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Can You Be Cured of High Blood Pressure?

Ask a Doctor

My cardiologist said I need to get my hypertension under control to avoid possible kidney disease. She said I would probably have to take medication for the rest of my life, even if I change my diet and start exercising. I hate the thought of being on medication long-term. Can you be cured of high blood pressure?

Doctor's Response

Lifelong control of hypertension will minimize the risk of developing heart attack, stroke, kidney failure, blindness, and a variety of other illnesses. Unlike other illnesses in which medications are taken for only a short period of time, high blood pressure medication is usually expected to be taken for the rest of the individual's life.

That said, it is uncommon, but not rare, that significant lifestyle changes can lower blood pressure readings to normal. Here are some tips that might help you minimize your medication, under the supervision of your doctor, of course:

  • Eat a nutritious, low-fat diet. The National Heart, Lung and Blood Institute of the NIH outlines the DASH diet, that is describes as a "flexible and balanced eating plan that helps create a heart-healthy eating style for life."
  • Get regular exercise.
    • Physical activity reduces total cholesterol and bad cholesterol (low density lipoprotein or LDL) and raises the good cholesterol (high density lipoprotein or HDL).
    • Both the American Heart Association (AHA) and the U.S. Surgeon General recommend 30 minutes of physical activity on most days of the week.
    • Physical activity includes many daily activities such as cleaning the house, raking the lawn, and walking. Other possible sources of activity can include using the stairs instead of an elevator or escalator, walking for errands instead of driving a car, and participating in a sport or social activity such dancing.
  • Decrease salt (sodium) intake, read food labels so you know the salt content before you buy a product in the grocery store or eating a meal at a fast food restaurant, and avoid adding salt to foods.
  • Maintain a healthy weight, and if you are overweight or obese, try to lose weight.
    • Aim for a healthy weight range for your height and body type. Your health care practitioner can help you calculate a healthy target weight.
    • Even a small amount of weight loss can make a major difference in lowering or preventing high blood pressure.
    • You must burn more calories than you take in to lose weight.
    • Crash or fad diets are not helpful and may be dangerous.
    • Some weight loss medications also carry major risks and may even elevate blood pressure, and great caution is advised in using these drugs. Please ask your health care practitioner or pharmacist for help in deciding if a weight loss medication is appropriate for your situation.
  • Drink alcohol in moderation.
  • Stop smoking.
  • Get routine health assessments and blood pressure screening.
  • Take your blood pressure medications as directed, even if you're feeling fine.
  • Reduce stress and practice relaxation techniques, for example, meditation, Yoga, Tai Chi, and other types of physical activity.

Alternative therapies may be helpful to people trying to control their blood pressure.

  • Acupuncture and biofeedback are well-accepted alternative techniques that may help some people with high blood pressure.
  • Techniques that induce relaxation and reduce stress are recommended. These include meditation, yoga, and relaxation training.
  • These techniques alone may not control high blood pressure for many people. They should not be used as a substitute for medical therapy without first consulting with your health care practitioner.

Dietary supplements and alternative medications and therapies are sometimes recommended for high blood pressure.

  • Examples include vitamins, garlic, fish oil, L-arginine, soy, coenzyme Q10, herbs, phytosterols, and chelation therapy.
  • While these substances may be beneficial, the exact nature of their benefits is not known.
  • Scientific studies have produced no evidence that these therapies lower blood pressure or prevent the complications of high blood pressure.
  • Most of these substances are harmless if taken in moderate doses. Most people can take them without problems.
  • Talk to your health care practitioner if you are considering any of these treatments. Substituting these therapies for medical therapies that have been shown to lower blood pressure and the risk of complications may have a harmful effect on your health.
Remember, even though it may be distasteful, stick to your medication if your doctor directs you to. Untreated or poorly controlled high blood pressure is a major risk factor for heart attack, stroke, and kidney failure. That is why high blood pressure is called "the silent killer."

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References
American Heart Association.

Czupryniak L, et al. Circadian blood pressure variation in morbidly obese hypertensive patients undergoing gastric bypass surgery; Am J Hypertens. 2005 Apr;18(4 Pt 1):446-51.

Dyer KL, et al. Use of myocardial performance index in pediatric patients with idiopathic pulmonary arterial hypertension; J Am Soc Echocardiogr. 2006 Jan;19(1):21-7.

Hoeper MM, et al. Goal-oriented treatment and combination therapy for pulmonary arterial hypertension; Eur Respir J. 2005 Nov;26(5):858-63.

Lipsitz LA, et al. Antihypertensive therapy increases cerebral blood flow and carotid distensibility in hypertensive elderly subjects; Hypertension. 2005 Feb;45(2):216-21. Epub 2005 Jan 17.

Pischke CR, et al. Comparison of coronary risk factors and quality of life in coronary artery disease patients with versus without diabetes mellitus; Am J Cardiol; 2006 May 1;97(9):1267-73. Epub 2006 Mar 10.

Whelton PK, et al. 2017 High Blood Pressure Clinical Practice Guideline: Executive Summary. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. Nov 2017.
<http://hyper.ahajournals.org/content/hypertensionaha/early/2017/11/10/HYP.0000000000000066.full.pdf?download=true>

NIH. Description of the DASH Eating Plan. Updated: Sep 16, 2015.
<https://www.nhlbi.nih.gov/health/health-topics/topics/dash>
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