No single medicine is ideal for all people. Drugs differ in the way they lower blood pressure and, depending on each person's characteristics, in their potential for unwanted side effects. If the first drug or drug dose you try does not work, your doctor will change the dose or the drug. This is not unusual, so don't be discouraged. It's hard to predict who will respond to particular medicines. Work with your doctor until you find the right medicines for you.
If your blood pressure is severely elevated, you may need to be hospitalized and given intravenous medicine while your blood pressure, heart rhythm and rate are monitored.
Doctors once believed that it was of no benefit to treat high blood pressure in people over age 60, and that treatment might even be harmful. The theory was that older people needed a higher blood pressure because their arteries were stiffer. Some doctors feared that lowering the blood pressure to levels that were normal in younger people might cause strokes or kidney failure.
A wealth of research now shows that people over 60 get just as much benefit, if not more, from having their high blood pressure treated. Proper treatment reduces the risk of major diseases in people over 60:
African-Americans generally respond best to blood- pressure medicines in one of three groups: diuretics, calcium channel blockers, and combination alpha and beta-blockers. Beta-blockers and ACE inhibitors are somewhat less powerful in African-Americans unless combined with diuretics.