High BP occurs when your blood vessels become stiff, and your heart must work harder to push blood through. Doctors can diagnose high blood pressure if the first or second number in a blood pressure reading is high.
High blood pressure, also called hypertension, is a common health condition affecting half of all adults and can be a significant health condition for older adults.
If left untreated, it can lead to other serious health conditions, such as:
- stroke
- eye conditions
- heart disease
- kidney disease
- vascular dementia
Systolic blood pressure, which is the first number in a BP reading, is the pressure in your blood vessels when the heart is pumping. Diastolic blood pressure is the pressure between pumps when your heart is at rest.
Both systolic and diastolic blood pressure are linked and changing one will also change the other.
The American College of Cardiology (ACC) defines the blood pressure stages as follows:
- Normal BP: a systolic reading of less than 120 and a diastolic reading of less than 80
- Elevated BP: a systolic reading of 120–129 and a diastolic reading of less than 80
- Stage 1 hypertension: a systolic reading of 130–139 and a diastolic reading of 80–89
- Stage 2 hypertension: a systolic reading of over 140 and a diastolic reading of over 89
How to lower diastolic blood pressure
Most people can manage and lower their blood pressure with daily practices. These can include:
- eating a diet of vegetables, fruits, whole grains, proteins, dairy, and healthy oils
- avoiding added salt
- drinking alcohol in moderation
- exercising regularly
- managing weight
- avoiding smoking
- managing stress
- getting enough sleep
Medications
There are several types of antihypertensive medications used to treat high blood pressure. However, they all work differently and may affect other organs, such as your kidneys. Therefore, it is crucial to tell your doctor about any other health conditions you have so they can help you determine your best treatment plan.
They will generally start with specific first-line blood pressure medications before moving on to other, stronger options.
Angiotensin converting enzyme (ACE) inhibitors
These medications lower blood pressure by preventing your body from making angiotensin II, an enzyme that narrows the blood vessels.
Without this enzyme in your bloodstream, your blood vessels dilate, and your heart doesn’t need to pump as hard.
Drugs in this class include:
- ramipril (Altace)
- perindopril (Aceon)
- quinapril (Accupril)
- enalapril (Vasotec)
- lisinopril (Zestril)
Angiotensin II receptor blockers (ARBs)
These medications block the angiotensin II enzyme from binding with receptors in the blood vessels so they don’t constrict and become narrow.
These drugs include:
- losartan (Cozaar)
- telmisartan (Micardis)
- valsartan (Diovan)
- olmesartan (Benecar)
- irbesartan (Avapro)
Beta-blockers
Beta-blockers block specific hormones, like adrenaline, from working. This can lower the heart rate and make it easier for blood to flow. Common beta blockers include:
Calcium channel blockers
Calcium channel blockers block calcium ions from entering the cells in the heart muscle, which can cause your blood vessels to dilate and decrease your heart rate. This type of medication includes:
Thiazide and thiazide-like diuretics
Although doctors don’t entirely understand how they work in the body, thiazide and thiazide-like diuretics are usually first-line treatments for hypertension. This drug type includes:
Diuretics
Diuretics pull fluid from the bloodstream, decreasing the pressure in the blood vessels. Diuretics include:
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