What is High Blood Pressure and How Should You Manage It?
High blood pressure is an increasing problem for many. As many as 1 out of 3 U.S. adults have this condition. High blood pressure can be a sign of underlying health problems and can lead to additional diseases, so it's important to try to prevent or treat it.
High Blood Pressure Explained
What is Blood Pressure?
As blood is pumped throughout your body, delivering oxygen and nutrients to all of your organs, it travels through blood vessels such as veins and arteries. Blood pressure measures the amount of force blood is putting on the walls of your vessels as it flows.
Blood Pressure Readings
When you get your blood pressure measured, it is reported as two numbers:
- Systolic: The first number measures the amount of pressure inside the arteries when your heart beats.
- Diastolic: The second number measures the amount of pressure inside the arteries in between heartbeats.
High blood pressure, also known as hypertension, occurs when your blood is pressing against blood vessels with high force. A normal blood pressure reading is 120/80 mmHg or below. People with elevated blood pressure, or pre-hypertension, have a systolic blood pressure between 120-129 mmHg and a diastolic blood pressure of 80 mmHg or below. Those with pre-hypertension are more likely to develop high blood pressure if it goes untreated. High blood pressure may be diagnosed when someone has a systolic pressure of 130 mmHg or higher or a diastolic pressure of 80 mmHg or higher.
How is High Blood Pressure Diagnosed?
Generally, high blood pressure doesn't cause any symptoms. This means that most people won't know they have hypertension until they get their blood pressure read by a healthcare provider.
Doctors generally won't diagnose someone with hypertension after a single high reading. This is because blood pressure levels fluctuate throughout the day, due to factors such as hormone levels, diet, and physical activity.
If your blood pressure readings are consistently high after multiple readings, your doctor may diagnose you with high blood pressure.
What Leads to High Blood Pressure?
Types of Hypertension
There are a couple of different types of high blood pressure. Primary hypertension has no clear cause. Secondary hypertension is caused by another underlying disease or medical condition, such as kidney disease, adrenal gland disorders, hyperparathyroidism, or obstructive sleep apnea.
Secondary hypertension can also be caused by certain medications, including:
- Certain herbal products such as ephedra
- Estrogen and hormonal birth control
- Over-the-counter cold medication
- Painkillers such as acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and migraine medication
- Testosterone and performance-enhancing drugs
High blood pressure can also develop during pregnancy. This condition is fairly common. Although it can cause problems for both the mother and baby before, during, and after pregnancy, it can be managed through diet, exercise, and medication. If you have high blood pressure, talk to your doctor before getting pregnant to learn how to safely manage hypertension throughout a pregnancy.
A person's blood pressure usually gets higher as they age, because blood vessels get stiffer over time. Additionally, people with certain characteristics or lifestyle factors are more likely to develop hypertension. Some of these risk factors are:
- Race: African-Americans have higher rates of hypertension
- Gender: For people under 55 years old, men are at higher risk of hypertension. For people over 55, women more often develop this condition.
- Physical inactivity
- High stress levels
- Drinking more than one serving of alcohol per day for women, or two servings per day for men
- Eating a diet high in salt
Genetics may also play a role in hypertension. People with a family history of high blood pressure are more likely to develop it.
Taking steps to live a healthy lifestyle can reduce your risk of hypertension. If you think you are at a higher risk of developing high blood pressure, consider the diet and exercise strategies listed below. Additionally, talk to your healthcare provider about your risk level and additional steps you can take to keep your blood pressure at healthy levels.
Why is Hypertension a Problem?
If you have high blood pressure, you are more likely to have other health problems. High blood pressure can damage your heart, kidneys, eyes, and other organs.
High blood pressure can also lead to other diseases, such as:
- Heart disease: Over time, hypertension can injure your blood vessels and make them stiffer. As a result, your blood may not flow as well, which can contribute to heart disease.
- Other heart conditions: Hypertension can make a person more likely to have a heart attack, in which blood and oxygen are blocked from reaching the heart. People with high blood pressure are also more likely to have heart failure.
- Stroke: Just as blood and oxygen can be blocked from reaching the heart, they may also have trouble flowing to the brain. Strokes are caused by a blockage of blood to the brain, or by a brain bleed. Both of these situations lead to death of brain cells.
- Dementia: people with hypertension are more likely to have problems with dementia as they get older.
- Chronic kidney disease: Many studies have linked high blood pressure and kidney problems.
The course of treatment that works best for you may depend on the cause of your hypertension. If your high blood pressure levels are caused by another health condition, you will need to work with your doctor to treat the underlying problem. If your high blood pressure might be caused by a medication, your doctor may want you to stop taking that drug or switch to a different one.
For other people with hypertension, the condition can be managed by diet, exercise, medication, or some combination of these.
There are two diet plans that doctors often recommend to people who are trying to prevent or manage high blood pressure. One plan is called the DASH diet, which stands for Dietary Approaches to Stop Hypertension. DASH encourages people to eat a lot of whole grains, vegetables, and fruits. It also includes lean meats such as fish and poultry as well as beans, nuts, healthy oils, and low-fat dairy. People who are on DASH avoid foods high in saturated fat and sugar.
Research also shows that following the Mediterranean diet can help lower blood pressure. The Mediterranean diet emphasizes plant-based meals consisting of lots of whole grains, produce, nuts, and beans. Lean meats are eaten only in limited quantities, although eating a lot of fish is emphasized. People on the Mediterranean diet are also encouraged to cook with olive oil and avoid heavy sauces.
Other healthy eating tips for people with high blood pressure include eating less salt and saturated fat and eating more potassium and fiber. People should also limit the amount of alcohol they drink.
Experts recommend getting 150 minutes of moderate aerobic physical activity per week, including jogging, swimming, biking, playing a sport such as tennis, or mowing the lawn with a push mower. This exercise can be broken up into several periods each day. For optimal health, weight training or muscle-strengthening exercises are also good. Make sure to do a combination of exercises that works all of your major muscle groups in your legs, hips, back, abdomen, chest, shoulders, and arms.
For enjoyable ways to incorporate more physical activity into your daily routine, try:
- Finding a workout buddy to go on walks or jogs with
- Joining a fitness class at a gym or online
- Getting a pedometer or fitness tracker, which reminds you to move throughout the day and allows you to cooperate or compete with friends and family
Getting more exercise throughout your week can play an important role in lowering blood pressure. Ask your doctor how much physical activity you should be aiming for in order to maintain a healthy blood pressure.
High stress levels play a large role in high blood pressure. Find ways to manage stress, such as:
- Exercising or going on a walk
- Listening to music
Some studies have linked hypertension to mental disorders such as depression and anxiety. If you think that you may be struggling with your mental health, talk to your healthcare provider. Strategies such as medication and therapy can help improve your mental health, which in turn can lead to better physical health and a reduced chance of high blood pressure and heart disease.
Smoking not only raises blood pressure, but also makes you more likely to have a heart attack or stroke. Quitting can be difficult, but many strategies can help, such as smartphone apps, text messaging programs, quitting plans, or support groups.
- Develop a sleep schedule, so that you go to bed and wake up at the same times each day
- Try to make your bedroom as dark and quiet as possible
- Have dinner earlier in the evening, and don't drink any alcohol or caffeine within a few hours of bed
- Limit electronic media before bedtime to reduce sleep-inhibiting blue light exposure
- Be more physically active during the day
Several medications are available to help people keep their blood pressure at healthy levels. Different drugs use different methods for reducing blood pressure, such as making your heart beat less forcefully or getting rid of excess water and salt in your body. Your doctor may prescribe medications like:
- ACE inhibitors
- Beta blockers
- Calcium channel blockers
If you are interested in trying blood pressure-reducing medication, talk to your doctor. Your doctor may prescribe one or more medications if it seems like a good fit for you. Most drugs in this category don't cause major side effects and have few risks.
Monitoring Your Blood Pressure at Home
People who are trying to prevent high blood pressure or lower their readings may want to start measuring it regularly at home. You can buy home measurement devices that are easy to use. Don't take your blood pressure within 30 minutes of smoking, eating, drinking, or exercising. While taking your blood pressure, keep both feet flat on the ground and rest your arm at chest height. Talk to your doctor about how often you should be taking blood pressure readings.
Telemedicine Can Be Even Better: Ambulatory Blood Pressure Monitoring
With the way that calendar year 2020 has gone for many, telemedicine has become even more popular than before. Ambulatory blood pressure monitoring is an excellent way for physicians and patients to continue to stay connected and for the physician to be informed about the patient's blood pressure from afar.
There are many devices that are used for this purpose and my favorite is from Preventric. It is a watch-like device that fits comfortably on the wrist. It has significant advantages over having your blood pressure taken at a clinic or using a home blood pressure monitoring cuff. One is that it continuously monitors your blood pressure during your normal daily and nightly activities unlike a blood pressure cuff which only takes a snapshot of your blood pressure at a given moment in time. Such readings are often affected by stress, anxiety, the digestion of a recent meal, a cup of coffee or numerous other factors which may not present a very representative reading of your blood pressure to your doctor and may not show how your blood pressure changes during the day. With a Preventric device, readings are instantly transmitted to Preventric for analysis and then on to your physician for review and diagnosis – all without you having to attend your doctor's office. It is simply more accurate, informative and convenient than traditional ways of taking and analyzing blood pressure.
This type of telemedicine continues to advance patient health and especially so during this time of pandemic when it may be inadvisable for those with hypertension to attend a physician's office.
Does Hypertension Play a Role in COVID-19?
High Blood Pressure and Severe COVID-19
People with more severe heart conditions, such as heart failure or coronary artery disease, are more likely to become severely ill if they are infected with COVID-19. When it comes to hypertension, the research is not as clear. Early studies seem to indicate that people with high blood pressure may be at increased risk as well. If you have hypertension, you may want to take extra precautions to socially distance yourself from others and reduce your risk of infection. It may also be a good idea to have an extra month's supply of medication on hand at all times.
Does Blood Pressure Medication Make COVID-19 Worse?
In the early days of the pandemic, some experts worried that taking medication for high blood pressure might lead to more severe illness. Some researchers thought that there was a possibility that these drugs could more easily allow the virus to enter cells. However, new research shows that this is likely not the case. A meta-analysis covering nearly 20 studies and 29,000 patients found that people with high blood pressure who used ACE inhibitors and angiotensin receptor blockers were actually more likely to survive COVID-19. Thus, experts recommend that people with high blood pressure continue to take their medications as prescribed.
Addressing high blood pressure involves first talking to your doctor. Your healthcare team can help you understand whether your blood pressure levels are normal, and what steps you can take to protect your heart health. By working with your doctor, you can come up with a plan that best fits you and your lifestyle.