the consumption of polyunsaturated omega-3 and omega-6 fatty acids (blue fish, corn). Reduce the intake of animal-origin saturated fatty acids. High in calcium (yogurt, milk, egg, beans, semolina), magnesium (beans, nuts, corn, bread, lentils), and potassium (lentils, nuts, bananas, potatoes, carrot, tomato). These are advisable because they might reduce pressure.

Pharmacological Treatment of High Blood Pressure

In addition to making lifestyle changes, the vast majority of patients must also take medications to lower their pressure.

The greatest benefit of medications is the very act of lowering the pressure. However, depending on the degree of hypertension. The presence or absence of organ damage, or, ultimately, the risk of suffering some cardiovascular complication, will determine which medications are best for lowering the pressure in each patient individually.

Often, more than two medications are needed to normalize the pressure. These combinations of two drugs are better taken in a single pill (fixed combination) than in two pills (one for each medication).

Patients must take the medication daily, not just when they believe they are “high in pressure.”

New Therapies for Patients

In whom pressure normalization is not possible despite adequate lifestyle changes and taking a minimum of 3 well-combined medications at full doses, known as resistant hypertension, there are some therapeutic alternatives.

It should always be checked that lifestyle changes have been correctly made, that treatment compliance is good, and that there are no other factors contributing to the lack of pressure control such as the interaction with other medications (like anti-inflammatories), or the presence of sleep apnea.

One should also consider the possibility that a specific disease raising the pressure, known as secondary hypertension, could cause the treatment not to work. For example, drug intake like cocaine, and tumors-producing substances raise the pressure, among others.

For very selected cases, and without much experience at the moment, there are two new types of interventional treatment for resistant hypertensive patients:

Carotid baroreceptor stimulation.

It involves the permanent electrical stimulation of nerves in the carotid sinus (located in the neck) through a device implanted under the skin (similar to a pacemaker). Besides a discrete risk associated with surgery, the system is very expensive and does not work for all patients.

Renal denervation.

Bilateral destruction of renal nerves is found along the renal artery using a radiofrequency ablation catheter inserted percutaneously (through a patch adhered to the skin that allows the passage of some substances until reaching the dermal capillaries) in the renal artery. It works in some patients. It is an expensive system, and its effectiveness has not been sufficiently proven.

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