The first form of treatment that is usually attempted is modification of lifestyle. This modification includes cessation of smoking, moderation of alcohol intake, and weight reduction, if applicable. It can also include programmed exercise and a reduction in sodium intake. People with essential hypertension may have a potassium deficiency, and there is evidence that eating food that is rich in potassium may help to lower blood pressure. There is also evidence that supplementing the diet with Ca2+ may be of benefit, but this is more controversial.
If lifestyle modifications alone are insufficient, various drugs may be prescribed. Most commonly, these are diuretics that increase urine volume, thus decreasing blood volume and pressure. Drugs that block Pi-adrenergic receptors (such as atenolol) lower blood pressure by decreasing the cardiac rate and are also frequently prescribed. ACE inhibitors, calcium antagonists, and various vasodilators (table 14.10) may also be used in particular situations. A new class of drugs, angiotensin II-receptor antagonists, is now also available.
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