How to Control High Blood Pressure

High blood pressure, or hypertension, is a very common condition. The blood pressure measurement consists of a "top value," the systolic blood pressure, and a "bottom value," the diastolic pressure. These are the pressures in your arteries when the heart contracts and relaxes respectively.

When the blood pressure is too high, it is considered elevated. When the blood pressure is too high for too long, there is a higher risk of organ damage. Organs commonly damaged by high blood pressure include the heart (e.g., heart attacks, congestive heart failure), the brain (high blood pressure increases stroke risk), the kidneys (high blood pressure is a common cause of kidney failure), and the eyes. Because of the risk of organ damage, it's important not to ignore high blood pressure and to get it treated.

How high is too high? The following table lists blood pressure levels by category:

Category	Systolic (mm Hg)	Diastolic (mm Hg)
Normal	< 120	< 80
Elevated	120–129	< 80
High Blood Pressure (Hypertension) Stage 1	130–139	80–89
High Blood Pressure (Hypertension) Stage 2	≥ 140	≥ 90
Hypertensive Crisis (May Need Emergency Care if you have severe headaches, chest pain, vision changes, dizziness, or anything else concerning)	≥ 180	≥ 120

In recent years, the target blood pressure has decreased because of clinical trials showing that lower blood pressure is better for preventing cardiovascular events and other complications. You should ask your doctor what your target blood pressure should be as this can vary by health conditions being treated as well as by the person. Your doctor may recommend medication to treat the blood pressure if the systolic value is over 140 or diastolic value over 90 mm Hg if you are otherwise healthy and a good target blood pressure might be around 120/80.

Treating high blood pressure is done by a combination of lifestyle changes and medication. Your doctor or qualified healthcare professional may recommend one or more of the following to improve your blood pressure:

• The Dietary Approaches to Stop Hypertension (DASH) diet: low sodium, whole grains, increased fruits/vegetable intake, low alcohol, low red meat, low sugar


• Regular exercise


• Weight loss


• Medications: first-line agents include ACE inhibitors such as lisinopril or rampril, ARBs such as losartan or olmesartan, thiazide diuretics such as HCTZ or chlorthalidone, or calcium channel blockers such as amlodipine or nifedipine

It may take several months to improve blood pressure with lifestyle change and/or medications. While you work on this, you can take other steps to help your doctor know how to best treat you. These include:

• Checking your blood pressure once or twice daily and writing down the values. Bring these values to your appointment.
• Ensure that you are checking your blood pressure at home in a consistent manner. This website can show you how to properly check your blood pressure at home: Home Blood Pressure Monitoring

By working with your doctor or healthcare professional, it is possible to get your blood pressure under good control. In turn, this will prevent serious health problems down the road and improve your wellbeing and longevity.