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Controlling your high blood pressure

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Controlling hypertension

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

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.

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 130 or higher.
  • The bottom number is called the diastolic blood pressure. For most people, this reading is too high if it is 80 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 different blood pressure goal. 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.

Video Transcript

Hypertension - overview - Animation

If left untreated, hypertension can lead to a thickening of arterial walls, causing the lumen, or blood passageway, to narrow in diameter. As a result, the heart must work harder to pump blood through the narrowed arterial openings. In addition, people with hypertension may be more susceptible to stroke.

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:

    Correct 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.

    Correct 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:

    Correct 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.

    Correct 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.

    Correct 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:

    Correct 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:

    Correct 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:

    Correct 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.

    Correct 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:

    Correct 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.

    Correct Answer
    The correct answer is true. Your doctor may 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:

  • 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
  • Some local fire stations
  • 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.

Video Transcript

Tracking your blood pressure at home - Animation

Following your blood pressure at home has gotten a lot easier in the last few years. I'm Dr. Alan Greene. I'd like to share with you a little bit about that. Not too long ago when you wanted to follow your blood pressure at home, you had to have the old fashioned sphygmomonometer, and the device was a complex as that word sounds. You had to pump something up, and put a stethoscope in your ears, and fumble all these different tubes and even so wouldn't get a very accurate reading. Now, there are simple, high quality, digital blood pressure cuffs. They're easy to use at home. They're built so they snap on the arm very easily, just press a single button, and the chip inside does the work for you. It blows it up, it gives you the reading, and some of the newer models even connect it to your PC and track the readings for you. Now, how accurate are they? They're really pretty good. I wouldn't trust a single reading that much if you get one that's high or low. I wouldn't be either reassured or panicked. But, I would trust the pattern of readings. So, if you have one that tracks it for you, that's great, if not, just write them down what date and time you took it and see what the pattern is over time. If there's anything of concern, be sure to report it to your physician.

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.

If you monitor your blood pressure at home, keep a written record. Bring the results to your office 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
Review Date: 7/14/2024

Reviewed By

Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

References

American Diabetes Association Professional Practice Committee. 10. Cardiovascular disease and risk management: standards of medical care in diabetes-2024. Diabetes Care. 2024;47(Supplement 1):S179-S218. PMID: 38078592 pubmed.ncbi.nlm.nih.gov/38078592/.

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.

Flack JM. Arterial Hypertension. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 64.

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/.

Disclaimer

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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Hypertension - overview

Hypertension - overview

Animation

Tracking your blood pressure at home

Tracking your blood pressure at home

Animation

Blood pressure check - Illustration Thumbnail

Blood pressure check

To measure blood pressure, your doctor uses an instrument call a sphygmomanometer, which is more often referred to as a blood pressure cuff. The cuff is wrapped around your upper arm and inflated to stop the flow of blood in your artery. As the cuff is slowly deflated, your doctor uses a stethoscope to listen to the blood pumping through the artery. These pumping sounds register on a gauge attached to the cuff. The first pumping sound your doctor hears is recorded as the systolic pressure, and the last sound is the diastolic pressure.

Illustration

Hypertension - overview

Hypertension - overview

Animation

Tracking your blood pressure at home

Tracking your blood pressure at home

Animation

Blood pressure check - Illustration Thumbnail

Blood pressure check

To measure blood pressure, your doctor uses an instrument call a sphygmomanometer, which is more often referred to as a blood pressure cuff. The cuff is wrapped around your upper arm and inflated to stop the flow of blood in your artery. As the cuff is slowly deflated, your doctor uses a stethoscope to listen to the blood pumping through the artery. These pumping sounds register on a gauge attached to the cuff. The first pumping sound your doctor hears is recorded as the systolic pressure, and the last sound is the diastolic pressure.

Illustration

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