19th June 2026

Management

Management of hypertension involves a combination of lifestyle interventions and pharmacological therapy, which aim to reduce blood pressure and prevent complications.

Lifestyle interventions are the first-line treatment for suspected or diagnosed hypertension. This includes:

• Dietary changes: reducing sodium intake, increasing potassium intake, and following a Mediterranean diet
• Regular physical activity
• Weight loss for overweight/obese individuals
• Reducing caffeine
• Limiting alcohol consumption
• Smoking cessation

The choice of pharmacological therapy depends on factors such as age, ethnicity, comorbidities and contraindications. Figure 1 below outlines the patient groups who should be offered antihypertensive treatment. Figure 2 shows the stepped-care treatment protocol recommended by NICE, with medications added or changed based on a patient’s response to treatment.

Summary of NICE guidelines on the initiation of antihypertensive drug treatment. Adapted from NICE guidelines (2019)

Stepped-care treatment protocol for the initiation of antihypertensives by NICE and the BIHS. Adapted from NICE guidelines (2019)

Table 5. NICE recommendations for blood pressure targets in patients with hypertension