If you have high blood pressure, you can lower it with small lifestyle changes. Work with your doctor to develop a plan for lowering your blood pressure. Part of the plan may also include taking blood pressure-lowering medicine. However, your lifestyle changes will be just as important.

Path to improved health

How do tobacco products affect blood pressure?

The nicotine in cigarettes and other tobacco products causes your blood vessels to constrict and your heart to beat faster. This temporarily raises your blood pressure. When you quit smoking or using other tobacco products, you can lower your blood pressure. Stopping tobacco significantly lowers your risk of heart disease and stroke.

What about losing weight and exercising?

If you’re overweight, losing weight usually helps lower blood pressure. Regular exercise is a good way to lose weight. It also seems to lower high blood pressure even if you don’t lose weight. And even a 5 pound weight loss can bring down blood pressure significantly if you are overweight.

Is sodium really off limits?

Not everyone is affected by sodium. However, sodium can increase blood pressure in some people. Most Americans who have a healthy blood pressure should limit the sodium in their diet to 2,300 mg per day. African Americans, older adults, and people who have high blood pressure should limit the sodium in their diet to 1,500 mg per day. Your doctor may tell you to limit your sodium even more.

To lower your sodium intake, don’t add salt to your food. Check food labels for sodium. Some foods, such as potato chips, obviously have a lot of sodium. But you may not realize how much sodium is in food like bread, canned vegetables, soups, and cheese. Also be aware that some medicines contain sodium.

Do I need to quit drinking alcohol?

In some people, alcohol causes blood pressure to rise quite a bit. In other people, it doesn’t. If you drink alcohol, limit it to no more than 1 drink per day for women or 2 drinks per day for men. One drink is a can of beer, a glass of wine (4-5 oz.), or 1 shot (jigger) of liquor. If your blood pressure increases when you drink alcohol, it’s best to not drink any alcohol.

Does stress affect my blood pressure?

Stress may affect blood pressure. To combat the effects of stress, try relaxation techniques or biofeedback. These things work best when used at least once a day. Ask your family doctor for advice.

Do other health conditions cause high blood pressure?

A little more than half of people who have diabetes have high blood pressure too. Talk to your doctor about other health conditions that could be causing your high blood pressure.

How can I know if changing my lifestyle is helping?

One of the best ways to know if what you are doing is working is to see for yourself. Consider buying a home blood pressure monitor. Use it to see whether what you are doing is lowering your blood pressure numbers. Ask your doctor to recommend a monitor.

Even if doing the things mentioned in this article don’t decrease your blood pressure, they still will promote your overall health and are worth continuing.

Things to consider

Not lowering your blood pressure puts you at higher risk for certain diseases. These can include:

• Stroke
• Heart attack
• Heart failure
• Kidney disease
• Early death

Questions to ask your doctor

• What are the symptoms of high blood pressure?
• What is considered normal blood pressure?
• Can I lower my blood pressure through lifestyle changes alone?
• What are the side effects of blood pressure medicine?
• Could any medications I am taking raise my blood pressure?

Resources

Centers for Disease Control and Prevention: Manage High Blood Pressure

National Institutes of Health, MedlinePlus: Controlling Your High Blood Pressure

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Many people monitor their blood pressure at home. They often do this to manage or treat a certain health condition. If you monitor your blood pressure at home, keep a record or log of the measurements. The record shows your doctor how your blood pressure changes throughout the day. If you take medicines to control your blood pressure, it will help document if they are working. Measuring your blood pressure at home is a good way to actively manage your health.

Path to improved well being

What equipment do I need to measure my blood pressure at home?

To measure your blood pressure at home, you can use either an aneroid (manual) monitor or digital monitor. Choose the type of monitor that best meets your needs. Look at the following features when you select a monitor.

• Size: The right cuff size is very important. The cuff size you need is based on the size of your arm. You can ask the doctor, nurse, or pharmacist to help you. Blood pressure readings can be wrong if your cuff is the wrong size.
• Price: Cost may be a key factor. Home blood pressure units vary in price. You may want to shop around to find the best deal. Keep in mind that pricey units may not be the best or most accurate.
• Display: The numbers on the monitor should be easy for you to read.
• Sound: You must be able to hear your heartbeat through the stethoscope (if checking manually).

Tests show that finger and wrist devices do not always provide correct measurements. These devices are sensitive to placement and body temperature. They also are expensive and can cost more than $100.

Aneroid monitor

The aneroid monitor manually checks your blood pressure. It has a gauge that you read by looking at a pointer on the dial. The cuff goes around your upper arm, and you squeeze a rubber bulb to inflate it by hand.

Aneroid monitors often cost less than digital monitors. They range in price from about $20 to $40. The cuff has a built-in stethoscope. You don’t need to buy a separate one. The unit may have a feature that makes it easy to put the cuff on with one hand. It also is portable and can be carried easily from one place to another.

There are some drawbacks to the aneroid monitor. It is a complex device that can be damaged easily and become less accurate. The device may be hard to use if it doesn’t have a metal ring to tighten the cuff. This is what makes it easier to put on the cuff. Additionally, the rubber bulb that inflates the cuff may be hard to squeeze. This type of monitor may not be best for hearing-impaired people, because of the need to listen to your heartbeat through the stethoscope.

Digital monitor

Digital monitors are more popular for measuring blood pressure. They often are easier to use than aneroid units. The digital monitor has a gauge and stethoscope in one unit. It also has an error indicator. The blood pressure reading displays on a small screen. This may be easier to read than a dial. Some units even have a paper printout that gives you a record of the reading.

Inflation of the cuff is either automatic or manual, depending on the model. Deflation is automatic. Digital monitors are good for hearing-impaired patients, since there is no need to listen to your heartbeat through the stethoscope.

There are some drawbacks to the digital monitor. Body movements or an irregular heart rate can affect its accuracy. Some models only work on the left arm. This can make them hard for some patients to use. Digital monitors are more expensive. They range in price from about $30 to more than $100. They also require batteries.

How do I know if my monitor is accurate or if I am using it correctly?

Once you buy your device, have your doctor check it for accuracy. They should check your monitor once a year. On your own, periodically check the tubing for cracks and leaks. Proper care and storage are necessary. Make sure the tubing is not twisted when you store it. Keep it away from heat.

Ask your doctor or nurse to teach you how to use your blood pressure monitor correctly. This will help you achieve good results in controlling your blood pressure.

How do I measure my blood pressure?

Before you check your blood pressure, you should:

• Wait 30 minutes after eating or using caffeine, alcohol, or tobacco products.
• Go to the bathroom and empty your bladder.
• Rest for 3 to 5 minutes and do not talk.
• Sit in a comfortable position, with your legs and ankles uncrossed and your back supported.
• Elevate your left arm to the level of your heart. Place it on a table or desk and sit still.
• Wrap the cuff around the upper part of your bare arm. The cuff should be smooth and snug. There should be enough room for you to slip one fingertip under the cuff.
• Check the placement of the cuff. The bottom edge of it should be 1 inch above the crease of your elbow.

Below are the steps to take to use an aneroid monitor.

• Put the stethoscope earpieces into your ears. The earpieces should face forward, toward your eyes.
• Place the stethoscope disk on the crease of your inside elbow.
• Inflate the cuff by squeezing the rubber bulb. Keep squeezing until the pointer on the dial reaches 30 to 40 points higher than your last systolic reading. The systolic reading is the top number of blood pressure. Inflate the cuff at a rapid rate, not just a little at a time. Inflating the cuff too slowly will cause a false reading.
• Slightly loosen the valve on the unit and slowly let some air out of the cuff. Deflate the cuff by 2 to 3 millimeters per second. If you loosen the valve too much, you won’t be able to measure your blood pressure.
• As you let the air out of the cuff, you will begin to hear your heartbeat. Listen carefully for the first sound. Check the blood pressure reading by looking at the pointer on the dial. This number is your systolic pressure.
• Continue to deflate the cuff. Listen to your heartbeat. You will hear your heartbeat stop at some point. Check the reading on the dial. This number is your diastolic pressure.
• Write down the measurement in your record. The systolic pressure goes in front of the diastolic pressure. For example, 120/80.
• If you need to repeat the measurement, wait 2 to 3 minutes before starting.

Below are the steps to take to use a digital monitor.

• Turn the power on to start the unit.
• On the automatic models, the cuff will inflate by itself with a push of a button. On the manual models, you have to inflate the cuff. You do this by squeezing the rubber bulb at a rapid rate.
• After the cuff inflates, the automatic device will slowly let air out.
• Look at the display screen to get your blood pressure reading. It will show your systolic and diastolic pressures. Write down the measurement in your record. The systolic pressure goes in front of the diastolic pressure. For example, 120/80.
• Press the exhaust button to release all of the air from the cuff.
• If you need to repeat the measurement, wait 2 to 3 minutes before starting.

Things to consider

What does my blood pressure reading mean?

Normal blood pressure is 120/80 or lower. High blood pressure is 140/90 or higher. If your blood pressure is between 120/80 and 140/90, you may have something called prehypertension. This means that you are at risk for high blood pressure.

If you have diabetes or kidney disease, high blood pressure ranges may be lower than for other people. Or, if you are older than 65, goal blood pressure may be higher. Talk to your doctor about what is considered high blood pressure for you. 

Medical terms

Monitoring your blood pressure at home can be confusing. Below is a list of terms that are helpful to know.

• Blood pressure: The force of blood against the walls of the artery.
• Hypertension: High blood pressure.
• Hypotension: Low blood pressure.
• Brachialartery: A blood vessel that goes from your shoulder to below your elbow. You measure your blood pressure in this artery.
• Systolic pressure: The highest pressure in an artery when your heart is pumping blood to your body.
• Diastolic pressure: The lowest pressure in an artery when your heart is at rest.
• Blood pressure measurement: A calculation of both the systolic and diastolic  It is written or displayed with the systolic number first and the diastolic pressure second. For example, 120/80. This is a normal blood pressure reading.

When to see the doctor

The doctor should check your monitor at least once a year. This ensures that the measurements are accurate.

Only a doctor can diagnose you with high blood pressure. A diagnosis requires multiple readings, so keeping a log is important. You should also log the time of day you you’re your blood pressure. Contact your doctor if you have high readings for several days. Be sure to take your blood pressure log with you to the visit.

Hypotension is low blood pressure. This occurs when your systolic pressure is consistently below 90 or is 25 points below your normal reading. Contact your doctor if you have low readings. Hypotension can be a sign of shock, which is life threatening. Call your doctor right away if you are dizzy or lightheaded.

Questions to ask your doctor

• Why do I need to monitor my blood pressure at home?
• How often do I need to measure my blood pressure?
• What type of monitor should I use?
• What do my blood pressure readings mean?
• What is considered a normal blood pressure for me?
• What should I do if my readings are abnormal?
• Are there any lifestyle changes I can make to help manage my blood pressure?
• Do I need to take medicine to manage my blood pressure?
• What other things can affect a blood pressure reading?

Resources

American Heart Association: Monitoring Your Blood Pressure at Home

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Blood pressure is the amount of force that your blood puts on your artery walls as it moves through your body. High blood pressure (also called hypertension) occurs when your blood moves through your arteries at a higher pressure than normal. Many different things can cause high blood pressure. If your blood pressure gets too high or stays high for a long time, it can cause health problems. That is why it is important to treat high blood pressure. Medicines are one of the most common methods of treatment.

Path to improved health

There are many types of medicine used to treat high blood pressure. Your doctor will decide which type of medicine is right for you. These are the most common:

• ACE inhibitors (angiotensin-converting enzyme inhibitors) keep your body from making the hormone angiotensin II. This hormone causes blood vessels to narrow. This type of medicine relaxes your blood vessels and opens them up.
• Alpha blockers help relax your blood vessels by reducing nerve impulses. This allows your blood to pass through more easily.
• Angiotensin II receptor blockers (ARBs) block the effects of the hormone angiotensin II. This hormone causes blood vessels to narrow. This type of medicine allows your blood vessels to stay open.
• Beta blockers make the heart beat slower so that blood passes through your blood vessels with less force.
• Calcium channel blockers (CCBs) prevent calcium from entering the cells of your heart and arteries. This helps keep your blood vessels from contracting with extra force.
• Central agonists reduce the nerve impulses that cause the blood vessels to tense up or contract. They work the same way as alpha and beta blockers, but they follow a different nerve pathway.
• Diuretics (water pills) help your body get rid of extra sodium (salt) and water. This reduces the amount of fluid flowing through your blood vessels and lowers your blood pressure. These will make you urinate more.
• Vasodilators (blood vessel dilators) relax the muscles in the blood vessel walls. This causes the blood vessels to widen (dilate) so blood can flow through better.

Things to consider

All medicines can have side effects. Some possible side effects of high blood pressure medicines include:

• Chest pain, heart palpitations (the feeling that your heart is racing), or arrhythmia (irregular heartbeat)
• Cough, fever, congestion, upper respiratory tract infection, or flu-like symptoms
• Diarrhea or constipation
• Dizziness or lightheadedness
• Headache
• Nausea
• Nervousness or anxiety
• Problems with erections and sexual function
• Skin rash
• Tiredness, weakness, drowsiness, or lethargy (lack of energy)
• Unintended weight loss or gain
• Vomiting

Tell your doctor as soon as possible if your side effects become severe or bothersome.

What about medicine interactions?

If you use 2 or more medicines at the same time, the way your body processes each one can change. When this happens, the risk of side effects from each medicine increases. Each medicine may not work the way it should. Be sure your doctor knows all the medicines you are taking. These include prescription and over-the-counter medicines, vitamins, and herbal supplements.

Also ask your doctor whether you need to avoid any foods or drinks while using your blood pressure medicine. For example, people taking certain CCBs may need to avoid eating grapefruit or drinking grapefruit juice.

Questions to ask your doctor

• What type of blood pressure medicine is best for me?
• How does this medicine work?
• What are the side effects of this medicine?
• How long will I need to take this medicine?
• Are there any lifestyle changes I can make to lower my blood pressure?

Resources

American Heart Association: What You Should Know About High Blood Pressure and Medications

U.S. National Library of Medicine, MedlinePlus: Blood Pressure Medicines

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If you have high blood pressure (hypertension), your doctor may ask you to wear an ambulatory blood pressure monitor. This is a small machine, about the size of a portable radio. You wear it on your belt for 24 hours. The blood pressure cuff can be worn under your clothes and is hidden so others don’t see it. The monitor records your blood pressure about every 30 minutes during your day. The information collected can help your doctor see if your blood pressure treatment is working.

Path to improved health

Not everyone with high blood pressure is asked to wear a monitor. Your doctor may want you to use an ambulatory blood pressure monitor if:

• You have “borderline” high blood pressure.
• You and your doctor can’t keep your blood pressure under control.
• You have blood pressure problems caused by your other medicines.
• You have changed your medicine.
• You’re pregnant and have high blood pressure.
• You have fainting spells.

The monitor may help your doctor find out if you’re a person who only has high blood pressure when you’re at the doctor’s office. This is called “white-coat hypertension.” It’s called this because your blood pressure rises when you’re nervous or fearful of medical environments. If you have this kind of hypertension, you may not need to take blood pressure medicine.

How it works

The small blood pressure cuff that’s connected to the monitor will automatically check your blood pressure about every 30 minutes. This includes while you’re sleeping. You also will be asked to keep a diary of your day’s activities. This gives your doctor information about when you were active and when you were resting. After 24 hours of monitoring, you will take the machine and your diary to the doctor’s office. The blood pressure information is transferred from the monitor to a computer. Your doctor will review the information with you and decide if your treatment program is working or if you need to make changes.

Things to consider

• Some people feel a little sore from the frequent pressure checks.
• Some people get a rash from the blood pressure cuff. It usually goes away without treatment.

Questions to ask your doctor

• Will my insurance pay for the monitor?
• Will I be able to read the monitor to see if I’m having high blood pressure at any given time?
• What if wearing the monitor annoys me or stresses me out? Will this cause my blood pressure to rise?
• Will I have to wear the monitor for longer than 24 hours?

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Wellness starts with a healthy diet. In fact, eating healthier foods improves many health problems. This includes high blood pressure (hypertension). The right foods can lower your blood pressure. Your doctor may recommend the DASH (Dietary Approaches to Stop Hypertension) diet to lower your blood pressure and your LDL (bad cholesterol).

The DASH diet promotes a balanced diet and portion control. It encourages introducing more fruits and vegetables, whole-grain foods, fish, poultry, nuts, and fat-free or low-fat milk products into your daily diet. It recommends reducing foods high in saturated fat, cholesterol, trans fats, sweets, sugary drinks, sodium (salt), and red meats.

Some people have high blood pressure because of a family history. For others, poor diet, lack of exercise, or another medical condition may be to blame. People who have high blood pressure often take medicine. However, diet and exercise can help lower high blood pressure, even if it’s part of your family history.

Path to improved well being

Following the DASH diet is simple. It doesn’t require any special or prepackaged meals. It relies on many standard foods you already have in your home. When following the DASH diet, you eat about 2,000 calories each day. These calories will come from a variety of foods.

The DASH diet recommendation includes:

• Whole grains (6 to 8 servings a day).
• Vegetables (4 to 5 servings a day).
• Fruits (4 to 5 servings a day).
• Low-fat or fat-free milk and milk products (2 to 3 servings a day).
• Lean meat, poultry, and fish (6 or fewer servings a day).
• Nuts, seeds, and beans (4 to 5 servings a week).
• Healthy fats and oils (2 to 3 servings a day).
• Sweets, preferably low-fat or fat-free (5 or fewer a week).
• Sodium (no more than 2,300 mg a day).
• If you drink alcohol, limit yourself to 2 drinks or less per day for men and 1 drink or less per day for women.
• To reduce your blood pressure even more, replace some DASH diet carbohydrates with low-fat protein and unsaturated fats.
• For weight loss, reduce your daily calories to 1,600 per day.
• Lower your sodium to no more than 1,500 mg per day if you are age 40 or older, are African American, or if you have been diagnosed with high blood pressure.

Adapt the DASH diet to meet your needs. For example, eating plenty of fruits, vegetables, and whole grains can provide some protection against cancer, osteoporosis, stroke, and diabetes. Immediate results are possible with the DASH diet. Blood pressure could go down a few points in as little as 2 weeks. However, continue to take your blood pressure medicine and see your doctor.

Things to consider

Don’t be discouraged if following the DASH diet is difficult at first. Start with small, achievable goals. The following ideas can help you make healthy changes.

• It’s easier to track your food if you keep a journal of what you eat each day. Write down the sodium content, when possible.
• Don’t throw in the towel if the DASH diet seems overwhelming at first. Try making one or two changes at a time until you can do it all.
• Learn to read labels. By knowing serving size, you know how much sodium you are getting per serving.
• Slow down when you eat.
• Exercise.
• Use spices and herbs to flavor your food instead of salt.
• Choose fewer processed foods (frozen meals, canned soups, packaged mixes, etc.). These contain more sodium.
• Look for foods that say, “no salt added,” “sodium-free,” and “low sodium.”
• Avoid fried foods. Grill, steam, roast, or poach your food instead.
• Apply your new knowledge to restaurant food, as well. Avoid ordering food with ketchup, mustard, pickles, or sauces. Don’t add salt. And if you have time, ask your server how the food is prepared.
• Reduce your alcohol intake to DASH-acceptable servings.

Most popular foods are full of salt. Here’s how many milligrams (mg) of salt you’re getting with:

Questions to ask your doctor

• Can caffeine increase your blood pressure?
• Can stress increase your blood pressure?
• What are the side effects to most blood pressure medicines?
• Are certain frozen foods, such as unsweetened fruit, acceptable?

Resources

National Heart, Lung and Blood Institute: DASH Eating Plan

National Institutes of Health, MedlinePlus: DASH Diet to Lower High Blood Pressure

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