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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:

      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.
  • 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 people age 60 and above, some doctors recommend a blood pressure goal of 150/90.Your health care provider will consider how these goals apply 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.

      Lifestyle Tips to Control Your Blood Pressure

      1. Normal blood pressure is lower than:

        1. A. 100 over 70
        2. B. 120 over 80
        3. C. 140 over 90

        The correct answer is 120 over 80. You have high blood pressure if the top number is at least 140 or the bottom number is at least 90. A blood pressure of 120-139/80-89 is called prehypertension. Making key lifestyle changes can help you get prehypertension or high blood pressure under control.

      2. Daily exercise lowers blood pressure.

        1. A. True
        2. B. False

        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.

      3. People with high blood pressure should limit alcohol to:

        1. A. None
        2. B. 1-2 drinks a day
        3. C. 3-4 drinks a day

        The correct answer is 1-2 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.

      4. When your stress level goes up, so does your blood pressure.

        1. A. True
        2. B. False

        The correct answer is true. Ask your doctor about healthy ways to reduce stress. Exercise, yoga, or meditation may be helpful.

      5. Your body weight does not affect your blood pressure.

        1. A. True
        2. B. False

        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.

      6. You can lower blood pressure by giving up:

        1. A. Naps
        2. B. Chewing gum
        3. C. Smoking
        4. D. All of the above

        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.

      7. People with high blood pressure should avoid foods that are high in:

        1. A. Salt
        2. B. Fiber
        3. C. Potassium
        4. D. All of the above

        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.

      8. People with high blood pressure should also avoid eating:

        1. A. Egg yolks
        2. B. Hard cheese
        3. C. Ice cream
        4. D. Fatty meats
        5. E. All of the above

        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.

      9. Diet changes can help lower blood pressure within a few weeks.

        1. A. True
        2. B. False

        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.

      10. You can add fiber to your diet by eating:

        1. A. Nuts
        2. B. Whole grains
        3. C. Fresh fruits and vegetables
        4. D. Beans
        5. E. All of the above

        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.

      11. You can keep track of your blood pressure at home.

        1. A. True
        2. B. False

        The correct answer is true. Your doctor will 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. At least 30 minutes a day of moderate aerobic exercise.
      • 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.
  • 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.

      Blood pressure check

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

    • Call your provider if your blood pressure goes well above your normal range.

      Also call 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
  • References

    • American Diabetes Association. Standards of Medical Care in Diabetes-2016 Abridged for Primary Care Providers. Clin Diabetes. 2016;34(1):3-21. PMID: 26807004 www.ncbi.nlm.nih.gov/pubmed/26807004.

      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 www.ncbi.nlm.nih.gov/pubmed/26724178.

      Gaziano JM, Ridker PM, Libby P. Primary and secondary prevention of coronary heart disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 49.

      James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507-520. PMID: 24352797 www.ncbi.nlm.nih.gov/pubmed/24352797.

      Peterson ED, Gaziano JM, Greenland P. Recommendations for treating hypertension: what are the right goals and purposes? JAMA. 2014;311(5):474-476. PMID: 24352710 www.ncbi.nlm.nih.gov/pubmed/24352710.

      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 www.ncbi.nlm.nih.gov/pubmed/25829340.

      Weber MA, Schiffrin EL, White WB, et al. Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens (Greenwich). 2014;16(1):14-26. PMID: 24341872 www.ncbi.nlm.nih.gov/pubmed/24341872.

      Wright JT Jr, Fine LJ, Lackland DT, Ogedegbe G, Dennison Himmelfarb CR. Evidence supporting a systolic blood pressure goal of less than 150 mm Hg in patients aged 60 years or older: the minority view. Ann Intern Med. 2014;160(7):499-503. PMID: 24424788 www.ncbi.nlm.nih.gov/pubmed/24424788.