In some cases, medication is necessary to lower blood pressure. It really depends on how high your blood pressure is and other risk factors, like family history of heart attack and stroke. Based on these risks and your current lifestyle, your doctor may prescribe common hypertension medications like lisinopril, amlodipine, losartan, and hydrochlorothiazide.

Doctors typically use an inflatable arm cuff to measure blood pressure, which is recorded in millimeters of mercury (abbreviated as “mmHg”) and has two numbers. The top number, called systolic blood pressure, measures pressure in the arteries when the heart beats. The bottom number, called diastolic blood pressure, refers to blood pressure when the heart is at rest. When patients have a blood pressure above normal (120/80 mmHg), they are considered to have prehypertension or hypertension.

Medicines are available if these changes do not help control your blood pressure within 3 to 6 months. Diuretics help rid your body of water and sodium. ACE inhibitors block the enzyme that raises your blood pressure. Other types of medicines— beta blockers, calcium channel blockers, and other vasodilators—work in different ways, but their overall effect is to help relax and widen your blood vessels and reduce the pressure inside the vessel. [See also the free government publication “Medicines to Help You: High Blood Pressure” (PDF) from the US Food and Drug Administration.]
Important complications of uncontrolled or poorly treated high blood pressure are due to chronic damage that occurs to different organs in the body and include heart attack, congestive heart failure, stroke, kidney failure, peripheral artery disease, and aneurysms (weakening of the walls of an artery, leading to a sac formation or ballooning of the artery wall). Aneurysms can be found in the brain, along the route of the aorta (the large artery that leaves the heart), and other arteries in the abdomen and extremities.
When a direct cause for high blood pressure can be identified, the condition is described as secondary hypertension. Among the known causes of secondary hypertension, kidney disease ranks highest. Hypertension can also be triggered by tumors or other abnormalities that cause the adrenal glands (small glands that sit atop the kidneys) to secrete excess amounts of the hormones that elevate blood pressure. Birth control pills -- specifically those containing estrogen -- and pregnancy can boost blood pressure, as can medications that constrict blood vessels.

Enlarged heart. High blood pressure increases the amount of work for your heart. Like any heavily exercised muscle in your body, your heart grows bigger (enlarges) to handle the extra workload. The bigger your heart is, the more it demands oxygen-rich blood but the less able it is to maintain proper blood flow. As a result, you feel weak and tired and are not able to exercise or perform physical activities. Without treatment, your heart failure will only get worse.
If your blood pressure is elevated, your doctor may request you have more readings over the course of a few days or weeks. A hypertension diagnosis is rarely given after just one reading. Your doctor needs to see evidence of a sustained problem. That’s because your environment can contribute to increased blood pressure, such as the stress you may feel by being at the doctor’s office. Also, blood pressure levels change throughout the day.