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- Written by Sandra Gordon Sandra Gordon
You can’t see or feel high blood pressure (hypertension), which is why — unlike, say, nausea or fainting — it can be easy to ignore. A better tactic?
Learn more about it, starting with what high blood pressure is.
“Most people think blood pressure is the pressure in their arm, but in reality, it’s the pressure in every blood vessel in your body, including the pressure inside the chamber of the heart,” says cardiologist Dr. Anuj Shah, founder and director of Apex Heart and Vascular Care in Passaic, New Jersey.
Over time, unmanaged high blood pressure — blood pressure greater than 130/80 (stage 1) or greater than 140/90 (stage 2) — can lead to serious health problems, including kidney disease, heart disease, and stroke, the leading causes of death in the U.S.
An estimated 50% of the U.S. adult population has blood pressure greater than 130/80. Normal blood pressure of 120/80 or less is the goal.
According to the Centers for Disease Control and Prevention (CDC), only about 1 in 4 adults with high blood pressure has it under control.
The good news? There’s a lot you can do to manage your blood pressure. We investigated the latest medical updates to narrow your to-do list to these three important steps.
1. Push yourself. If you’re diagnosed with high blood pressure, your doctor may suggest focusing on lifestyle changes first before prescribing medication.
This approach could include losing weight, reducing caffeine to less than 300 mg per day (about two to three cups of coffee), limiting alcohol to no more than two drinks daily (men) or one (women), and exercising 90-150 minutes per week.
Of those lifestyle changes, “exercise gives you the most bang for your buck,” Shah says. “Even if you’re overweight, there’s a higher chance you’ll be able to maintain all of your cardiovascular risk factors, including blood pressure control, if you exercise regularly.”
Aerobic exercise, like brisk walking or jogging, has been shown to lower blood pressure by 5-7 mmHg in adults with hypertension, which is significant.
To maximize exercise’s blood-pressure-lowering potential, do even more than 90-150 minutes of weekly aerobic exercise.
A study in Current Hypertension Reports, which reviewed 33 studies on the blood pressure response to exercise, recommended aerobic exercise on most, preferably all, days of the week, and dynamic resistance training (strength training) on two to three days in that same week, which can lower blood pressure by 2-3 mmHg.
According to the researchers, this combination could lower cardiovascular disease risk by 20-30%.
2. Do a mental reset. There’s an emotional component to high blood pressure that’s gaining ground. Ongoing stress can set off a hormonal cascade that triggers the autonomic nervous system: the fight-or-flight response.
“Your autonomic nervous system is a set of nerves that controls blood pressure,” Shah says.
It knows no bounds. The autonomic nervous system can be helpful if you’re running out of the way of an oncoming car. But it can chronically raise your blood pressure if it’s constantly activated because you’re worried about losing your job or paying the bills.
To gain better control of your blood pressure, train your mind to deactivate the autonomic nervous system in your daily life. Physical activity is one way to help calm your nerves and another reason to be active.
Consider adding meditation to the mix. A study in the International Journal of Hypertension found that meditation techniques may produce small yet meaningful reductions in blood pressure.
And don’t skimp on rest.
“Getting enough sleep also plays a role in controlling blood pressure,” Shah says.
3. Double up on medication. Besides lifestyle, genetics plays a role in hypertension.
“You’re more likely to have high blood pressure if one or two of your parents has it,” says Dr. Daniel Devine, an internal and geriatric medicine physician. Under those circumstances, you may need medication in addition to modifying your lifestyle to control your blood pressure.
There are four classes of blood-pressure-lowering medication: diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), and calcium channel blockers.
“Any one of these four medications will help reduce blood pressure by 10-15 mmHg,” says Devine.
The trend now is to prescribe two of these medications at once in lower doses.
“We’ve found that summation of two medicines has a greater effect at reducing blood pressure. They have a synergistic effect,” Devine says.
Blood Pressure Monitor Buying Tips
Do you really have high blood pressure, or is it just elevated in the doctor’s office, a phenomenon known as “white coat hypertension”?
To get a true assessment, check your blood pressure at home in the morning and evening; keep a log for one to two weeks or longer, and bring it to your doctor.
Blood pressure monitors come with cuffs in pediatric, small adult, regular adult, and large and extra-large adult, depending on the diameter of your arm.
Blood pressure monitors aren’t regulated by the U.S. Food and Drug Administration. To select a home monitor that’s clinically accurate, visit the American Medical Association’s validated device listing at validatebp.org before shopping.
For the most accurate home reading, buy an automatic home blood pressure monitor with an upper arm cuff, which measures blood pressure in the brachial artery, an artery close to the heart.
“There’s a bit of a Goldilocks fit. You want to make sure the cuff is the appropriate size for the size of your arm,” Devine says.