High blood pressure is a leading cause of stroke
and heart disease. Dozens of medications and other therapies are available to
treat high blood pressure, also known as hypertension. Yet many people can't
get their blood pressure under control even by taking multiple medications, reports
the September 2014 Harvard Heart Letter.
"When people have high blood pressure despite being on
three different medications, including a thiazide diuretic, they have what's
known as resistant hypertension," says Dr. Joshua Beckman, a cardiologist
at Harvard-affiliated Brigham and Women's Hospital.
Some people with resistant hypertension may have "white-coat
hypertension." That means their blood pressure is high in a doctor's
office or other medical setting but normal at home. White-coat hypertension is
thought to result from stress or anxiety, which raises blood pressure. To rule
this out, a doctor may recommend using a home blood pressure monitor or a
device that automatically takes blood pressure every 15 to 30 minutes over a
Other people with resistant hypertension may
not be taking their medicines correctly. To help his patients stick to their
medication schedules, Dr. Beckman lowers the number of pills they need to take
each day. That's often easy because many common, generic blood pressure
medications are available in combination pills. "Initially, doctors often
prescribe single-ingredient medications because it's easier to adjust the
dosage. But once you get to a certain dose on several drugs, it's better to
switch to a combination drug," he says.
A number of other things can help lower blood pressure
independent of medications. At the top of the list: Daily exercise, and weight
loss for people who are overweight. Other tips include:
- Eat more
potassium-rich fruits and vegetables. Potassium helps lower blood pressure.
Good choices include tomatoes, spinach, sweet potatoes, avocados, dried
apricots, bananas, oranges, and cantaloupes.
- Try not
to eat processed and restaurant-prepared foods. These foods can be loaded
with sodium, which raises blood pressure. Common sources of extra sodium
include cold cuts and cured meats, pizza, soups, sandwiches, and cheese.
- Go easy
on alcohol. Too much alcohol can raise
blood pressure. Men should have no more than two drinks per day, women
should have no more than one drink per day.
over-the-counter medications. Many drugs can boost blood pressure. Common
ones include painkillers such as ibuprofen (Advil, Motrin) and naproxen (Aleve,
Anaprox) as well as cold and flu remedies that contain decongestants such as pseudoephedrine,
phenylephrine, and oxymetazoline, or eye drops such as naphazoline.
full-length article: "How to tame stubbornly high blood pressure"