Our ability to recognize and control high blood pressure has had a dramatic impact on people dying from heart attack over the last forty years. There are scores of different medications that can be used to safely lower blood pressure.
Patients are still confused about what the goal is for blood pressure. And we've learned that measuring blood pressure in the doctors office is not the best way to see if the goal is reached. Patient anxiety, lack of skill by the doctor or nurse and just poor hearing through the stethoscope can affect the results.
New guidelines have evolved and here they are:
Goal blood pressure for most patients younger than 80 years is lower than 140/90. The goal should be under 130/85 if the patient has diabetes, kidney disease or cardiovascular disease.
The patient should have their own automated blood pressure monitor that they use at home and if the majority of readings are not below 140/90, medication should be adjusted or added to reach the goal. Some patients require three different drugs to achieve normal blood pressure. The most important factor in preserving kidney function or reducing heart attack is bringing blood pressure down to goal.
There are over 80 different drugs and combination drugs available to treat hypertension. (That tells you it is a common and chronic condition.) They fall in following classes of drugs:
- Angiotensin-converting enzyme (ACE) inhibitors
- Angiotensin receptor blockers (ARB)
- Beta blockers
- Calcium channel blockers