Hypertension

Learning About High Blood Pressure

What is high blood pressure?

Blood pressure is a measure of how hard the blood pushes against the walls of your arteries. It's normal for blood pressure to go up and down throughout the day, but if it stays up, you have high blood pressure. Another name for high blood pressure is hypertension.

Two numbers tell you your blood pressure. The first number is the systolic pressure. It shows how hard the blood pushes when your heart is pumping. The second number is the diastolic pressure. It shows how hard the blood pushes between heartbeats, when your heart is relaxed and filling with blood.

Adults should have a blood pressure of less than 120/80 (say "120 over 80"). High blood pressure is 140/90 or higher. Many people fall into the category in between, called prehypertension. People with prehypertension need to make lifestyle changes to bring their blood pressure down and help prevent or delay high blood pressure.

What happens when you have high blood pressure?

Blood flows through your arteries with too much force. Over time, this damages the walls of your arteries. But you can't feel it. High blood pressure usually doesn't cause symptoms.
Fat and calcium start to build up in your arteries. This buildup is called plaque. Plaque makes your arteries narrower and stiffer. Blood can't flow through them as easily.
This lack of good blood flow starts to damage some of the organs in your body. This can lead to problems such as coronary artery disease and heart attack, heart failure, stroke, kidney failure, and eye damage.

How can you prevent high blood pressure?

Stay at a healthy weight.
Try to limit how much sodium you eat to less than 2,300 milligrams (mg) a day. And try to limit the sodium you eat to less than 1,500 mg a day if you are 51 or older, are black, or have high blood pressure, diabetes, or chronic kidney disease.

Buy foods that are labeled "unsalted," "sodium-free," or "low-sodium." Foods labeled "reduced-sodium" and "light sodium" may still have too much sodium.
Flavor your food with garlic, lemon juice, onion, vinegar, herbs, and spices instead of salt. Do not use soy sauce, steak sauce, onion salt, garlic salt, mustard, or ketchup on your food.
Use less salt (or none) when recipes call for it. You can often use half the salt a recipe calls for without losing flavor.

Be physically active. Get at least 30 minutes of exercise on most days of the week. Walking is a good choice. You also may want to do other activities, such as running, swimming, cycling, or playing tennis or team sports.
Limit alcohol to 2 drinks a day for men and 1 drink a day for women.
Eat plenty of fruits, vegetables, and low-fat dairy products. Eat less saturated and total fats.

How is high blood pressure treated?

Your doctor will suggest making lifestyle changes. For example, your doctor may ask you to eat healthy foods, quit smoking, lose extra weight, and be more active.
If lifestyle changes don't help enough or your blood pressure is very high, you will have to take medicine every day.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

High Blood Pressure: After Your Visit

Your Care Instructions

If your blood pressure is usually above 140/90, you have high blood pressure, or hypertension. Despite what a lot of people think, high blood pressure usually doesn't cause headaches or make you feel dizzy or lightheaded. It usually has no symptoms. But it does increase your risk for heart attack, stroke, and kidney or eye damage. The higher your blood pressure, the more your risk increases.

Your doctor will give you a goal for your blood pressure. This goal may be below 140/90. Or it may be even lower if you have other health problems, such as diabetes, heart failure, or coronary artery disease.

Changes in your lifestyle, such as staying at a healthy weight, may help you lower your blood pressure. Your treatment also will include medicine. If you stop taking your medicine, your blood pressure will go back up.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

Medical treatment

Take your medicine exactly as prescribed. You may take one or more types of medicine to lower your blood pressure. They include diuretics, beta-blockers, ACE inhibitors, calcium channel blockers, angiotensin II receptor blockers, and other medicines. Call your doctor if you think you are having a problem with your medicine.
Your doctor may suggest that you take one low-dose aspirin (81 mg) a day. This can help reduce your risk of having a stroke or heart attack.
See your doctor at least 2 times a year. You may need to see the doctor more often at first or until your blood pressure comes down.
If you are taking blood pressure medicine, talk to your doctor before you take decongestants or anti-inflammatory medicine, such as ibuprofen. Some of these medicines can raise blood pressure.
Learn how to check your blood pressure at home.

Lifestyle changes

Stay at a healthy weight. This is especially important if you put on weight around the waist. Losing even 10 pounds can help you lower your blood pressure.
If your doctor recommends it, get more exercise. Walking is a good choice. Bit by bit, increase the amount you walk every day. Try for at least 30 minutes on most days of the week. You also may want to swim, bike, or do other activities.
Avoid or limit alcohol. Talk to your doctor about whether you can drink any alcohol.
Limit salt.
Eat plenty of fruits (such as bananas and oranges), vegetables, legumes, whole grains, and low-fat dairy products.
Lower the amount of saturated fat in your diet. Saturated fat is found in animal products such as milk, cheese, and meat. Limiting these foods may help you lose weight and also lower your risk for heart disease.
Do not smoke. Smoking increases your risk for heart attack and stroke. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

When should you call for help?

Call your doctor now or seek immediate medical care if:

Your blood pressure is much higher than normal (such as 180/110 or higher).
You think high blood pressure is causing symptoms such as:

Severe headache.
Blurry vision.
Nausea or vomiting.

Watch closely for changes in your health, and be sure to contact your doctor if:

You do not get better as expected.

DASH Diet: After Your Visit

Your Care Instructions

The DASH diet is an eating plan that can help lower your blood pressure. DASH stands for Dietary Approaches to Stop Hypertension. Hypertension is high blood pressure.

The DASH diet focuses on eating foods that are high in calcium, potassium, and magnesium. These nutrients can lower blood pressure. The foods that are highest in these nutrients are fruits, vegetables, low-fat dairy products, nuts, seeds, and legumes. But taking calcium, potassium, and magnesium supplements instead of eating foods that are high in those nutrients does not have the same effect. The DASH diet also includes whole grains, fish, and poultry.

The DASH diet is one of several lifestyle changes your doctor may recommend to lower your high blood pressure. Your doctor may also want you to decrease the amount of sodium in your diet. Lowering sodium while following the DASH diet can lower blood pressure even further than just the DASH diet alone.

How can you care for yourself at home?

Following the DASH diet

Eat 4 to 5 servings of fruit each day. A serving is 1 medium-sized piece of fruit, 1/2 cup chopped or canned fruit, 1/4 cup dried fruit, or 4 ounces (1/2 cup) of fruit juice. Choose fruit more often than fruit juice.
Eat 4 to 5 servings of vegetables each day. A serving is 1 cup of lettuce or raw leafy vegetables, 1/2 cup of chopped or cooked vegetables, or 4 ounces (1/2 cup) of vegetable juice. Choose vegetables more often than vegetable juice.
Get 3 servings of low-fat dairy each day. A serving is 8 ounces of milk, 1 cup of yogurt, or 1 1/2 ounces of cheese.
Eat 7 to 8 servings of grains each day. A serving is 1 slice of bread, 1 ounce of dry cereal, or 1/2 cup of cooked rice, pasta, or cooked cereal. Try to choose whole-grain products as much as possible.
Limit lean meat, poultry, and fish to 6 ounces each day. Six ounces is about the size of two decks of cards.
Eat 4 to 5 servings of nuts, seeds, and legumes (cooked dried beans, lentils, and split peas) each week. A serving is 1/3 cup of nuts, 2 tablespoons of seeds, or 1/2 cup cooked dried beans or peas.

Tips for success

Start small. Do not try to make dramatic changes to your diet all at once. You might feel that you are missing out on your favorite foods and then be more likely to not follow the plan. Make small changes, and stick with them. Once those changes become habit, add a few more changes.
Try some of the following:

Make it a goal to eat a fruit or vegetable at every meal and at snacks. This will make it easy to get the recommended amount of fruits and vegetables each day.
Try yogurt topped with fruit and nuts for a snack or healthy dessert.
Add lettuce, tomato, cucumber, and onion to sandwiches.
Combine a ready-made pizza crust with low-fat mozzarella cheese and lots of vegetable toppings. Try using tomatoes, squash, spinach, broccoli, carrots, cauliflower, and onions.
Have a variety of cut-up vegetables with a low-fat dip as an appetizer instead of chips and dip.
Sprinkle sunflower seeds or chopped almonds over salads. Or try adding chopped walnuts or almonds to cooked vegetables.
Try some vegetarian meals using beans and peas. Add garbanzo or kidney beans to salads. Make burritos and tacos with mashed pinto beans or black beans.