When to Treat Hypertension

When your blood pressure is over 140/90 mm Hg (millimeters of mercury), lifestyle changes might not be able to bring it back to normal levels. If after three or six months there is no improvement, you need medicines to control the condition.

"Hypertension treatment clearly prevents death and illness. Data recently compiled from many studies show that for mild and severe hypertension, combined antihypertensive drugs reduce the incidence of strokes 42 percent and heart disease 14 percent," according to Larry Katzenstein, senior editor of American Health magazine.

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In the past, taking drugs for hypertension meant choosing between the lesser of two evils. It was a difficult choice since hypertension often has no symptoms but could eventually lead to a stroke or heart attack.

While drug therapy prevented these dangers, it made patients suffer from impotence, headaches, dizziness, dry mouth, fatigue, frequent urination, and other unpleasant side effects.

Although some of these drugs remain in use today, reduced doses given by doctors nowadays have greatly lessened side effects and can effectively treat hypertension at the same time. What's more, other new medications have been developed which can control high blood pressure without making things difficult for the patient.

"In the past decade, literally hundreds of new medications that are much easier to take have become available for the management of high blood pressure. There's no longer any reason for you to fear their consequences. If you can't tolerate a particular one, there are several others on which to fall back," said Dr. Isadore Rosenfeld of the New York Hospital - Memorial Sloan -Kettering Cancer Center in "The Best Treatment."

"Patients with side effects for one drug can usually be shifted to another that won't cause problems. Most of the drugs can be taken just once a day, which adds to their convenience. The goal is a drug regimen that lowers blood pressure below 140/90 mm Hg while causing minimal side effects," Katzenstein added.

In treating hypertension with drugs, how low should you go? Doctors once thought that the lower the blood pressure, the better for the patient. They even kept readings below 120/80 - the classic "normal" blood pressure. Such low levels, however, can be just as bad as hypertension, especially in the elderly.

"A study published in the Journal of the American Medical Association suggested that patients faced an increased risk of heart attack when their diastolic pressures fell below 85 mm Hg. The authors speculate that hypertensives with preexisting heart disease may need the heart's blood flow maintained above that level," warned Katzenstein. (Next: Drugs for hypertension.)

When to Treat Hypertension

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