sodium consumption, as high amounts of dietary
sodium cause the body to maintain fluid. This
increases blood volume and, correspondingly,
blood pressure. Doctors also recommend reducing
dietary fat, especially saturated fat, and cholesterol
to reduce the risk for HYPERLIPIDEMIAand athero-
sclerosis. Atherosclerosis narrows and stiffens the
arteries, increasing the resistance blood encoun-
ters, and is a significant factor in hypertension.
The mainstay of treatment for hypertension is
medication. There are numerous classifications
and kinds of drugs that can lower blood pressure
through different actions and mechanisms. Often
the doctor will combine medications in a multifac-
eted approach. Many of the medications used to
treat hypertension also treat other cardiovascular
conditions. Cardiologists often prescribe beta
blockers and calcium channel blockers, for exam-
ple, to treat ARRHYTHMIA, CARDIOMYOPATHY, and
HEART FAILURE. Because cardiovascular disease is
often a constellation of conditions, this is an effec-
tive approach for preventing further cardiovascu-
lar disease from developing.
The decision to begin medication for hyperten-
sion depends on the blood pressure elevation and
other cardiovascular disease or risk factors. Doctors
may choose to initiate antihypertensive medication
therapy for stage 1 hypertension in people who
have multiple cardiovascular risks, yet try three to
six months of lifestyle modification for people who
have few or no other known cardiovascular risks.
Medication needs may change if other health con-
ditions develop or cardiovascular status changes.
On the positive side, lifestyle modifications in com-
bination with medication therapy often can reduce
or eliminate the need for medication in people who
have stage 1 hypertension and occasionally in peo-
ple who have stage 2 hypertension.
KINDS OF MEDICATIONS TO TREAT HYPERTENSIONangiotensin II receptor angiotensin-converting enzyme
blockers (ARBs) (ACE) inhibitors
beta blockers calcium channel blockers
diuretics vasodilators
Risk Factors and Preventive Measures
The leading risk factors for hypertension are age,
cigarette smoking, dietary habits, and physical
inactivity. Health conditions such as obesity, dia-
betes, and atherosclerosis further increase the risk
for hypertension. Health experts recommend all
adults over age 40 undergo annual blood pressure
screening, with more frequent screening for peo-
ple who have increased risk. Daily physical exer-
cise such as walking helps control weight as well
as maintain cardiovascular efficiency, reducing
risk across the spectrum of cardiovascular disease.
See alsoCARDIOVASCULAR DISEASE PREVENTION; DIET
AND CARDIOVASCULAR HEALTH; LIFESTYLE AND CARDIO-
VASCULAR HEALTH; PHYSICAL EXERCISE AND CARDIOVAS-
CULAR HEALTH; SMOKING CESSATION.hypotension Below-normal BLOOD PRESSURE.
Hypotension is most often a SIDE EFFECTof medica-
tions, a complication of HEART ATTACK, the result of
significant BLOODloss, or a component of cardio-
vascularSHOCK. Factors that decrease the flow of
blood through the body typically result in reduced
blood pressure. Idiopathic hypotension (hypoten-
sion that exists without apparent cause) often sug-
gests a neurologic cause that reflects damage to
the brainstem or HYPOTHALAMUS. STROKEthat inter-
rupts blood flow to these parts of the BRAINmay be
accountable, interfering with the body’s blood
pressure regulation mechanisms.
Hypotension is a frequent side effect of many
MEDICATIONS TO TREAT CARDIOVASCULAR DISEASE,
among them diuretics, antihypertensives (drugs to
lower blood pressure), and alpha blockers (drugs
to lower blood pressure or treat ARRHYTHMIA). Car-
diovascular conditions that reduce CARDIAC OUTPUT
(the heart’s ability to pump an adequate volume
of blood to meet the body’s OXYGENATIONneeds)
are common causes of hypotension. Such condi-
tions include severe dilated CARDIOMYOPATHY,
advanced HEART FAILURE, bradycardia and other
arrhythmias that slow the heart, AORTIC STENOSIS,
and unrecognized HEART ATTACK. Hypotension,
notably postural hypotension (a sudden drop in
blood pressure upon arising), may be a symptom
of ADDISON’S DISEASE, an autoimmune disorder that
destroys the ADRENAL GLANDS. The adrenal glands
produce the key hormones that increase blood
pressure, ALDOSTERONE, EPINEPHRINE, and NOREPI-
NEPHRINE.
The most common symptoms of hypotension
are lightheadedness and SYNCOPE(fainting), espe-
cially when rising from sitting or lying down. Thehypotension 67