High Blood Pressure Articles

Cheat Sheet / Updated 09-25-2023

After you have received a blood pressure measurement and a classification from your doctor, make sure you follow the recommended schedule for medical rechecks. Make the necessary lifestyle changes to lower your blood pressure, look for signs of secondary high blood pressure, and if you need high blood pressure medication, consult a physician to find the right medication for you.

Article / Updated 03-19-2021

Hypertension can be serious when not treated properly, but for most people it’s a very manageable condition. The best way to manage hypertension is by setting long-term goals rather than focusing on nonexistent quick fixes. In this article, we share the 10 best lifestyle changes you can make to create optimal health and lower your blood pressure. Controlling hypertension doesn’t happen overnight, but you can turn the corner by following our tips. Before you implement any major changes to your diet or exercise regimen, talk to your doctor first to make sure what you’re planning is medically safe. Then check in with your doctor regularly to keep her abreast of your progress and challenges to ensure the best management of your hypertension. Lose weight and keep it off Weight loss is often the number-one treatment for hypertension, and even a small drop in pounds helps. Being overweight strains your body and your heart, and losing weight will usually help to improve your blood pressure. After you’ve lost the weight, the key is to keep it off. A healthy diet, like the DASH (Dietary Approaches to Stop Hypertension) diet, is not a one-and-done situation. To maintain that weight loss you worked so hard to achieve, you must maintain the lifestyle changes that got you there: eating the right amounts of the right foods (lean meats, vegetables, fruits, dairy, grains, less salt, and smaller portions of treats) and exercising 20 to 30 minutes per day. You’ll be rewarded with the energy and vitality you crave. Sticking to lifestyle changes often means continuously setting new goals to avoid a setback. A great tool to help you set diet and exercise goals—and stick to them—is Calorie Counter Journal For Dummies, by coauthors Rosanne and Meri Raffetto (Wiley). Develop an exercise routine Along with eating right, regular exercise keeps your weight under control, improves your cardiovascular health, and reduces your stress level, all of which help you curb hypertension in the long run. Regular is the magic word here. Scheduling a 20- to 30-minute walk five days a week is a great way to begin moving regularly. Do whatever you can at first, and then add minutes each week. After you’re up to 30 to 45 minutes of walking, gradually increase your pace until you can walk a mile in 15 to 20 minutes. Weight-bearing exercise is important too, especially as you age because muscle and bone loss occur at a more rapid rate. Adding workouts with weights or resistance bands two or three times a week to your aerobic activity is a great plan. Some forms of yoga can help, too. Stick to DASH Although one of the goals of DASH eating is to reduce sodium, saturated fat, and cholesterol in the diet, DASH is more about what to add to your diet than what you should limit. Fruits and vegetables, for instance, are very important sources of potassium and magnesium (which help lower blood pressure), antioxidants (such as vitamins C and A), and fiber (which helps keep cholesterol in check). DASH also encourages you to include more monounsaturated fats and low-fat dairy products. Following the DASH dietary guidelines has been proven to lower hypertension. Enjoy the recipes in Part 4, which all incorporate aspects of the DASH plan, and check out Part 3 for even more information on what to eat and how to navigate restaurants and get-togethers so you can stay true to your DASH eating plan for the long haul. Eat less salt A high-salt diet has been shown to raise blood pressure in some people, so reducing your intake of high-sodium foods and the amount of salt you use in cooking is a good idea (daily goal: 1,500 to 2,300 milligrams). Because more than three-fourths of the salt in most people's diets comes from prepared foods, the first step is to read food labels and reduce your consumption of highly processed packaged foods. Eating out less often (and eating smaller portions) will also help, because restaurant foods tend to be highly salted. By cutting back in stages, you’ll find that your cravings will gradually subside. Ingredient lists and product labels usually refer to salt in terms of sodium, a building block of salt, but may also include other forms of sodium such as monosodium glutamate (MSG), which is typically found in Asian foods and some processed products. Also, be aware that salt commonly hides in restaurant foods. Add good fats to your diet Hypertension is a risk factor for heart disease; so is high blood cholesterol. Consuming heart-healthy fats may help improve the balance of good and bad cholesterol in your blood stream. On the other hand, saturated fats from red meat and tropical oils may make it worse. Vegetable oils such as olive, canola, avocado, and peanut oils are your best bet because they’re high in heart-smart monounsaturated fat. Other vegetable oils are higher in polyunsaturated fat, which isn’t harmful but seems to have a neutral effect. Adding nuts, seeds, avocados, olives, and monounsaturated oils to your diet is a good idea, but keep in mind that good fats have just as many calories as the bad stuff. Try walnuts or plain roasted sunflower seeds in salads or mixed into vegetable dishes or in stir-fries. Nuts can also be a nutritious snack as long as you don’t overindulge (about 15 to 20 nuts is sufficient). Avoid drinking alcohol excessively Although one glass of red wine or other alcoholic beverage a day may be beneficial to your blood circulation and heart health, overindulging is not. If you’re male, drinking more than two drinks a day can lead to heart damage, high blood pressure, and high triglycerides. For women, the threshold is more than one drink daily; this level can also increase the risk for breast cancer. The U.S. Centers for Disease Control and Prevention define heavy drinking as consuming 15 or more drinks per week for men and 8 or more drinks per week for women. One drink is equivalent to a 5-ounce glass of wine, a 12-ounce beer, or 1-1/2 ounces of 80-proof liquor. So keep your alcohol intake moderate for heart health — and if you don’t drink alcohol, there’s no need to start. Make other heart-healthy lifestyle choices instead, such as adding more grapes and colorful fruits and vegetables to your diet, and exercising regularly. Don’t use tobacco products Smoking causes coronary heart disease, contributes to stroke, and increases the risk of peripheral vascular disease (obstruction of the large arteries in the arms and legs, resulting in pain and possible tissue death which may lead to amputation). Chewing tobacco isn’t much better because it raises blood pressure, harms the arteries, and increases the risk of a wide variety of cancers. Tobacco is also a factor in dementia. Basically, there’s nothing good about it. If you use tobacco products, talk to your doctor. Although quitting isn’t easy, there are products and programs that can help. Stress less Stress has both direct and indirect effects on blood pressure. Work, family, health, and your personal life may affect your overall stress level, causing poor-quality sleep and unhealthy food choices, both of which can contribute to hypertension. Finding ways to manage stress helps you cope more effectively with day-to-day life and simply makes you feel better. You can reduce stress in a number of ways. One of the best strategies is to engage in regular exercise. For starters, put on your sneakers and take a walk. Yoga is another excellent stress reducer, and many people find that a meditation practice helps to calm the mind and body. Even simple breathing exercises can help reduce stress. Try taking long, slow breaths: Inhale to a count of four; then exhale to a count of eight. Enlist your family and friends Having the support of family and friends can keep you on track with your lifestyle changes, turning eating well and exercising regularly into a shared and social experience. Let your family know that by choosing a healthy way of life, you have made a commitment to your well-being, both now and into the future. Emphasize that you need their help and positive support. If they decide to get onboard, that’s fantastic; if not, don’t let that discourage you. It may help to ask a friend to meet you for a walk or at the gym so you can maintain a regular exercise program. But don’t make your plans subject to anyone else’s obligations. Do it for yourself, and you’ll find that it gets easier over time. If your workout buddy can’t make it one day, don’t use his absence as an excuse to slack off. You owe it to yourself to stick with your program, no matter who else comes along for the ride. After you get going, you’ll feel great! Follow your doctor’s orders If you’ve been diagnosed with hypertension, be sure to follow your doctor’s advice and keep regular appointments, including an annual physical exam. Take any prescribed medications as directed and keep track of your own blood pressure. If you have any concerns about the medication or treatment your doctor recommends, ask questions. Blood pressure medication is not a one-size-fits-all proposition. Thanks to the variety of medications available, your doctor can almost always find an option, or a combination, that works for you.

Article / Updated 03-26-2016

Blood pressure isn't the same during a pregnancy as before the pregnancy. The pregnant woman's body goes through many changes to provide the best possible environment for the growing fetus. The mother-to-be must sustain the placenta, the umbilical cord (the connection between the mother and the fetus), and the fetus itself with nutrition and fluid. To do this, the expectant mother's blood vessels widen, and the volume of water and salt increases in her body. She gains about 8 liters (2 gallons) of water. The opening of blood vessels normally causes the blood pressure to fall during the first six months of the pregnancy. (A woman with pre-existing high blood pressure may even be able to stop high blood pressure medications during pregnancy because the blood pressure may drop into the normal range.) Pre-existing conditions, especially those related to high blood pressure, are extremely important to control during a pregnancy. Work with your doctor if You suffer from kidney disease. The risk of kidney failure increases significantly during pregnancy. Potential mothers should discuss with their doctor whether pregnancy is advisable. For this reason, be sure to get a complete medical evaluation prior to becoming pregnant for any evidence of target-organ damage (damage to the organs that high blood pressure affects, especially in the heart, kidneys, and eyes). You're on ACE inhibitors or angiotensin receptor blockers. These must be stopped because they may damage the fetus. Other classes may be used prior to becoming pregnant. You have high blood pressure before you become pregnant. Have your doctor check your blood pressure after you become pregnant to see whether you can reduce or stop blood pressure medication. You have high blood pressure before your pregnancy and are able to stop your medications for the first six months. Consider staying off the medications for the rest of the pregnancy, even if your blood pressure rises — so long as you have no eye, kidney, or heart damage. Note: You may be able to stay off the meds as you breast-feed as well.

Article / Updated 03-26-2016

Plenty of drugs are on the market that actually raise blood pressure on their own or because they block the action of a drug that lowers blood pressure. If you can possibly avoid them, do so. Sometimes, however, the problem that makes you need the other drug is so severe that you can't avoid it. You then have to use the drugs for high blood pressure to overcome the blood pressure elevation of the essential drug. Monitor your blood pressure whenever you start or stop a drug. The new drug may raise the blood pressure or block your own blood pressure drugs. A drug that you were taking and are now stopping may also have interacted with your blood pressure medication in some way, so that your pressure was under control when you used the drug but will rise when you stop it. Many cold medications contain drugs that cause constriction of arteries and elevation of blood pressure. You need to read the label on any cold medication that you plan to use. The label should say clearly that it contains medications that should not be taken by a person who has high blood pressure. If uncertain, check with your doctor before you use it. Certain diet pills contain phenylpropa-nolamine. This drug, which is similar to amphetamine, raises blood pressure. You shouldn't use these drugs if you have high blood pressure already. Yet millions of people take them to slim down. Of the drugs that your doctor may prescribe for you, many steroids, such as cortisone or prednisone, raise blood pressure. Several of the antidepressant drugs, particularly trimipramine and venlafaxine, have caused sustained increases in blood pressure. Other antidepressant drugs from the class called monoamine oxidase inhibitors raise blood pressure by preventing the breakdown of epinephrine. Drugs in this class include phenylzine and tranylcypromine. Any of the nonsteroidal anti-inflammatory agents also raise blood pressure. The worst offenders are indomethacin, naprosyn, and ibuprofen, especially in large doses. Certain drugs that fight against your blood pressure medications make your blood pressure medication less effective. Numerous drugs fall into this category, some of which you can't avoid if you have certain problems. For example, if you have kidney disease, you may have to take erythropoietin to combat anemia. As much as you don't need another way for your blood pressure to elevate, erythropoietin will do it. But you have to take it because it's the only way to increase your blood count -- besides transfusions, which don't tend to keep your count higher for very long. Colestipol, a drug for lowering cholesterol, is another one that fights against blood pressure medications. Fortunately, the choices for treating cholesterol are numerous, so this drug can be stopped, if necessary. Cholestyramine is also a cholesterol-lowering drug with the same tendency to raise blood pressure. Oral contraceptives, when they contained higher amounts of estrogen, were notorious for raising blood pressure. The newer preparations with less estrogen are much better in that respect. You still should have your blood pressure checked before you start taking an oral contraceptive and have it checked every so often after you're on them. Estrogen taken for menopause, however, may actually lower blood pressure. Some antacids contain an abundance of salt, which you know doesn't help your blood pressure. Check the label before you decide to buy a particular antacid. If you're taking in 900 milligrams of salt each time your stomach aches, you aren't doing your blood pressure any favors. You can find plenty of good choices, such as various calcium-containing antacids and magnesium-containing antacids, so read the label to see what you're getting! Illegal drugs that raise blood pressure, such as cocaine, shouldn't be taken in the first place, much less by a person who has high blood pressure. Some drugs may raise blood pressure in only one person -- you! Check with your doctor to make sure that your new medication doesn't raise your blood pressure or block your blood pressure drugs.

Article / Updated 03-26-2016

Salt, which is made up of 40 percent sodium and 60 percent chloride, is critical to your life. You can't live without it. Sodium helps to maintain your blood's water content, serves to balance the acids and bases in your blood, and is necessary for the movement of electrical charges in the nerves that move our muscles. It's generally believed that the inability of your kidney to excrete sodium is responsible for sodium-induced high blood pressure. By increasing blood pressure, more sodium is filtered by the kidney, enters the urine, and the body compensates for its inability to excrete sodium. This increased blood pressure helps to eliminate more sodium, but it also puts a strain on your arteries and sets the downward spiral of blood-pressure damage in motion — a vicious cycle. The recommendation for sodium in the Dietary Guidelines for Americans from the U.S. Department of Health and Human Services as well as the American Heart Association is 2,400 milligrams (mg) daily for adults. This is about the amount in 1 teaspoon of salt (2,300 mg to be exact). The average American consumes 5,000 mg of sodium daily — twice the necessary amount. Normal sodium balance can be maintained with 500 mg daily (or a little more than one-fourth teaspoon of salt), so Americans are eating ten times as much as they really need. Canada, Australia, the United Kingdom, and Portugal all have about the same recommendation of 2,400 mg of sodium. Some countries, such as Germany (4,000 mg), the Netherlands (3,600 mg) and Belgium (3,500 mg), are more liberal and at least one country, Sweden (800 mg), is more restrictive than the United States. "Where is all this sodium coming from?" you may ask. Many foods (such as meat and fish) are natural sources of sodium while others contain salt added during processing (prepared soup and crackers, for example). Surprisingly, you're responsible for only 15 percent of the sodium in your diet. Food has about 10 percent of your sodium already naturally in it. The food industry is responsible for adding 75 percent of the sodium that you consume each day to the prepared foods that you buy. For example, the following additives contain plenty of sodium: Color Developer: Promotes the development of color in meats and sauerkraut. Fermentation Controller: Keeps organic action in check in cheeses, sauerkraut, and baked goods. Binder: Holds meat together as it cooks. Texture Aid: Allows dough to expand and not tear. For these and other reasons, salt is part of food processing. It may not be for taste. The only way that you can successfully reduce the sodium in your diet is by switching from processed foods to fresh foods or selecting low-salt processed foods. Buying low-sodium foods The Food and Drug Administration has definite guidelines as to the terms a food company can use when describing the sodium in the food on the label. Keep these terms in mind and make a point of buying low-salt foods on your next trip to the grocery store: Sodium free means less than 5 mg sodium in a portion. Very low sodium means less than 35 mg sodium in a portion. Low sodium means less than 140 mg sodium in a portion. Reduced sodium food contains 25 percent less sodium than the original food item. Light in sodium food has 50 percent less sodium than the original food item. Unsalted, No salt added, or Without added salt means absolutely no salt has been added to a food that's normally processed with salt. Take time to read the Nutrition Facts label on food items. Avoid items that contain more than 180 milligrams of sodium. Avoiding high-sodium foods The following processed foods are particularly high in sodium. Steer clear of these heavily laced edibles as much as possible. Fortunately, after many years of urging and recommendations from health organizations, manufacturers have begun to lower the sodium in foods, so you may find several of these foods in a low-salt form. Check the food label. Anchovies Bacon Bouillon cubes Canned soup Canned tuna Canned vegetables Cheese Cold cuts Condiments Cooking sauces Cottage cheese Croutons Gravy Ham Hot dogs Olives Pickles Salad dressings Salsa Sausage Sea salt Soy sauce Spaghetti sauce Tomato or vegetable juice Going on a low-sodium diet Besides avoiding high-sodium foods, you can make a few other changes to lower your salt intake: Cook with herbs, spices, fruit juices, and vinegars for flavor rather than salt. Eat fresh vegetables. Keep the saltshaker in the kitchen cupboard rather than at the table, where it's so easy to use. Use less salt than the recipe calls for. Select low-salt canned foods or rinse your food with water. Select low-salt frozen dinners. Use high-salt condiments, such as ketchup and mustard, sparingly. Snack on fresh fruits rather than salted crackers or chips. When eating out, ask that your food be prepared with only a little salt. Request your salad dressing "on the side" of the salad, so you can control the amount that goes on it. Be careful of salt substitutes. Some contain sodium. Check the label. You could end up eating so much of the substitute in an attempt to get that salty taste that your total sodium intake is just as high as using salt.

Article / Updated 03-26-2016

Your blood pressure can be taken with a mercury blood pressure gauge, an aneroid manometer, or an electronic device for measuring the blood pressure, as long as the device has been recently calibrated and validated. With rare exceptions, blood pressure gauges found in supermarkets or pharmacies aren't properly maintained and shouldn't be used. Following a few simple rules is important to get an accurate reading: First, don't smoke or drink alcohol or coffee within 15 minutes of a blood pressure measurement. Second, the length of the bladder on the device should be 80 percent of the circumference of the upper arm. This means that heavy or very muscular people with thick arms need a larger bladder, while children need a smaller bladder. Third, your posture is important. Sit with your back supported and your elbow at about the level of your heart with your arm supported. Your legs should not be dangling. It's better if you rest for several minutes in that position before the measurement. Don't talk during the measurement. To take the reading, follow these steps: 1. Leaving the cuff's lower edge about an inch above the bend of the elbow, place the cuff over your bare arm, close the cuff around the arm, and then stick the Velcro together at the ends of the cuff. 2. Place the earpieces of the stethoscope in your ears and place the stethoscope bell at the side of the cuff away from your heart and over the brachial artery, which is found in the inner area of your bent elbow. The stethoscope, a convenient device to listen for sounds at various body sites, has a point of contact known as the stethoscope's bell. The two earpieces at the other end of the stethoscope enable the individual taking the measurement to hear the steady "thump" in the brachial artery. 3. Tighten the screw at the side of the rubber bulb and squeeze the bulb. Air is pumped into the bulb, and thus the cuff expands. 4. The cuff is inflated until the blood flow through your brachial artery stops. With sufficient compression, the cuff cuts off blood flow through the artery, and no sound is heard in the stethoscope. The pressure in the cuff is increased rapidly to 30 millimeters of mercury above the point that no blood flow is taking place through the cuff when no sound can be heard in the stethoscope or when a pulse can no longer be felt in the wrist. 5. Turn the screw again to loosen the valve in the bulb and to lessen the air pressure. Pressure is then decreased so that the rate of drop is 2 millimeters per second. When the pressure falls to the point that blood begins to flow through the artery again, the number that the column of mercury has risen to at the first sound heard in the stethoscope is the systolic blood pressure (SBP), the first number in the blood pressure reading 6. Look at the column of mercury to see the number at that pressure point. 7. When the cuff decompresses to the point that blood flows freely in the artery, the sound is no longer heard in the stethoscope. The number next to the top of the column of mercury when the sound ceases is the diastolic blood pressure (DBP), the second number in the blood pressure reading. 8. Again, look at the column of mercury to see the number at that pressure point. 9. Record the SBP and the DBP numbers immediately (don't depend on memory), and note the arm (right or left) used for taking the measurement is noted. 10. If the first measurement is elevated, take another measurement in the same arm after 60 seconds. Then the other arm is measured. The arm that has the higher blood pressure is the one that's used in the future. (They're often the same.) The average of the two measurements in the arm that supplies the more abnormal reading is considered to be the correct blood pressure. Measure the blood pressure while the patient is in a standing position especially in the event that the patient experiences lightheadedness on standing. If a fall of 20 or more millimeters of mercury occurs in systolic blood pressure or 10 or more in diastolic blood pressure, the patient is considered to have orthostatic hypotension, an abnormally great fall in blood pressure with standing. If your blood pressure isn't normal, don't start any treatment on the basis of one office visit. This is treatment for life and should be done only after confirmation at a second and even a third office visit. It may even be that your blood pressure in your doctor's office is not an accurate assessment of your blood pressure despite using entirely correct techniques. A blood pressure reading that's greater than 180/120 millimeters of mercury (mm Hg) requires immediate treatment.

Article / Updated 03-26-2016

Caffeine is a chemical compound in the leaves, seeds, and fruits of more than 63 plant species, but it most commonly comes from coffee and cocoa beans, cola nuts, and tea leaves. But coffee isn't the only source of caffeine — a can of cola contains 45 mg, green tea has 30 mg, an ounce of chocolate has 20 mg, and even Anacin comes in at 65 mg for two tablets. Although the case against caffeine isn't nearly as tidy as the ones against tobacco and alcohol, caffeine in any form has been shown to temporarily raise blood pressure. A cup or two of coffee doesn't seem to be damaging over the long-term, but the tendency to drink multiple cups of high-octane (heavily caffeinated) coffee is a definite cause of persistently elevated blood pressure. People who drink four to five cups of coffee daily have an increase in blood pressure of 5 mm Hg. If they continue to drink that same amount, the blood pressure may fall if they don't have high blood pressure already. However, if they do have high pressure, they may be more sensitive to the blood-pressure-raising effect of caffeine; this blood pressure rise is then sustained. The effect is particularly true of the elderly population. A 5 mm Hg rise in blood pressure may sound trivial, but it results in a 21 percent rise in the incidence of heart disease and a 34 percent increase in the incidence of brain attacks. In addition, when taken with alcohol or tobacco, which is so often the case, the combination greatly increases the blood-pressure-raising effect of those drugs. Studies about the effect of caffeine on blood pressure continue to come in. In the November 2005 Journal of the American Medical Association, a study of more than 250,000 women found that those who drank the most caffeine-containing drinks (including coffee and sodas) tended to have the highest blood pressures. Having a cup of coffee just before your blood pressure is measured is unwise. The acute elevation in blood pressure may convince your doctor that you have sustained high blood pressure.