Blood Pressure

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Encino Medical Pharmacy’s staff will take your blood pressure free of charge and provide recommendations based on your readings.

High blood pressure should be treated earlier with lifestyle changes and in some patients with medication – at 130/80 mm Hg rather than 140/90 – based on new ACC and American Heart Association (AHA) guidelines for the detection, prevention, management and treatment of high blood pressure.

The new guidelines – the first comprehensive set since 2003 – lower the definition of high blood pressure to account for complications that can occur at lower numbers and to allow for earlier intervention. The new definition will result in nearly half of the U.S. adult population (46 percent) having high blood pressure, with the greatest impact expected among younger people. Additionally, the prevalence of high blood pressure is expected to triple among men under age 45, and double among women under 45, the guideline authors note. However, only a small increase is expected in the number of adults requiring antihypertensive medication.

Blood pressure categories in the new guideline are:

  • Normal: Less than 120/80 mm Hg;
  • Elevated: Systolic between 120-129 and diastolic less than 80;
  • Stage 1: Systolic between 130-139 or diastolic between 80-89;
  • Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg;
  • Hypertensive crisis: Systolic over 180 and/or diastolic over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage.

10 ways to control high blood pressure without medication

By making these 10 lifestyle changes, you can lower your blood pressure and reduce your risk of heart disease.

If you’ve been diagnosed with high blood pressure, you might be worried about taking medication to bring your numbers down.

Lifestyle plays an important role in treating your high blood pressure. If you successfully control your blood pressure with a healthy lifestyle, you might avoid, delay or reduce the need for medication.

Here are 10 lifestyle changes you can make to lower your blood pressure and keep it down.

1. Lose extra pounds and watch your waistline (if we can just put one thru 10 and link the content other each it will be awesome)

Blood pressure often increases as weight increases. Being overweight also can cause disrupted breathing while you sleep (sleep apnea), which further raises your blood pressure.

Weight loss is one of the most effective lifestyle changes for controlling blood pressure. Losing even a small amount of weight if you’re overweight or obese can help reduce your blood pressure. In general, you may reduce your blood pressure by about 1 millimeter of mercury (mm Hg) with each kilogram (about 2.2 pounds) of weight you lose.

Besides shedding pounds, you generally should also keep an eye on your waistline. Carrying too much weight around your waist can put you at greater risk of high blood pressure.

In general:

  • Men are at risk if their waist measurement is greater than 40 inches (102 centimeters).
  • Women are at risk if their waist measurement is greater than 35 inches (89 centimeters).

These numbers vary among ethnic groups. Ask your doctor about a healthy waist measurement for you.

2. Exercise regularly

Regular physical activity — such as 150 minutes a week, or about 30 minutes most days of the week — can lower your blood pressure by about 5 to 8 mm Hg if you have high blood pressure. It’s important to be consistent because if you stop exercising, your blood pressure can rise again.

If you have elevated blood pressure, exercise can help you avoid developing hypertension. If you already have hypertension, regular physical activity can bring your blood pressure down to safer levels.

Some examples of aerobic exercise you may try to lower blood pressure include walking, jogging, cycling, swimming or dancing. You can also try high-intensity interval training, which involves alternating short bursts of intense activity with subsequent recovery periods of lighter activity. Strength training also can help reduce blood pressure. Aim to include strength training exercises at least two days a week. Talk to your doctor about developing an exercise program.

3. Eat a healthy diet

Eating a diet that is rich in whole grains, fruits, vegetables and low-fat dairy products and skimps on saturated fat and cholesterol can lower your blood pressure by up to 11 mm Hg if you have high blood pressure. This eating plan is known as the Dietary Approaches to Stop Hypertension (DASH) diet.

It isn’t easy to change your eating habits, but with these tips, you can adopt a healthy diet:

  • Keep a food diary.Writing down what you eat, even for just a week, can shed surprising light on your true eating habits. Monitor what you eat, how much, when and why.
  • Consider boosting potassium.Potassium can lessen the effects of sodium on blood pressure. The best source of potassium is food, such as fruits and vegetables, rather than supplements. Talk to your doctor about the potassium level that’s best for you.
  • Be a smart shopper.Read food labels when you shop and stick to your healthy-eating plan when you’re dining out, too.

4. Reduce sodium in your diet

Even a small reduction in the sodium in your diet can improve your heart health and reduce blood pressure by about 5 to 6 mm Hg if you have high blood pressure.

The effect of sodium intake on blood pressure varies among groups of people. In general, limit sodium to 2,300 milligrams (mg) a day or less. However, a lower sodium intake — 1,500 mg a day or less — is ideal for most adults.

To decrease sodium in your diet, consider these tips:

  • Read food labels.If possible, choose low-sodium alternatives of the foods and beverages you normally buy.
  • Eat fewer processed foods.Only a small amount of sodium occurs naturally in foods. Most sodium is added during processing.
  • Don’t add salt.Just 1 level teaspoon of salt has 2,300 mg of sodium. Use herbs or spices to add flavor to your food.
  • Ease into it.If you don’t feel you can drastically reduce the sodium in your diet suddenly, cut back gradually. Your palate will adjust over time.

5. Limit the amount of alcohol you drink

Alcohol can be both good and bad for your health. By drinking alcohol only in moderation — generally one drink a day for women, or two a day for men — you can potentially lower your blood pressure by about 4 mm Hg. One drink equals 12 ounces of beer, five ounces of wine or 1.5 ounces of 80-proof liquor.

But that protective effect is lost if you drink too much alcohol.

Drinking more than moderate amounts of alcohol can actually raise blood pressure by several points. It can also reduce the effectiveness of blood pressure medications.

6. Quit smoking

Each cigarette you smoke increases your blood pressure for many minutes after you finish. Stopping smoking helps your blood pressure return to normal. Quitting smoking can reduce your risk of heart disease and improve your overall health. People who quit smoking may live longer than people who never quit smoking.

7. Cut back on caffeine

The role caffeine plays in blood pressure is still debated. Caffeine can raise blood pressure up to 10 mm Hg in people who rarely consume it. But people who drink coffee regularly may experience little or no effect on their blood pressure.

Although the long-term effects of caffeine on blood pressure aren’t clear, it’s possible blood pressure may slightly increase.

To see if caffeine raises your blood pressure, check your pressure within 30 minutes of drinking a caffeinated beverage. If your blood pressure increases by 5 to 10 mm Hg, you may be sensitive to the blood pressure raising effects of caffeine. Talk to your doctor about the effects of caffeine on your blood pressure.

8. Reduce your stress

Chronic stress may contribute to high blood pressure. More research is needed to determine the effects of chronic stress on blood pressure. Occasional stress also can contribute to high blood pressure if you react to stress by eating unhealthy food, drinking alcohol or smoking.

Take some time to think about what causes you to feel stressed, such as work, family, finances or illness. Once you know what’s causing your stress, consider how you can eliminate or reduce stress.

If you can’t eliminate all of your stressors, you can at least cope with them in a healthier way. Try to:

  • Change your expectations.For example, plan your day and focus on your priorities. Avoid trying to do too much and learn to say no. Understand there are some things you can’t change or control, but you can focus on how you react to them.
  • Focus on issues you can control and make plans to solve them.If you are having an issue at work, try talking to your manager. If you are having a conflict with your kids or spouse, take steps to resolve it.
  • Avoid stress triggers.Try to avoid triggers when you can. For example, if rush-hour traffic on the way to work causes stress, try leaving earlier in the morning, or take public transportation. Avoid people who cause you stress if possible.
  • Make time to relax and to do activities you enjoy.Take time each day to sit quietly and breathe deeply. Make time for enjoyable activities or hobbies in your schedule, such as taking a walk, cooking or volunteering.
  • Practice gratitude.Expressing gratitude to others can help reduce your stress.

9. Monitor your blood pressure at home and see your doctor regularly

Home monitoring can help you keep tabs on your blood pressure, make certain your lifestyle changes are working, and alert you and your doctor to potential health complications. Blood pressure monitors are available widely and without a prescription. Talk to your doctor about home monitoring before you get started.

Regular visits with your doctor are also key to controlling your blood pressure. If your blood pressure is well-controlled, check with your doctor about how often you need to check it. Your doctor may suggest checking it daily or less often. If you’re making any changes in your medications or other treatments, your doctor may recommend you check your blood pressure starting two weeks after treatment changes and a week before your next appointment.

10. Get support

Supportive family and friends can help improve your health. They may encourage you to take care of yourself, drive you to the doctor’s office or embark on an exercise program with you to keep your blood pressure low.

If you find you need support beyond your family and friends, consider joining a support group. This may put you in touch with people who can give you an emotional or morale boost and who can offer practical tips to cope with your condition

Medications treatment

Medication options

If a trial of making lifestyle changes isn’t enough to control your blood pressure, you’ll likely receive a prescription for one or more of these medications in addition to maintaining your lifestyle measures.

  • Diuretics (water pills).Your doctor might first suggest diuretics, which remove excess water and sodium from your body. That decreases the amount of fluid flowing through your blood vessels, which reduces pressure on your vessel walls.

There are three types of diuretics: thiazide, loop and potassium-sparing. The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends that most people try thiazide diuretics first to treat high blood pressure and heart problems related to high blood pressure.

If diuretics aren’t enough to lower your blood pressure, your doctor might recommend adding other blood pressure medications to your treatment.

  • Angiotensin-converting enzyme (ACE) inhibitors.These help relax blood vessels by preventing the formation of a hormone called angiotensin, a substance in your body that narrows blood vessels. Frequently prescribed ACE inhibitors include enalapril (Vasotec), lisinopril (Prinivil, Zestril) and ramipril (Altace).
  • Angiotensin II receptor blockers (ARBs).These help relax blood vessels by blocking the action, not the formation, of angiotensin, a chemical in your body that narrows blood vessels. ARBs include valsartan (Diovan), losartan (Cozaar) and others.
  • Calcium channel blockers.These medications prevent calcium from entering heart and blood vessel muscle cells, thus causing the cells to relax. Frequently prescribed calcium channel blockers include amlodipine (Norvasc), diltiazem (Cardizem, Tiazac, others) and nifedipine (Adalat CC, Afeditab CR, Procardia).
  • Beta blockers.Also known as beta-adrenergic blocking agents, these work by blocking the effects of the hormone epinephrine, also known as adrenaline. They cause your heart to beat slower and with less force.

Frequently prescribed beta blockers include metoprolol (Lopressor, Toprol-XL), nadolol (Corgard) and atenolol (Tenormin).

  • Renin inhibitors.Renin is an enzyme produced by your kidneys that starts a chain of chemical steps that increases blood pressure. Aliskiren (Tekturna) slows the production of renin, reducing its ability to begin this process.

Other medications sometimes used to treat high blood pressure

If you’re unable to reach your blood pressure goal with one or more of the above medications, other drugs that lower blood pressure include:

  • Alpha blockers.Alpha blockers relax certain muscles and help small blood vessels remain open. They work by keeping the hormone norepinephrine (noradrenaline) from tightening the muscles in the walls of smaller arteries and veins, which causes the vessels to remain open and relaxed.

Frequently prescribed alpha blockers include doxazosin (Cardura), prazosin (Minipress) and terazosin.

  • Alpha-beta blockers.Alpha-beta blockers work similarly to beta blockers. They might be prescribed for people with high blood pressure who are at risk of heart failure. Alpha-beta blockers include carvedilol (Coreg) and labetalol (Trandate).
  • Central-acting agents.These prevent your brain from sending signals to your nervous system to speed up your heart rate and narrow your blood vessels. As a result, your heart doesn’t pump as hard and your blood flows more easily through your blood vessels.

Clonidine (Catapres, Kapvay), guanfacine (Intuniv, Tenex) and methyldopa are examples of central-acting agents.

  • Vasodilators.These medications open (dilate) blood vessels. They affect the muscles in blood vessel walls, preventing the muscles from tightening and the walls from narrowing. As a result, blood flows more easily through your vessels and your heart doesn’t have to pump as hard.

Other blood pressure medications, such as calcium channel blockers, also dilate blood vessels. But the vasodilators that work directly on the vessel walls are hydralazine and minoxidil.

  • Aldosterone antagonists.These are often used with other drugs, such as a diuretic, for black people, older people, people with heart failure, and people with diabetes and people whose hypertension is difficult to treat. Examples are spironolactone (Aldactone) and eplerenone (Inspra).

Each of the blood pressure drugs has been shown to lower blood pressure. However, different people respond better to certain drugs than other people do, which often depends on age, sex, race, how high your blood pressure is and your other health conditions.

A two-drug combination generally is more effective than is a single drug to get your blood pressure under control. Sometimes a third medication, or more, is needed to achieve your blood pressure goal.

High blood pressure and other health problems

High blood pressure often goes hand in hand with other health problems, including:

  • Heart failure
  • Previous heart attack or stroke
  • Coronary artery disease
  • Enlarged or thickened left chamber of the heart (left ventricular hypertrophy)
  • Diabetes
  • Chronic kidney disease

High blood pressure itself puts you at higher risk of having one of these conditions. If you already have one or more of these conditions plus high blood pressure, your chance of developing complications increases. A targeted treatment approach might reduce your risk of these complications.

For example, if you have chest pain (angina), your doctor may recommend a beta blocker, which can lower your blood pressure and also prevent your chest pain, reduce your heart rate and decrease your risk of death. If you have diabetes and high blood pressure, taking a diuretic plus an ACE inhibitor can decrease your risk of a heart attack and stroke. If you have diabetes, high blood pressure and kidney disease, you may need an ACE inhibitor or an angiotensin II receptor blocker.

Keep trying to reach your blood pressure goal

It’s not unusual to try several medications or doses before finding what works best for you. An important way for you and your doctor to know if your treatment is working is to monitor your blood pressure at home.

Home blood pressure monitors are widely available and inexpensive, and you don’t need a prescription to buy one. Regular, accurate recordings can help your doctor monitor your treatment program. However, home blood pressure monitoring isn’t a substitute for visits to your doctor, and home blood pressure monitors have some limitations.

In most cases, a combination of lifestyle changes and medication can help you successfully control your blood pressure. Finding the right combination of treatments to keep your blood pressure under control is likely to take time and effort, but it can mean a longer life, with fewer health problems.