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Controlling your high blood pressure
Hypertension is another term used to describe high blood pressure. High blood pressure can lead to stroke, heart attack, heart failure, kidney disease, and early death.
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. This reading is too high if it is 140 or higher.
- The bottom number is called the diastolic blood pressure. It is too high if it is 90 or higher.
If you've had a stroke or you have heart or kidney problems, your doctor may want your blood pressure to be round 130 to 140/80 mm Hg.
The blood pressure numbers listed above are goals agreed upon by most experts for most people. Yet your doctor will always consider how these goals apply to you specifically.
Medications for blood pressure
Many medicines can help you control your blood pressure. Your doctor will prescribe the best medicine for you, monitor your medicines, and make changes if needed.
Older adults tend to take more medicines overall. This puts them at greater risk for side effects, which can be harmful. One side effect of blood pressure medicine is an increased risk for falls. When treating older adults, blood pressure targets need to be balanced against drug side effects.
Diet, exercise, and other lifestyle changes
In addition to taking medicine, you can do many things to help control your blood pressure.
- 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 doctor can help you find programs for losing weight, stopping smoking, and exercising. You can also get a referral from your doctor to a dietitian. The dietitian can help you plan a diet that is healthy for you.
Checking your blood pressure
Your blood pressure can be measured many places, including:
- At home
- Your doctor's office
- Your local fire station
- The pharmacy
Your doctor 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 doctor 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 usually higher when you are at work. It drops slightly when you are at home. It is usually 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.
Your doctor will give you a physical exam and check your blood pressure often. With your doctor, establish a goal for your blood pressure.
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 doctor if your blood pressure goes well above your normal range.
Also call your doctor if you have any of the following symptoms:
- Severe headache
- Irregular heartbeat or pulse
- Chest pain
- 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
- Trouble seeing
- Difficulty speaking
- Other side effects that you think might be from your medicine or your blood pressure
American Diabetes Association. Standards of medical care in diabetes -- 2014. Diabetes Care. 2014;37 Suppl 1:S14-S80.
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. Saunders; 2011:chap 49.
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 Apr 1;160(7):499-503.
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Editorial update: 05/14/14