Know Your Numbers

For many people, being diagnosed with high blood pressure comes as a complete surprise. Often, there are no symptoms, or any pain. Yet it can contribute to serious, life threatening health problems such as heart attack, stroke, and kidney failure.

What is high blood pressure?
Classifications and Recommendations
Treatment options
Simple tips

When high blood pressure is not found and treated early, it can cause:

The heart to get larger, which may lead to heart failure.
Small bulges (aneurysms) to form in blood vessels. Common locations are the main artery from the heart (aorta), arteries in the brain, legs, and intestines, and the artery leading to the spleen.
Blood vessels in the kidney to narrow, which may cause kidney failure.
Arteries throughout the body to "harden" faster, especially those in the heart, brain, kidneys, and legs. This can cause a heart attack, stroke, kidney failure, or amputation of part of the leg.
Blood vessels in the eyes to burst or bleed, which may cause vision changes and can result in blindness.

What is blood pressure?

Blood is carried from the heart to all parts of your body in vessels called arteries. Blood pressure is the force of the blood pushing against the walls of the arteries. Each time the heart beats (about 60-70 times a minute at rest), it pumps out blood into the arteries. Your blood pressure is at its highest when the heart beats, pumping the blood. This is called systolic pressure. When the heart is at rest, between beats, your blood pressure falls. This is the diastolic pressure.

Blood pressure is always given as these two numbers, the systolic and diastolic pressures. Both are important. Usually they are written one above or before the other, such as 120/80 mmHg. The top number is the systolic and the bottom the diastolic. When the two measurements are written down, the systolic pressure is the first or top number, and the diastolic pressure is the second or bottom number (for example, 120/80). If your blood pressure is 120/80, you say that it is "120 over 80."

Blood pressure changes during the day. It is lowest as you sleep and rises when you get up. It also can rise when you are excited, nervous, or active.

Still, for most of your waking hours, your blood pressure stays the same when you are sitting or standing still. That level should be lower than 120/80. When the level stays high, 140/90 or higher, you have high blood pressure. With high blood pressure, the heart works harder, your arteries take a beating, and your chances of a stroke, heart attack, and kidney problems are greater.

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Classifications and Follow Up Recommendations

A blood pressure reading below 120/80 is considered normal. Most people have blood pressure within a range of 90/60 to 130/90 mm Hg. In general, lower is better. However, very low blood pressures can sometimes be a cause for concern and should be checked out by a doctor. Low blood pressure can result in light-headedness or dizziness. Research has shown that blood pressures higher than 140/90 mm Hg (either number) can have adverse effects on an individual’s cardiovascular risk. A blood pressure that is consistently higher than 140/90 mm Hg is considered high blood pressure, or hypertension.

Blood Pressure Classifications and Follow Up Recommendations chart (PDF)

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Treatment

Adoption of healthy lifestyles by all persons is critical for the prevention of high blood pressure and is an indispensable part of the management of those with hypertension. Major lifestyle modifications shown to lower blood pressure include:

Weight reduction in those individuals who are overweight or obese,
Adoption of the Dietary Approaches to Stop Hypertension (DASH) eating plan which is rich in potassium and calcium - for more information download and print the New DASH Diet (PDF).
Dietary sodium reduction,
Physical activity, and
Moderation of alcohol consumption.

Lifestyle modifications reduce blood pressure, enhance the efficacy of blood pressure medications, and decrease cardiovascular risk. For example, a 1,600 mg sodium DASH eating plan has effects similar to single drug therapy. Combinations of two (or more) lifestyle modifications can achieve even better results. Physical activity has been shown to decrease systolic blood pressure by 10-12 points, and diastolic blood pressure by 8 points.

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Simple Tips to Control Your Blood Pressure

There are a number of things you can do to control your blood pressure. These examples are ways that have worked for many people. However, consult with your physician for a plan that will work the best for you.

1. Reduce the sodium (salt) in your diet.

Choose fresh foods
Avoid adding salt at the table. Use herbs and spices liberally.
Limit canned soups, frozen dinners and entrees and vegetables with sauces. Choose "low-sodium" products. You may rinse canned foods with water.
Reduce your intake of bacon, sausage, hot dogs and luncheon meats such as corned beef, pastrami, bologna, ham, processed turkey and salami.
Avoid smoked, pickled and cured foods.

2. Achieve a healthy body weight.

Reduce your calories by choosing low-fat foods and eating smaller portions.
Increase dietary fiber. Try to get 20-35 grams of fiber daily.
Exercise regularly. Your goal should be at least 30-minutes of aerobic exercise daily.

3. Increase foods that are high in potassium, magnesium and fiber.

Eat at least 4-5 servings a day of whole fresh fruit and 4-5 servings a day of vegetables. A serving is approximately 1/2 cup cooked or 1-cup raw fruit or vegetable, or 1 small piece of fruit.
Eat citrus fruit 3 times a week for potassium and fiber.
Eat nuts, seeds, dried beans and peas at least 4 times a week for potassium, magnesium and fiber.
Eat more potatoes, tomatoes and bananas for potassium.
Eat whole grains and whole grain products for fiber and magnesium.

4. Increase foods that are high in calcium.

Choose 2-3 cups low-fat or fat-free dairy products daily.
If you are lactose intolerant, use Lactaid to improve absorption of dairy products.
If you do not eat dairy products, supplement your diet with calcium.

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5. Reduce caffeine.

Choose decaffeinated coffee, tea and diet sodas.
Limit caffeinated beverages to fewer than 3 cups per day.
Avoid caffeine-containing medications such as Anacin Tablets and Caplets, Dristan Capsules, Excedrin Extra Strength Caplets and Tablets, Midol Caplets, NoDoz and Vivarin.

6. Drink adequate fluids.

As a good rule of thumb, drink 8 cups of water per day.
Fill up a pitcher of water and keep it on your desk or on the counter so that you are reminded to drink it.

7. Quit smoking.

To start, reduce the numbers of cigarettes you smoke each day.
Seek assistance in quitting. The American Lung Association has local telephone numbers in all communities and offers various programs. For information on quitting, visit our Tobacco Cessation web page.
Discuss with your physician.

8. Take medication as directed by your doctor.

Do not skip your blood pressure medication.
If you notice any side effects, notify your doctor.
Discuss the use of drugs called "NSAIDs" such as ibuprofen (Advil, Motrin), naproxen (Aleve) and ketoprofen (Orudis-KT) with your physician. NSAIDs appear to raise blood pressure in older people with hypertension. They may also blunt the action of certain antihypertensive medications

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