What is high blood pressure? (hypertension)
A blood pressure reading consists of two numbers. The top number is the pressure within your arteries when your heart contracts, also known as systolic blood pressure (SBP). The bottom number is the pressure within your arteries when your heart is relaxed, also known as diastolic blood pressure (DBP).
What is normal vs. high blood pressure?
Normal: SBP 120 or less and DBP 80 or less
High: SBP 130 or above and/or DBP 80 or above
Crisis: SBP 180 or above and/or DBP 120 or above
Beware of the white coat
White Coat Syndrome is when your blood pressure is elevated in a clinic or hospital setting, however, normal at home or other settings.
How is high blood pressure diagnosed?
Your doctor will measure your blood pressure in the clinic and then will have you check your blood pressure at home or have you return to the clinic to re-measure your blood pressure.
How can I lower my blood pressure?
To avoid having to take blood pressure medication, start with lifestyle changes:
- Lower your sodium (<2,400 mg/day)
- Change your diet (DASH diet)
- Exercise at least 30 minutes, five days a week
- Lose weight
- Reduce alcohol intake
- Stop smoking or using any tobacco products
- Practice mind-body connection, such as meditation, biofeedback device or breathing
A DASH diet is rich in vegetables, fruits and whole grains and can help lower your blood pressure within two weeks. With the DASH diet, you will limit your sodium intake to 2,300 mg a day. The diet includes fat-free or low-fat dairy products, fish, poultry, beans and nuts. It limits foods high in saturated fat. For more information on DASH, visit mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-20048456.
What to do if your blood pressure remains elevated
If you’re diagnosed with high blood pressure and it’s not controlled with lifestyle changes, your doctor will help you decide which medication is best for you. It will be important for you to take the medication as instructed. If you make lifestyle changes and you are able to lower your blood pressure naturally, you may be able to stop the medication. However, never stop a medication without consulting your doctor first.
Common blood pressure medications
- Acetylcholinesterase inhibitors (ACEi)
- Angiotensin receptor blockers (ARBs)
- Beta blockers
- Calcium channel blockers
Monitoring your blood pressure at home
Ask your doctor how to measure your blood pressure at home. Your doctor may recommend that you keep a blood pressure log to help with medication adjustments and monitoring.
The importance of controlling your blood pressure
High blood pressure can lead to the following complications:
- Vision loss, such as blindness
- Heart failure/heart attack
- Kidney disease
- Sexual dysfunction
When to get help
Go to the emergency department if your blood pressure is 180/120 or higher and you have any of the following symptoms:
- Chest pain
- Difficulty speaking
- Numbness/tingling sensation
- Shortness of breath
- Severe headache
- Vision changes
Sources: American Heart Association: AAFP Hypertension; Mayo Clinic: UpToDate hypertension in adults