According to the general treatment guideline, medication is started if blood pressure is 140/90 mmHg when checked at a clinic or 135/85 mmHg or higher when checked at home even after 3–6 months of lifestyle therapy. There are several pharmaceutical products available for treating high blood pressure. The choice of medication depends on factors such as kidney functions and other medical conditions.
Normally, the primary blood pressure for a person with diabetes include angiotensin-converting-enzyme inhibitors (ACE inhibitors) or angiotensin receptor blockers (ARBs), provided that there are no contraindications to using them. The dose of the medicine is gradually increased based on the blood pressure monitoring results. It will take approximately 4 weeks for the final effect of these medicines to show. Although the anti-hypertensive drug is normally taken in the morning, it can also be divided into morning and evening doses.
If one pharmaceutical product alone is not enough to bring the blood pressure to the targeted level, it is possible to use several products separately or as a combination product. Other common blood pressure medications includes diuretics, calcium channel blockers and beta blockers. A combination drug includes two or three different blood pressure medicines in the same tablet. Blood pressure medication is for the long term, in many cases, whole life.
Medication can also be started straight away, together with lifestyle management if the blood pressure is high from the start. If the blood pressure is higher than 160/90 mmHg, the treatment can start with a combination drug. Even after the medication starts, it is beneficial to keep making blood pressure-reducing life choices because it increases the effectiveness of the medication and enables effectiveness of smaller medication doses.
Once the medication starts, it is a good idea to self-monitor the blood pressure on a weekly basis. Initially, it is appropriate to stay in contact with healthcare provider on a more regular basis, every 1–2 months, in order to ensure the suitability of the medication, correct dosing and achieving the treatment goal. Once the treatment goal has been reached, it is enough to assess the situation annually, including laboratory tests.