High Blood Pressure
Treating High Blood Pressure
A Lifelong Focus
If you have high blood pressure, you will need to treat it and control it for life. This means making lifestyle changes, and, in some cases, taking prescribed medicines and getting ongoing medical care.
In most cases, your goal is probably to keep your blood pressure below 140/90 mmHg (130/80 if you have diabetes or chronic kidney disease). Normal blood pressure is less than 120/80. Ask your doctor what your blood pressure goal should be.
Treatment can help control blood pressure, but it will not cure high blood pressure, even if your blood pressure readings appear normal. If you stop treatment, your blood pressure and risk for related health problems will rise. For a healthy future, follow your treatment plan closely. Work with your health care team for lifelong blood pressure control.
Healthy Lifestyle Changes
These healthy lifestyle habits can help you control high blood pressure.
- healthy eating
- being physically active
- maintaining a healthy weight
- limiting alcohol intake
- managing and coping with stress
To help make lifelong lifestyle changes, try making one healthy lifestyle change at a time and add another change when you feel that you have successfully adopted the earlier changes. When you practice several healthy lifestyle habits, you are more likely to lower your blood pressure and maintain normal blood pressure readings.
To help treat high blood pressure, health care providers recommend that you eat foods that are heart healthy, limit sodium and salt intake, and increase potassium.
Heart-healthy eating includes these foods.
- whole grains
- fruits, such as apples, bananas, oranges, pears, and prunes
- vegetables, such as broccoli, cabbage, and carrots
- legumes, such as kidney beans, lentils, chick peas, black-eyed peas, and lima beans
- fat-free or low-fat dairy products, such as skim milk
- fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about twice a week
The DASH eating plan is a good heart-healthy eating plan, even for those who don’t have high blood pressure. Read more about the DASH eating plan.
Limit Sodium and Salt. A low-sodium diet can help you manage your blood pressure. You should try to limit the amount of sodium that you eat. This means choosing and preparing foods that are lower in salt and sodium. Try to use low-sodium and “no added salt” foods and seasonings at the table or while cooking. Food labels tell you what you need to know about choosing foods that are lower in sodium. Try to eat no more than 2,300 mg sodium a day. If you have high blood pressure, you may need to restrict your sodium intake even more.
Increase potassium. A potassium-rich diet may help to reduce elevated or high blood pressure, but be sure to get your potassium from food sources, not from supplements. Many fruits and vegetables, some milk products, and fish are rich sources of potassium.
When following a heart-healthy diet, you should avoid eating
- a lot of red meat
- palm and coconut oils
- sugary foods and beverages.
Be Physically Active
Regular physical activity can lower high blood pressure and reduce your risk for other health problems. Everyone should try to participate in moderate-intensity aerobic exercise at least 2 hours and 30 minutes per week, or vigorous-intensity aerobic exercise for 1 hour and 15 minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats harder and you use more oxygen than usual. The more active you are, the more you will benefit. Participate in aerobic exercise for at least 10 minutes at a time, spread throughout the week.
Talk with your health care provider before you start a new exercise plan. Ask him or her how much and what kinds of physical activity are safe for you.
(Watch the video to learn how exercise helps maintain healthy aging. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)
Maintain a Healthy Weight
Maintaining a healthy weight can help you control high blood pressure and reduce your risk for other health problems. Blood pressure rises as body weight increases, and losing even 10 pounds can lower blood pressure.
If you’re overweight or obese, try to lose weight. A loss of just 3 to 5 percent can lower your risk for health problems. Greater amounts of weight loss can improve blood pressure readings, lower LDL cholesterol, and increase HDL cholesterol. However, research shows that no matter your weight, it is important to control high blood pressure to maintain good health.
A useful measure of overweight and obesity is body mass index (BMI). BMI measures your weight in relation to your height. To figure out your BMI, See the BMI calculator to determine your body mass index or talk to your health care provider.
- below 18.5 is a sign that you are underweight.
- between 18.5 and 24.9 is in the healthy range.
- between 25 and 29.9 is considered overweight.
- of 30 or more is considered obese.
A general goal to aim for is a BMI below 25. Your health care provider can help you set an appropriate BMI goal.
Measuring waist circumference helps screen for possible health risks. If most of your fat is around your waist rather than at your hips, you’re at a higher risk for heart disease and type 2 diabetes. This risk may be high with a waist size that is greater than 35 inches for women or greater than 40 inches for men. To learn how to measure your waist, visit Assessing Your Weight and Health Risk. For more information about losing weight or maintaining your weight, see Aim for a Healthy Weight.
Limit Alcohol Intake
Drinking too much alcohol can raise your blood pressure. Alcohol also adds extra calories, which may cause weight gain. Men should have no more than two drinks a day, and women should have no more than one drink a day.
If you drink and would like tips on how to cut back, watch the video "How To Cut Back on Your Drinking." (To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)
Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health and can lower high blood pressure. Stress management techniques include
- being physically active
- listening to music or focusing on something calm or peaceful
- performing yoga or tai chi
Keep Up Your Healthy Habits
Although some people can control their high blood pressure with lifestyle changes alone, many people can't. Keep in mind that the main goal is blood pressure control. If your doctor prescribes medicines as a part of your treatment plan, keep up your healthy lifestyle habits. They will help you better control your blood pressure.
Common Blood Pressure Medications
Blood pressure medicines work in different ways to lower blood pressure. Some drugs lower blood pressure by removing extra fluid and salt from your body. Others affect blood pressure by slowing down the heartbeat, or by relaxing and widening blood vessels. Often, two or more drugs work better than one.
Here are the types of medicines used to treat high blood pressure.
- Diuretics (water or fluid Pills) flush excess sodium from your body, which reduces the amount of fluid in your blood and helps to lower your blood pressure. Diuretics are often used with other high blood pressure medicines, sometimes in one combined pill.
- Beta Blockers help your heart beat slower and with less force. As a result, your heart pumps less blood through your blood vessels, which can help to lower your blood pressure.
- Angiotensin-Converting Enzyme (ACE) Inhibitors. Angiotensin-II is a hormone that narrows blood vessels, increasing blood pressure. ACE converts Angiotensin I to Angiotensin II. ACE inhibitors block this process, which stops the production of Angiotensin II, lowering blood pressure.
- Angiotensin II Receptor Blockers (ARBs) block angiotensin II hormone from binding with receptors in the blood vessels. When angiotensin II is blocked, the blood vessels do not constrict or narrow, which can lower your blood pressure.
- Calcium Channel Blockers keep calcium from entering the muscle cells of your heart and blood vessels. This allows blood vessels to relax, which can lower your blood pressure.
- Alpha Blockers reduce nerve impulses that tighten blood vessels. This allows blood to flow more freely, causing blood pressure to go down.
- Alpha-Beta Blockers reduce nerve impulses the same way alpha blockers do. However, like beta blockers, they also slow the heartbeat. As a result, blood pressure goes down.
- Central Acting Agents act in the brain to decrease nerve signals that narrow blood vessels, which can lower blood pressure.
- Vasodilators relax the muscles in blood vessel walls, which can lower blood pressure.
After You Start Medication
Check and record your blood pressure often to see if the medicine is working for you. If your blood pressure continues to measure 140/90 mmHg or higher (130/80 or higher if you have diabetes or chronic kidney disease) after you start taking medicine, your doctor may need to add a second drug or try you on different medicines until you find one that helps you reach your goal.
Don’t stop taking your medicine if your blood pressure is normal. That means the medicine is working.
Be sure to talk with your doctor or health care provider about side effects from your medications, and don't make any changes to your medications without talking with your doctor first.