How can you lower your blood pressure?
Blood pressure is regulated by a complex system with various feedback loops and different "levers" that can be targeted with medication. Accordingly, there are many ways medications can lower blood pressure. The foundation of treatment is always the recommended lifestyle changes. Lifestyle changes alone can be enough for people with mild hypertension (grade 1) to prevent or at least delay the need for medication. In addition, if blood-pressure-lowering medicines are still needed, lifestyle changes can enhance their effect and may reduce the amount of medication required.
The following measures are recommended:
- Stop smoking
- Reduce alcohol intake to less than 14 units per week for men and 8 units per week for women (1 unit = 125 ml wine or 250 ml beer).
- Lose weight if you are overweight
- Regular physical activity: at least 30 minutes on 5-7 days per week.
- Reduce salt intake to less than five grams per day
- Eat more vegetables, fruit, fish, nuts and unsaturated fats (olive oil). Also choose low-fat dairy products and limit red meat.
- Avoid binge drinking completely
A sufficient, but not excessive, intake of potassium from food (for example, fruit, vegetables, and legumes) can have a beneficial effect on blood pressure. However, before taking over-the-counter potassium effervescent tablets or similar products, be sure to speak with your doctor to avoid side effects. This is especially important if you have kidney disease, because in that case you should not consume too much potassium. It is therefore essential to discuss this with your doctor.
If blood pressure is correspondingly high (hypertension grade II or III) or if additional risk factors are present (for example diabetes), drug treatment is started early.
Antihypertensives - blood pressure-lowering medications
For routine treatment, medications from five different drug classes are recommended; they are generally considered roughly equivalent to each other (depending on other underlying conditions). All of them are suitable for both the initial and long-term treatment of high blood pressure. These are:
- Diuretics - water pills
- Beta blockers
- Calcium channel blockers (three different groups)
- ACE inhibitors
- Angiotensin receptor blockers (ARBs)
For most patients, treatment is started right away with a combination of two drug classes, preferably combined in a single pill.
Monotherapy that is, treatment with only one drug class should be used only for grade 1 hypertension or selected patients (e.g. very advanced age). As long as the target blood pressure is not reached, medication should be intensified. A triple combination therapy may also be considered.
The final treatment decision is up to your treating physician.
For more information, see our article on high blood pressure medications.
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Sources:
This article is from Tensana – the leading app since 2011, helping hundreds of thousands of people monitor their blood pressure every day.
Our content is based on carefully researched, evidence-based data and is continuously updated (as of 11/2025).
Author Dr. med. Christine Berchtold-Benchieb is a specialist in general medicine who studied at LMU Munich and worked in a hospital as well as several general and specialist medical practices. Her many years of daily care for patients with high blood pressure combines evidence-based expertise with practical experience and ensures reliable recommendations.
Author Dr. med. Christine Berchtold-Benchieb is a specialist in general medicine who studied at LMU Munich and worked in a hospital as well as several general and specialist medical practices. Her many years of daily care for patients with high blood pressure combines evidence-based expertise with practical experience and ensures reliable recommendations.
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