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Understanding Your Treatment
If you have been diagnosed with high blood pressure you will need a thorough check–up with your doctor. This is to look for any signs of damage (e.g. to your eyes or kidneys) and to get a detailed medical history to look for any possible causes. Your doctor may also want you to have some tests / investigations.
What treatment you receive to lower your blood pressure will depend upon your individual situation. You doctor will take into account how high your blood pressure is as well as your ethnic origin, your general fitness, your age and any other medical conditions you might have before deciding what treatment is best for you.
Initial treatment will involve:
- Advice on making lifestyle changes
- Monitoring your blood pressure
- Prescribing drugs to lower your blood pressure
Questions you may have about your treatment include:
- Will I need to start treatment straightaway?
- What are the aims of drug treatment?
- How do blood pressure lowering drugs work?
- How will my doctor find the right drug for me?
Will I need to start treatment straightaway?
When to start treatment with blood pressure lowering drugs will again depend upon your individual situation.
- In general, a sustained blood pressure of 160/100mmHg or above indicates the need to consider drug treatment.
- If you have cardiovascular disease (heart disease or stroke) and you have a sustained systolic blood pressure greater than 140mmHg and / or diastolic blood pressure greater than 90mmHg you should be considered for drug treatment.
- If you have 10–year CVD risk of 20% or greater and you have a sustained systolic blood pressure greater than 140mmHg and / or diastolic blood pressure greater than 90mmHg you should be considered for drug treatment.
- if you cardiovascular disease AND chronic kidney disease or diabetes you may be considered for treatment if your systolic blood pressure is greater than 130mmHg and / or diastolic blood pressure is greater than 80mmHg. These figures also apply if blood pressure has caused other damage throughout your body.
- If your blood pressure is higher than 180/110mmHg and there are signs of increased pressure in your eyes then you may be referred to a specialist.
It is essential to try making some lifestyle changes and to maintain these changes even if you have to take drugs to lower your blood pressure.
What are the aims of drug treatment?
The aim of drug treatment is to try and get control of high blood pressure and get it as close to the target range as possible.
- This is currently 140/90mmHg or less.
- If you have diabetes the lower target range of 130/80mmHg is used.
Once you reach the target range it is likely you will have to continue taking drugs to lower your blood pressure. If you stop taking them, your blood pressure may quickly rise again.
Sometimes it is not possible to reach the target range even with treatment. However, any reduction in high blood pressure helps to reduce your risk of heart disease and stroke.
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How do blood pressure lowering drugs work?
There are different groups of drugs that are used to treat high blood pressure; each works in a different way.
Generally, they work by manipulating your body's own mechanisms for controlling the blood flow to the different organs in your body. The end result is that they widen your blood vessels and / or reduce the work of your heart.
More specifically, they work on your brain, kidneys, heart or arteries, all of which are involved in regulating your blood pressure.
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How will my doctor choose the right drug for me?
It is likely you may have to take more than one group of blood pressure lowering drugs. Your doctor will choose the best combination for you depending on your individual situation and how well your blood pressure responds to treatment.
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