High blood pressure- also known as hypertension- is a medical condition that affects nearly half of all American adults. That’s right, 48.1% of Americans over 20 have a blood pressure that is considered too high! So, if you have just discovered that you are one of the many people with hypertension, you are not alone.
What is High Blood Pressure?
You may be wondering what it means to have high blood pressure and why it matters. To understand this, it is helpful first to define what blood pressure is. Blood pressure measures the pressure your blood puts on your arteries as it flows through them. It is measured with two numbers.
The top number of a blood pressure reading is known as systolic blood pressure. This measures the pressure in your arteries as your heart squeezes the blood through them. The bottom number is known as the diastolic blood pressure. This is the pressure in your arteries as your heart relaxes between beats. The goal blood pressure is anything less than 130/80; normal is considered less than 120/80.
Why Does Your Blood Pressure Matter?
The higher the blood pressure, the more strain is put on your heart and blood vessels. After a while, the blood vessels start to stiffen in response. Eventually, this makes them weaker, increasing the risk of heart attack and stroke. These damaged blood vessels can also cause kidney and vision problems, in addition to early dementia and cognitive problems.
Some people with high blood pressure argue that they feel fine, and don’t want to take medications until they have symptoms. Unfortunately, that is a very dangerous way of thinking. Hypertension is known as the “silent killer”- you may not even be aware that you have high blood pressure, but it is causing damage to your body. The damage it does will not be reversed by starting blood pressure medicine after your first heart attack or stroke.
What Should You Do to Manage Hypertension?
Most importantly, if your doctor has prescribed you medication for your blood pressure, you must take it as directed. Antihypertensive medication is not meant to be taken “as needed”- it works best when taken at the same time every day. If you check your blood pressure one day and it is normal, this does not mean you should skip your next dose of medicine- this means that your medicine is working, and you should continue to take it as prescribed.
Lifestyle Changes Can Help
Medication is not the only way to treat hypertension, however. The following interventions can make a huge difference:
- Exercise: Regular daily exercise has been shown to help lower blood pressure. Exercising for 30 minutes, 5 days per week is a great way to control your blood pressure.
- Healthy diet: A healthy diet high in fruits and vegetables and low in salt can help with blood pressure management. The DASH eating plan is a great way to introduce the right foods into your diet to help with your blood pressure- read more about it here: https://www.nhlbi.nih.gov/education/dash-eating-plan
- Limit alcohol: If you are a woman, do not drink more than one alcoholic beverage per day. Men should limit their alcohol intake to two alcoholic beverages per day.
- Quit smoking: It is certainly a challenge to do so, but not only will quitting smoking help your blood pressure, it will lower your risk of heart attack as well.
- Lose weight: Obesity is one of the risk factors for high blood pressure. Controlling your weight can also help control your blood pressure. Following the DASH eating plan noted above will help you to both lose weight and control your blood pressure.
- Control stress: Increased life stressors can contribute to high blood pressure as well. Meditation and exercise are great ways to help lower your stress level.
Do Genetics Play a Role?
Adding the above recommendations to whatever medication(s) your doctor has prescribed will help keep your blood pressure under control, and help keep you from developing some of the medical problems associated with untreated hypertension. Some people are fortunate in that losing some weight and exercising work so well to control their blood pressure that ultimately they are able to stop taking their medication (with their doctor’s guidance, of course).
But genetics plays a role as well, and even a vegetarian ultra-marathoner yoga instructor might need blood pressure medication because their genes cause them to have high blood pressure. So if you are “doing everything right” and still have high blood pressure, do not blame yourself- keep living your healthy lifestyle and take your medication, knowing that you are doing a great job decreasing your risk of heart attack and stroke.
Can You Check Your Blood Pressure At Home?
Being aware of your blood pressure at home in between doctor’s visits can be a great way to make sure your blood pressure is under control. Buy a good home blood pressure cuff- some insurance plans will even pay for this. Bring your cuff with you to your next doctor’s appointment to make sure it is accurate- you can check your blood pressure on your machine, then have your doctor recheck it- the readings should match.
Check your blood pressure once per day, at the same time every day. Make sure you didn’t just run up a flight of stairs or have an argument with your teenager right before testing it. Sit down, relax, and take a few deep breaths- then test. One to two minutes later, recheck your blood pressure to confirm it is the same.
You can record your readings in a notebook to bring to your next doctor’s appointment so they can see if your blood pressure has been well-controlled over a period of time. This can be very helpful to your physician, because some people have “white-coat hypertension”- meaning they get anxious at the doctor’s office and their blood pressure is higher than normal when they are there.
What Do You Do If Your Blood Pressure Is Much Higher Than Usual?
If your blood pressure is 180/90, and you sit down and relax and check it again and it is still 180/90? Should you immediately go to the emergency room? In general, if you are having no other symptoms and otherwise feel well, the answer is no.
Think back on your day:
If you are on blood pressure medicine, did you miss your dose today? Have you been under more stress? Did you have a large latte with an extra shot of espresso? Sometimes there is a simple reason for your higher reading.
You can call your doctor and they likely will have you come in for a blood pressure recheck in the next few days. If your doctor’s office is closed, however, this does not mean that you need to go to the ER. Just keep track of your readings and review them with your doctor in the next few days.
One thing you should avoid is continuing to check your blood pressure over and over after one elevated reading- if you check it every 5 minutes for the rest of the day, it is guaranteed to increase due to your stress about the initial high reading. However, if you are having chest pain (or pressure, tightness, or heaviness), trouble breathing, severe headache, or other concerning symptoms, that is a different story- an emergency room visit is a good idea.
When Is Medication Necessary?
If your blood pressure continues to be high, your doctor may need to change or add medications. Some people even require two or three to control their blood pressure. You might need to try several different medications until you find the combination that works for you. If you are taking blood pressure medication and feel like you are having side effects- fatigue, or cough, or leg swelling for example- let your doctor know! There are many options that can be tried, and your doctor wants you to be on a medication that works well for you.
With a few lifestyle changes and help from your doctor, managing your blood pressure can be easier than you would think. You are not alone- connect with other people with hypertension on PatientsLikeMe!
This blog is medically written and verified by Kathleen O’Shea Northrup, MD