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Controlling your high blood pressure

Description

Hypertension is another term used to describe high blood pressure. High blood pressure can lead to:

  • Stroke
  • Heart attack
  • Heart failure
  • Kidney disease
  • Early death

You are more likely to have high blood pressure as you get older. This is because your blood vessels become stiffer as you age. When that happens, your blood pressure goes up.

Patient Education Video: Essential hypertension

Alternative Names

Controlling hypertension

When is Your Blood Pressure a Concern?

If your blood pressure is high, you need to lower it and keep it under control. Your blood pressure reading has 2 numbers. One or both of these numbers can be too high.

  • The top number is called the systolic blood pressure. For most people, this reading is too high if it is 140 or higher.
  • The bottom number is called the diastolic blood pressure. For most people, this reading is too high if it is 90 or higher.

The above blood pressure numbers are goals that most experts agree on for most people. For some people age 60 years and above, some health care providers recommend a blood pressure goal of 150/90. Some patients may have blood pressure goals lower than these targets, in particular circumstances. Your provider will work with you to create a blood pressure goal that applies to you specifically.

Medicines for Blood Pressure

Many medicines can help you control your blood pressure. Your provider will:

  • Prescribe the best medicine for you
  • Monitor your medicines
  • Make changes if needed

Older adults tend to take more medicines and this puts them at greater risk for harmful side effects. One side effect of blood pressure medicine is an increased risk for falls. When treating older adults, blood pressure goals need to be balanced against medicine side effects.

Blood Pressure and Lifestyle Quiz

Normal blood pressure is lower than:

Answer:

The correct answer is 120 over 80. You have high blood pressure if one or both of your blood pressure readings are higher than 130/80 mm Hg most of the time. If the top blood pressure number is between 120 and 130 mm Hg, and the bottom blood pressure number is less than 80 mm Hg, it is called elevated blood pressure. Making key lifestyle changes can help you get elevated blood pressure or high blood pressure under control.
Daily exercise lowers blood pressure.

Answer:

The correct answer is true. Try to get at least 30 minutes a day of moderate aerobic exercise, such as walking, running, cycling, or swimming. Check with your doctor before beginning any new exercise program.
People with high blood pressure should limit alcohol to:

Answer:

The correct answer is 1 to 2 drinks a day. Women should have no more than 1 drink a day and men no more than 2 drinks a day. Sticking to these limits or cutting back even further can help bring down blood pressure. Talk with your doctor if you have trouble cutting back your drinking.
When your stress level goes up, so does your blood pressure.

Answer:

The correct answer is true. Ask your doctor about healthy ways to reduce stress. Exercise, yoga, or meditation may be helpful.
Your body weight does not affect your blood pressure.

Answer:

The correct answer is false. If you are overweight, losing weight is an important part of controlling your high blood pressure. Even a small amount of weight loss can help. Controlling your portions, eating a heart-healthy diet, and getting regular exercise can all help you drop excess weight.
You can lower blood pressure by giving up:

Answer:

The correct answer is smoking. If you've tried to quit before without success, remember that the more times you try, the better your chances of quitting for good. Your doctor can recommend a smoking cessation program or other strategies to help you quit.
People with high blood pressure should avoid foods that are high in:

Answer:

The correct answer is salt. If you have high blood pressure, it's important to limit the amount of salt you eat. Aim for less than 1,500 mg of sodium a day. That's a little more than ½ a teaspoon of salt. Start by taking the salt shaker off the table and avoiding processed foods.
People with high blood pressure should also avoid eating:

Answer:

The correct answer is all of the above. These foods are high in saturated fats, which can increase your risk of heart disease. Foods with the words "hydrogenated" or "partially hydrogenated" on the label also have saturated fats, so keep them out of your shopping cart.
Diet changes can help lower blood pressure within a few weeks.

Answer:

The correct answer is true. The Dietary Approaches to Stop Hypertension (DASH) diet can help lower blood pressure, sometimes within a few weeks. Besides limiting salt and saturated fats, this diet is high in fiber, potassium, calcium, and magnesium. Your doctor can recommend a dietitian to help you plan DASH diet meals.
You can add fiber to your diet by eating:

Answer:

The correct answer is all of the above. Simple strategies to take in more fiber include replacing white rice with brown, replacing white bread with whole-grain bread, and eating high-fiber breakfast cereals. Aim for 30 grams of fiber a day.
You can keep track of your blood pressure at home.

Answer:

The correct answer is true. Your doctor want you to measure your blood pressure at home. Get a quality device with a cuff for your arm and a digital readout. Be sure the cuff fits you. This will let you see how lifestyle changes affect your blood pressure. As your blood pressure gets lower, so will your stroke and heart attack risk.

Diet, Exercise, and Other Lifestyle Changes

In addition to taking medicine, you can do many things to help control your blood pressure. Some of these include:

Patient Education Video: Heart disease - modifiable risk factor types

  • Limit the amount of sodium (salt) you eat. Aim for less than 1,500 mg per day.
  • Limit how much alcohol you drink, no more than 1 drink a day for women and 2 a day for men.
  • Eat a heart-healthy diet that includes the recommended amounts of potassium and fiber.
  • Drink plenty of water.
  • Stay at a healthy body weight. Find a weight-loss program, if you need it.
  • Exercise regularly. Get at least 40 minutes of moderate to vigorous aerobic exercise at least 3 to 4 days a week aiming for at least 150 minutes per week.
  • Reduce stress. Try to avoid things that cause you stress, and try meditation or yoga to de-stress.
  • If you smoke, quit. Find a program that will help you stop.

Your provider can help you find programs for losing weight, stopping smoking, and exercising. You can also get a referral to a dietitian from your provider. The dietitian can help you plan a diet that is healthy for you.

Checking Your Blood Pressure

Your blood pressure can be measured at many places, including:

  • Home
  • Your provider's office
  • Your local fire station
  • Some pharmacies

Your provider may ask you to keep track of your blood pressure at home. Make sure you get a good quality, well-fitting home device. It is best to have one with a cuff for your arm and a digital readout. Practice with your provider to make sure you are taking your blood pressure correctly.

It is normal for your blood pressure to be different at different times of the day.

It is most often higher when you are at work. It drops slightly when you are at home. It is most often lowest when you are sleeping.

It is normal for your blood pressure to increase suddenly when you wake up. For people with very high blood pressure, this is when they are most at risk for heart attack and stroke.

Patient Education Video: Tracking your blood pressure at home

Follow-up

Your provider will give you a physical exam and check your blood pressure often. With your provider, establish a goal for your blood pressure.

Wrist pulse
To measure the pulse at the wrist, place the index and middle finger over the underside of the opposite wrist, below the base of the thumb. Press firmly with flat fingers until you feel the pulse in the radial artery.

If you monitor your blood pressure at home, keep a written record. Bring the results to your clinic visit.

When to Call the Doctor

Contact your provider if your blood pressure goes well above your normal range.

Also contact your provider if you have any of the following symptoms:

  • Severe headache
  • Irregular heartbeat or pulse
  • Chest pain
  • Sweating
  • Nausea or vomiting
  • Shortness of breath
  • Dizziness or lightheadedness
  • Pain or tingling in the neck, jaw, shoulder, or arms
  • Numbness or weakness in your body
  • Fainting
  • Trouble seeing
  • Confusion
  • Difficulty speaking
  • Other side effects that you think might be from your medicine or your blood pressure

Gallery

Taking your blood pressure at home
After you are diagnosed with high blood pressure, your health care provider may ask you to keep track of your blood pressure by measuring it at home. There are easy-to-use devices that can help you monitor your blood pressure at home. Practice with your provider to make sure you are taking your blood pressure correctly. Compare your home machine with the one at your provider's office to be sure it is reading correctly.
Wrist pulse
To measure the pulse at the wrist, place the index and middle finger over the underside of the opposite wrist, below the base of the thumb. Press firmly with flat fingers until you feel the pulse in the radial artery.
Low sodium diet
If you have high blood pressure or heart, liver, or kidney problems, your health care provider may suggest you lower your sodium intake. Look for these words on labels low-sodium, sodium-free, no salt added, or unsalted. Check all labels to see how many milligrams of sodium there are per serving. Be sure to note how many servings there are in the package. Also, avoid foods that list salt near the top of the list of ingredients. Try to choose foods that have 140 milligrams or less of sodium per serving.

References

American Diabetes Association Professional Practice Committee. 10. Cardiovascular disease and risk management: standards of medical care in diabetes-2022. Diabetes Care. 2022;45(9):2178-2181. PMID: 34964815 pubmed.ncbi.nlm.nih.gov/34964815/.

Bakris GL, Sorrentino MJ. Systemic hypertension: mechanisms, diagnosis, and treatment. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 26.

Ettehad D, Emdin CA, Kiran A, et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet. 2016;387(10022):957-967. PMID: 26724178 pubmed.ncbi.nlm.nih.gov/26724178/.

Rosendorff C, Lackland DT, Allison M, et al. Treatment of hypertension in patients with coronary artery disease: a scientific statement from the American Heart Association, American College of Cardiology, and American Society of Hypertension. Circulation. 2015;131(19):e435-e470. PMID: 25829340 pubmed.ncbi.nlm.nih.gov/25829340/.

Whelton PK, Carey RM, Aronow WS, et al. ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. J Am Coll Cardiol. 2018;72(3):e33. PMID: 29133354 pubmed.ncbi.nlm.nih.gov/29133354/.

Last reviewed August 23, 2022 by Thomas S. Metkus, MD, Assistant Professor of Medicine and Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team..