Treatment of hypertension

Treatment of hypertension

Non-pharmacological treatment is the preferred treatment of hypertension. Quitting smoking, losing weight, regular exercise, and dietary restrictions (e.g. reduced salt/alcohol intake) can all help to reduce blood pressure. If these strategies are not sufficient, drugs will lower the blood pressure. Six groups of drugs can be applied for antihypertensive treatment:

  • Diuretics act in the kidneys by increasing water excretion.
  • β-blockers inhibit the tone of the sympathetic nervous system, decrease heart rate and cardiac output, and reduce the kidney renin production.
  • Calcium antagonists act directly on the heart by binding to calcium channels.
  • ACE inhibitors inhibit the angiotensin converting enzyme and thus synthesis of active angiotensin II.
  • Renin inhibitors act earlier in the angiotensin pathway by inhibiting the renin enzyme itself.
  • Vasodilators act directly on the arterioles and decrease their resistance through dilation.

These drugs can be used as monotherapy or in combination. The choice depends on patient-specific data (age, comorbidity, race, renal function, etc.). In general, diuretics and β-blockers are preferred, with ACE inhibitors as alternative.


Treatment with antihypertensives should continue for: