If your blood pressure is high, it doesn’t necessarily mean you’ll need to take blood pressure medicines.

However, your risk of developing cardiovascular disease — such as stroke and heart attack — increases with high blood pressure.

In deciding whether you need antihypertensive medicines, your doctor will check your overall risk of developing cardiovascular disease in the next 5 years or so.

The Royal Australian College of General Practitioners recommends that you regularly review with your doctor or specialist any medications you are taking for high blood pressure or high cholesterol to assess the ongoing benefits and risks.

For further information, visit the Choosing Wisely Australia website.

The higher your risk, the more likely you’ll need medicines.

Usually doctors will start a person on a low dose of a medicine and see how it goes. If it doesn’t work well enough, or if there are troublesome side effects, other medicines will be used, sometimes in combination, until the blood pressure is controlled. This can take time. Some people will take medicines for life, although others will find that continuing to lose weight and change their diet reduces the need for medicines.

Someone whose blood pressure is very high or causing symptoms such as headache, or if they have conditions such as heart disease or diabetes, may need urgent treatment with medicines to bring the blood pressure down to normal levels.

Types of blood pressure medicines

The most common blood pressure medicines are ACE inhibitors, calcium channel blockers, beta blockers and diuretics. Many people need more than one medicine to bring their high blood pressure under control.

ACE inhibitors and ARBs

ACE (angiotensin-converting enzyme) inhibitors and ARBs (angiotensin receptor blockers) work by widening your blood vessels. This reduces the pressure in the vessels and allows blood to flow more easily — making it easier for your heart to pump blood around your body.

Calcium channel blockers

Calcium channel blockers stop calcium from entering the heart muscle and blood vessel cells. This widens the blood vessels and relaxes the heart muscle, making it easier for your heart to pump blood around the body.

Beta blockers

Beta blockers work by reducing nerve signals to the heart and blood vessels. This reduces your blood pressure and the amount of work your heart needs to do. Find more on the beta blockers page.

Diuretics

Diuretics are also known as fluid tablets. They work by making you urinate more to get rid of any excess water in your body. When the excess fluid is reduced, the pressure in your blood vessels and heart also lowers.

Lifestyle changes to treat high blood pressure

You may be able to reduce your blood pressure and reduce your risk of heart disease in other ways. Some people are able to reduce their blood pressure without taking blood pressure medicines. It helps to:

• exercise regularly
• reduce your salt intake
• eat plenty of plant-based foods
• lose weight if you are overweight
• limit alcohol
• quit smoking if you smoke

Your doctor can give you more specific guidance to suit your needs.

Many people with high blood pressure don’t have any symptoms. It is recommended for all adults to get their blood pressure checked at least every 2 years.