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HEALTH CONDITIONS
HIGH BLOOD PRESSURE
What is it?
Blood pressure is the force of blood pushing against
the artery walls. Blood pressure is at its highest
when the heart beats, or contracts. That's because
your ventricles (the heart's lower chambers) pump
with great force so that blood can reach all the blood
vessels throughout your body. In between
contractions, your blood pressure is lower.
Blood pressure is measured in millimeters of
mercury (mm Hg). A normal blood pressure reading
is lower than 120/80 mm Hg (referred to as 120 over
80). High blood pressure is a reading of 140/90 mm
Hg or higher. What do the numbers mean?
• Top number—systolic pressure. This is the higher pressure as your heart
beats or contracts. (Another word for the heart's contraction is systole.)
• Bottom number—diastolic pressure. This is the lower pressure in between
beats. (Another word for the heart's relaxation is diastole.)
Over time, high blood pressure can harden and narrow your arteries. The high
blood pressure also makes your heart work harder. That’s why high blood
pressure puts you at risk for a number of different heart and blood vessel
conditions.
To learn more about how blood flows through arteries and veins, go to the Heart
& Blood Vessel Basics section.
Another name for high blood pressure: hypertension.
What is the cause?
High blood pressure is often caused by lifestyle habits.
Risk factors you can change
• Eating high-fat and salty foods (you may want to learn about the DASH diet to
help with your blood pressure)
• Drinking too much alcohol
• Lack of exercise
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• Smoking
• Stress
• Excess weight
Risk factors you cannot change
• Age—the risk increases with age
• Heredity—the risk increases if there is family history of heart or blood vessel
disease
Other health conditions that can increase your risk
• Diabetes
• Coronary artery disease (CAD)
To learn more, go to the Risk Factors section and the Health Conditions section
(to learn about diabetes and CAD).
High blood pressure, in turn, can cause or contribute to these other health
conditions:
• Heart attack
• Heart failure
• Kidney disease
• Stroke
• Worsening of atherosclerosis, coronary artery disease (CAD), or carotid artery
disease—all of which are related to plaque building up and blocking arteries
What are the symptoms?
High blood pressure is sometimes called "the silent killer," because for most
people it doesn't cause any symptoms. A few people may experience
headaches, dizziness, or nosebleeds.
What tests could I have?
You have probably had a blood pressure test (described below) many times in
the doctor's office. If your doctor thinks high blood pressure could be causing
other health problems, you may need follow-up tests. The test results can also
help your doctor choose the best treatment(s) for you.
Blood Pressure Test
Your doctor or nurse measures your blood pressure with a cuff that wraps around
your upper arm. The cuff is pumped full of air, which stops the blood flow in your
artery for a few seconds. As the blood flow begins again, the cuff is deflated. The
blood pressure reading is visible on a dial or in a digital panel.
Some people feel anxious about having their blood pressure measured, and their
readings are higher as a result. If this happens to you, avoid caffeine for at least
30 minutes before the test. Make sure your bladder is empty. And ask the nurse
if you can take a minute or two before the test to sit quietly and breathe deeply to
relax.
What are the treatment options?
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Lifestyle factors can affect high blood pressure. Part of your treatment may
include living a healthier lifestyle. For instance, if you smoke, your doctor or
nurse can describe some stop-smoking programs that might work for you. To
learn more, go to the Risk Factors section.
Other types of treatment depend on your test results. Your doctor may
recommend one or more of these medications.
Medications
ACE Inhibitors
Angiotensin Receptor Blockers
Beta Blockers
Calcium Channel Blockers
Diuretics
Vasodilators
MEDICATIONS
Tips for Taking Heart Medications
If you have a heart or blood vessel condition, you might want to know more about
some of the medications you take. The information in this section describes
some medications commonly prescribed for heart or blood vessel conditions. It
also includes some tips to help you take your medications as ordered.
Make sure you tell your doctor—or any new doctor who prescribes medication for
you—about all the medications and dietary supplements you take. Your doctor
can then help make sure you get the most benefit from your medications. Telling
your doctor this information also helps avoid harmful interactions between
medications and supplements.
You may also want to discuss these topics with your doctor or nurse each time
you get a new medication:
• The reason you're taking the medication, its expected benefits, and its
possible side effects
• How and when to take your medications
• If you take other medicines, vitamins, supplements, or other over-the-counter
products
In some cases, your heart needs several months to adjust to new medications.
So you may not notice any improvement right away. It also may take time for
your doctor to determine the correct dosage.
Blood tests are sometimes necessary for people who take heart medications.
The blood tests help your doctor determine the correct dosage—and therefore
help avoid harmful side effects.
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Never stop taking your medication or change the dosage on your own because
you don't believe you need it anymore, don't think it's working properly, or feel
fine without it.
Be sure to talk to your doctor or nurse if you have:
• Questions about how your medications work
• Unpleasant side effects
• Trouble remembering to take your pills
• Trouble paying for your medications
• Other factors that prevent you from taking your medications as needed
• Questions about taking any of your medications
And don't hesitate to ask your pharmacist if you have questions about how and
when to take your medications.
ACE Inhibitors
“ACE” is short for “angiotensin-converting enzyme." ACE inhibitors are
medications that help prevent your body from producing too much of a natural
chemical called angiotensin II.
Some generic (and Brand) names
All medications are approved by the Food and Drug Administration (FDA) for a
specific patient group or condition. Only your doctor knows which medications
are appropriate for you.
benazepril (Lotensin)
captopril (Capoten)
enalapril (Vasotec)
fosinopril (Monopril)
lisinopril (Prinivil, Zestril)
moexipril (Univasc)
perindopril erbumine (Aceon)
quinapril (Accupril)
ramipril (Altace)
trandolapril (Mavik)
What they're used for
To treat high blood pressure
To treat heart failure and related conditions, such as low ejection fraction (EF)
To reduce damage after a heart attack and to help reduce the chance for further
heart attacks
How they work
ACE inhibitors block an enzyme that is needed to produce angiotensin II. The
body uses angiotensin II to maintain proper blood pressure and fluid balance. But
angiotensin II can have harmful long-term effects on your heart and blood
vessels. It can cause blood vessels to narrow and can also raise blood pressure.
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Taking ACE inhibitors can:
Relax the arteries
Lower blood pressure
Help the heart work more effectively
Angiotensin Receptor Blockers
Angiotensin receptor blockers (ARBs) are medications that help block the effects
of a natural chemical—called angiotensin II—that your body produces. For that
reason ARBs are also called angiotensin II inhibitors. ARBs and ACE inhibitors
have similar effects on your body. In fact, doctors often prescribe ARBs for
people who cannot take ACE inhibitors.
Some generic (and Brand) names
All medications are approved by the Food and Drug Administration (FDA) for a
specific patient group or condition. Only your doctor knows which medications
are appropriate for you.
candesartan (Atacand)
eprosartan (Teveten)
irbesartan (Avapro)
losartan (Cozaar)
olmesartan (Benicar)
telmisartan (Micardis)
valsartan (Diovan)
What they're used for
To treat high blood pressure
To treat heart failure and related conditions
How they work
Angiotensin II is a chemical that causes the blood vessels to narrow (constrict).
ARBs block the effect of this chemical. (ACE inhibitors, on the other hand,
prevent your body from producing this chemical.) In this way, ARBs can allow
blood vessels to remain wider (dilated), lowering blood pressure.
Taking ARBs can:
Lower blood pressure
Lessen work for the heart
Beta Blockers
Beta blockers get their name because they "block" the effects of substances like
adrenaline on your body's "beta receptors."
Some generic (and brand) names
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All medications are approved by the Food and Drug Administration (FDA) for a
specific patient group or condition. Only your doctor knows which medications
are appropriate for you.
acebutolol (Sectral)
atenolol (Tenormin)
betaxolol (Kerlone)
bisoprolol (Zebeta)
carvedilol (Coreg)
labetalol (Trandate)
metoprolol (Lopressor, Toprol)
nadolol (Corgard)
penbutolol (Levatol)
pindolol (Visken)
propranolol (Inderal)
sotalol (Betapace, Sorine)
timolol (Blocadren)
What they're used for
To treat high blood pressure
To slow fast arrhythmias (abnormal heartbeats, or heart rhythms)
To prevent angina (chest pain due to blocked blood flow to parts of the heart)
To prevent long-term damage after a heart attack
To treat heart failure and related conditions, such as low ejection fraction (EF)
How they work
These medications block activity of your sympathetic nervous system. The
sympathetic nervous system reacts when you are stressed or when you have
certain health conditions. When your system responds, your heart beats faster
and with more force. Your blood pressure also goes up.
Beta blockers block signals from the sympathetic nervous system. This slows
your heart rate and keeps your blood vessels from narrowing. These two actions
can result in:
Lower heart rate
Lower blood pressure
Less angina (chest pain related to the heart)
Fewer arrhythmias (abnormal heartbeats, or heart rhythms)
Calcium Channel Blockers
Calcium channel blockers help relax the heart muscle and blood vessels.
Some generic (and Brand) names
All medications are approved by the Food and Drug Administration (FDA) for a
specific patient group or condition. Only your doctor knows which medications
are appropriate for you.
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amlodipine (Norvasc)
diltiazem (Cardizem, Dilacor, Diltia, Tiazac, Taztia)
felodipine (Plendil)
isradipine (DynaCirc)
nicardipine (Cardene)
nifedipine (Adalat, Procardia)
verapamil (Calan, Covera, Isoptin, Verelan)
What they're used for
To treat high blood pressure
To treat angina (chest pain) which can result from atherosclerosis (blocked blood
vessels) and coronary artery disease (CAD)
To treat some arrhythmias (abnormal heartbeats, or heart rhythms)—usually fast
arrhythmias
How they work
Calcium channel blockers prevent calcium from entering parts of the cells in
blood vessels. When calcium is blocked from entering these cells, it relaxes the
blood vessels and the heart. As a result, calcium channel blockers:
• Decrease the work of the heart by allowing more blood and oxygen to flow to
the heart muscle
• Lower the heart rate
• Lower blood pressure
Diuretics (Water Pills)
Diuretics remove excess water from your body.
Some generic (and brand) names
All medications are approved by the Food and Drug Administration (FDA) for a
specific patient group or condition. Only your doctor knows which medications
are appropriate for you.
amiloride (Midamor)
bendroflumethiazide (Naturetin)
bumetanide (Bumex)
chlorothiazide (Diuril)
chlorthalidone (Hygroton, Thalitone)
eplerenone (Inspra)
ethacrynic acid (Edecrin)
furosemide (Lasix)
hydrochlorothiazide (Microzide, Oretic)
indapamide (Lozol)
methyclothiazide (Enduron)
metolazone (Zaroxolyn)
polythiazide (Renese)
spironolactone (Aldactone)
torsemide (Demadex)
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triamterene (Dyrenium)
What they're used for
To lower blood pressure
To reduce edema (swelling caused by excess fluid in your body—often in the
legs and feet) associated with conditions such as heart failure
How they work
Some diuretics work by causing the kidneys to release more sodium (salt) into
urine. Sodium helps draw water out of the blood. With less fluid in your blood,
your blood pressure decreases.
Diuretics also relieve symptoms like shortness of breath. That's because excess
fluid in your lungs can cause these symptoms.
Vasodilators
One purpose of vasodilators is to lower blood pressure. To understand how
vasodilators work, imagine the same amount of water moving through a 1-inch
diameter hose versus a 2-inch diameter hose. The bigger the hose, the less
pressure on the walls of the hose.
Medications such as vasodilators can help relax and widen (dilate) blood vessels
that have become narrowed (constricted).
Some generic (and Brand) names
All medications are approved by the Food and Drug Administration (FDA) for a
specific patient group or condition. Only your doctor knows which medications
are appropriate for you.
doxazosin (Cardura)
guanabenz (Wytensin)
guanfacine (Tenex)
hydralazine (Apresoline)
isosorbide dinitrate (Dilatrate, Isordil, Isochon)
isosorbide mononitrate (Imdur, ISMO, Monoket
methyldopa (Aldomet)
minoxidil (Loniten)
nitroglycerin (Minitran, Nitro-Bid, Nitro-Dur, Nitrogard, Nitrolingual, NitroQuick,
Nitrostat))
prazosin (Minipress)
reserpine (Serpalan)
terazosin (Hytrin)
You may have heard of other types of vasodilators. Beta blockers, which are a
common heart and blood vessel medication, are one type of vasodilator. Another
type is calcium channel blockers.
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What they're used for
To treat high blood pressure
To treat/prevent angina (chest pain related to the heart) which can result from
atherosclerosis (blocked blood vessels) and coronary artery disease (CAD)
How they work
Vasodilators help relax and dilate the blood vessels, so blood moves through
them more easily. This helps to:
Lower blood pressure
Allow the heart to work with less effort
Decrease the amount of angina (chest pain)
Important Safety Information
Medications, procedures and tests can have some risks and possible side effects. Results may vary
from patient to patient. This information is not meant to replace advice from your doctor. Be sure to
talk to your doctor about these risks and possible side effects.
Boston Scientific is a trademark and HEARTISTRY is a service mark of Boston Scientific Corporation.
All other brand names mentioned are used for identification purposes only and are trademarks of their respective owners.
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