Managing Essential Hypertension: Medication, Diet, and Lifestyle Tips

Q: Managing Essential Hypertension: Medication, Diet, and Lifestyle Tips

Hello： 1. <br>The target blood pressure for patients with hypertension is below 140/90 mmHg, while for patients with diabetes or chronic kidney disease, the target blood pressure is more stringent： below 130/80 mmHg. <br>2. <br>Non-pharmacological management of hypertension inclu

Essential hypertension

Hello Dr.
Yang,
My boyfriend recently went to the emergency room due to high blood pressure exceeding 170.
He has a hereditary form of essential hypertension.
Does this mean he will need to take medication for life? He was diagnosed early on, and his usual blood pressure is around 155.

I would like to ask you, since I have a habit of making juice for him, I came across information online about the benefits of celery, which suggests that a certain amount of celery can have effects comparable to a dose of antihypertensive medication.
Is this a viable method? He has already seen a doctor and started medication.
Can I refer to some online or commercial resources to select fruits that have blood pressure-lowering effects for juicing?
Additionally, is it necessary for someone with essential hypertension to be on medication for life, or is it possible to manage it through dietary therapy? The doctor has prescribed an ARB, which is a direct vasodilator.
I am curious about the severity of its side effects.
I have also heard that antihypertensive medications can affect sexual function; does ARB have any impact in this regard? If we are considering marriage, are there any aspects of sexual health we should be aware of? I recently heard about a senior who had a stroke on his wedding night, so I would appreciate your advice.
Thank you.

beiki, 20~29 year old female. Ask Date: 2009/08/17

Dr. Yang Zhongwei reply Internal Medicine

Hello: 1.
The target blood pressure for patients with hypertension is below 140/90 mmHg, while for patients with diabetes or chronic kidney disease, the target blood pressure is more stringent: below 130/80 mmHg.
2.
Non-pharmacological management of hypertension includes: (1) achieving ideal body weight, (2) following a low-sodium diet, and (3) increasing physical activity.
As for your interest in using celery to address hypertension, there is currently no scientific evidence to support this.
3.
Pharmacological treatment for hypertension typically involves combination therapy, as the proportion of patients who can achieve target blood pressure with a single medication is relatively low, especially for those with systolic blood pressure exceeding 160 mmHg, who usually require two or more medications.
4.
Angiotensin II receptor blockers (ARBs) are medications that have a moderate effect and do not impact sexual function; rather, it is hypertension itself that can lead to decreased sexual function.
If a second medication is necessary, it is essential to discuss this with the treating physician.
5.
Many people worry that taking antihypertensive medications for a lifetime may harm their health; however, it is important to consider that the real risk of complications, such as stroke, myocardial infarction, and kidney disease, arises from poorly controlled hypertension, not from the antihypertensive medications themselves.

Reply Date: 2009/08/17

More Info

Managing essential hypertension, especially when it has a hereditary component, can be a multifaceted approach that includes medication, dietary changes, and lifestyle modifications. Your boyfriend's situation, with a blood pressure reading of 170 mmHg, indicates that he is at a significant risk for cardiovascular complications, and it is understandable that you are concerned about his health and the implications of his condition.

Medication and Long-term Management
For individuals diagnosed with essential hypertension, particularly when it is hereditary, medication is often necessary to manage blood pressure effectively. Angiotensin Receptor Blockers (ARBs) are commonly prescribed because they help relax blood vessels, making it easier for the heart to pump blood. While some patients may hope to manage their blood pressure solely through diet and lifestyle changes, it is crucial to understand that for many, especially those with a genetic predisposition, medication may be required for life.
The good news is that with proper management, including adherence to medication, many individuals can maintain their blood pressure within a normal range and reduce their risk of complications. Regular follow-ups with a healthcare provider are essential to monitor blood pressure and adjust medications as needed.

Dietary Considerations
Regarding your question about celery and its potential effects on blood pressure, while some studies suggest that celery may have a mild antihypertensive effect due to its high potassium content and other beneficial compounds, it should not be viewed as a substitute for prescribed medication. Juicing fruits and vegetables can be a healthy addition to his diet, but it is essential to ensure that these juices do not contain excessive sugar, which can counteract the benefits.
Incorporating a variety of fruits and vegetables, particularly those rich in potassium (like bananas, oranges, and spinach), magnesium (like nuts and seeds), and fiber (like whole grains), can support overall cardiovascular health. However, it is advisable to consult with a healthcare provider or a registered dietitian before making significant changes to his diet, especially if he is on medication.

Lifestyle Modifications
In addition to dietary changes, lifestyle modifications play a critical role in managing hypertension. Regular physical activity, maintaining a healthy weight, reducing sodium intake, and avoiding excessive alcohol consumption are all beneficial strategies. Stress management techniques, such as mindfulness, yoga, or meditation, can also help in controlling blood pressure.

Side Effects and Sexual Health
As for the side effects of ARBs, they are generally well-tolerated, but like any medication, they can have side effects. Common side effects may include dizziness, fatigue, or gastrointestinal issues. Regarding sexual function, ARBs are less likely to cause erectile dysfunction compared to other antihypertensive medications, such as beta-blockers. However, individual responses can vary, and it is essential to discuss any concerns about sexual health with a healthcare provider, especially if marriage and intimacy are considerations.

Conclusion
In summary, managing essential hypertension involves a comprehensive approach that includes medication, dietary changes, and lifestyle modifications. While natural remedies like celery may offer some benefits, they should not replace prescribed treatments. Regular monitoring and open communication with healthcare providers are crucial for effective management. If your boyfriend is considering marriage, it is wise to discuss any health concerns, including those related to sexual health, with his doctor to ensure both partners are informed and prepared.

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