{"categories":"DiagnosableCondition,Adult,Adult,Clinical Care Concept","keywords":"High blood pressure,45 to 64 middle,19 to 44 younger,Risk factor","abstract":"\u003cp\u003eHigh blood pressure \u0026mdash; Comprehensive overview covers symptoms, treatment and prevention of hypertension.\u003c/p\u003e","title":"High blood pressure (hypertension)","body":"\u003cdiv class='section'\u003e\u003cdiv class='SectionHead'\u003eDefinition\u003c/div\u003e\u003cdiv class='SectionHTML'\u003e\u003cp\u003eHigh blood pressure is a common condition in which the force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease. \u003c/p\u003e\u003cp\u003eBlood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure. \u003c/p\u003e\u003cp\u003eYou can have high blood pressure (hypertension) for years without any symptoms. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke. \u003c/p\u003e\u003cp\u003eHigh blood pressure typically develops over many years, and it affects nearly everyone eventually. Fortunately, high blood pressure can be easily detected. And once you know you have high blood pressure, you can work with your doctor to control it. \u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class='section'\u003e\u003cdiv class='SectionHead'\u003eSymptoms\u003c/div\u003e\u003cdiv class='SectionHTML'\u003e\u003cp\u003eMost people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels. \u003c/p\u003e\u003cp\u003eAlthough a few people with early-stage high blood pressure may have dull headaches, dizzy spells or a few more nosebleeds than normal, these signs and symptoms typically don't occur until high blood pressure has reached a severe \u0026mdash; even life-threatening \u0026mdash; stage. \u003c/p\u003e\u003ch3\u003eWhen to see a doctor\u003c/h3\u003e\u003cp\u003eYou'll likely have your blood pressure taken as part of a routine doctor's appointment. \u003c/p\u003e\u003cp\u003eAsk your doctor for a blood pressure reading at least every two years starting at age 18. He or she will likely recommend more frequent readings if you've already been diagnosed with high blood pressure or other risk factors for cardiovascular disease. Children age 3 and older will usually have their blood pressure measured as a part of their yearly checkups. \u003c/p\u003e\u003cp\u003eIf you don't regularly see your doctor, you may be able to get a free blood pressure screening at a health resource fair or other locations in your community. You can also find machines in some stores that will measure your blood pressure for free, but these machines can give you inaccurate results. \u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class='section'\u003e\u003cdiv class='SectionHead'\u003eCauses\u003c/div\u003e\u003cdiv class='SectionHTML'\u003e\u003cp\u003eThere are two types of high blood pressure. \u003c/p\u003e\u003ch3\u003ePrimary (essential) hypertension\u003c/h3\u003e\u003cp\u003eFor most adults, there's no identifiable cause of high blood pressure. This type of high blood pressure, called essential hypertension or primary hypertension, tends to develop gradually over many years. \u003c/p\u003e\u003ch3\u003eSecondary hypertension\u003c/h3\u003e\u003cp\u003eSome people have high blood pressure caused by an underlying condition. This type of high blood pressure, called secondary hypertension, tends to appear suddenly and cause higher blood pressure than does primary hypertension. Various conditions and medications can lead to secondary hypertension, including: \u003c/p\u003e\u003cul\u003e    \u003cli\u003eKidney problems\u003c/li\u003e    \u003cli\u003eAdrenal gland tumors\u003c/li\u003e    \u003cli\u003eCertain defects in blood vessels you're born with (congenital)\u003c/li\u003e    \u003cli\u003eCertain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs\u003c/li\u003e    \u003cli\u003eIllegal drugs, such as cocaine and amphetamines\u003c/li\u003e\u003c/ul\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class='section'\u003e\u003cdiv class='SectionHead'\u003eRisk factors\u003c/div\u003e\u003cdiv class='SectionHTML'\u003e\u003cp\u003eHigh blood pressure has many risk factors, including: \u003c/p\u003e\u003cul\u003e    \u003cli\u003e\u003cstrong\u003eAge.\u003c/strong\u003e The risk of high blood pressure increases as you age. Through early middle age, high blood pressure is more common in men. Women are more likely to develop high blood pressure after menopause.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eRace.\u003c/strong\u003e High blood pressure is particularly common among blacks, often developing at an earlier age than it does in whites. Serious complications, such as stroke and heart attack, also are more common in blacks.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eFamily history.\u003c/strong\u003e High blood pressure tends to run in families.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eBeing overweight or obese.\u003c/strong\u003e The more you weigh, the more blood you need to supply oxygen and nutrients to your tissues. As the volume of blood circulated through your blood vessels increases, so does the pressure on your artery walls.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eNot being physically active.\u003c/strong\u003e People who are inactive tend to have higher heart rates. The higher your heart rate, the harder your heart must work with each contraction \u0026mdash; and the stronger the force on your arteries. Lack of physical activity also increases the risk of being overweight.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eUsing tobacco.\u003c/strong\u003e Not only does smoking or chewing tobacco immediately raise your blood pressure temporarily, but the chemicals in tobacco can damage the lining of your artery walls. This can cause your arteries to narrow, increasing your blood pressure. Secondhand smoke also can increase your blood pressure.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eToo much salt (sodium) in your diet.\u003c/strong\u003e Too much sodium in your diet can cause your body to retain fluid, which increases blood pressure.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eToo little potassium in your diet.\u003c/strong\u003e Potassium helps balance the amount of sodium in your cells. If you don't get enough potassium in your diet or retain enough potassium, you may accumulate too much sodium in your blood.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eToo little vitamin D in your diet.\u003c/strong\u003e It's uncertain if having too little vitamin D in your diet can lead to high blood pressure. Vitamin D may affect an enzyme produced by your kidneys that affects your blood pressure.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eDrinking too much alcohol.\u003c/strong\u003e Over time, heavy drinking can damage your heart. Having more than two drinks a day can raise your blood pressure.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eStress.\u003c/strong\u003e High levels of stress can lead to a temporary, but dramatic, increase in blood pressure. If you try to relax by eating more, using tobacco or drinking alcohol, you may only increase problems with high blood pressure.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eCertain chronic conditions.\u003c/strong\u003e Certain chronic conditions also may increase your risk of high blood pressure, including high cholesterol, diabetes, kidney disease and sleep apnea.\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eSometimes pregnancy contributes to high blood pressure, as well. \u003c/p\u003e\u003cp\u003eAlthough high blood pressure is most common in adults, children may be at risk, too. For some children, high blood pressure is caused by problems with the kidneys or heart. But for a growing number of kids, poor lifestyle habits \u0026mdash; such as an unhealthy diet and lack of exercise \u0026mdash; contribute to high blood pressure. \u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class='section'\u003e\u003cdiv class='SectionHead'\u003eComplications\u003c/div\u003e\u003cdiv class='SectionHTML'\u003e\u003cp\u003eThe excessive pressure on your artery walls caused by high blood pressure can damage your blood vessels, as well as organs in your body. The higher your blood pressure and the longer it goes uncontrolled, the greater the damage. \u003c/p\u003e\u003cp\u003eUncontrolled high blood pressure can lead to: \u003c/p\u003e\u003cul\u003e    \u003cli\u003e\u003cstrong\u003eHeart attack or stroke.\u003c/strong\u003e High blood pressure can cause hardening and thickening of the arteries (atherosclerosis), which can lead to a heart attack, stroke or other complications.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eAneurysm.\u003c/strong\u003e Increased blood pressure can cause your blood vessels to weaken and bulge, forming an aneurysm. If an aneurysm ruptures, it can be life-threatening.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eHeart failure.\u003c/strong\u003e To pump blood against the higher pressure in your vessels, your heart muscle thickens. Eventually, the thickened muscle may have a hard time pumping enough blood to meet your body's needs, which can lead to heart failure.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eWeakened and narrowed blood vessels in your kidneys.\u003c/strong\u003e This can prevent these organs from functioning normally.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eThickened, narrowed or torn blood vessels in the eyes.\u003c/strong\u003e This can result in vision loss.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eMetabolic syndrome.\u003c/strong\u003e This syndrome is a cluster of disorders of your body's metabolism \u0026mdash; including increased waist circumference, high triglycerides, low high-density lipoprotein (HDL), or \"good,\" cholesterol, high blood pressure, and high insulin levels. If you have high blood pressure, you're more likely to have other components of metabolic syndrome. The more components you have, the greater your risk of developing diabetes, heart disease or stroke.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eTrouble with memory or understanding.\u003c/strong\u003e Uncontrolled high blood pressure may also affect your ability to think, remember and learn. Trouble with memory or understanding concepts is more common in people who have high blood pressure.\u003c/li\u003e\u003c/ul\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class='section'\u003e\u003cdiv class='SectionHead'\u003ePreparing for your appointment\u003c/div\u003e\u003cdiv class='SectionHTML'\u003e\u003cp\u003eIf you think you may have high blood pressure, make an appointment with your family doctor to have your blood pressure checked. \u003c/p\u003e\u003cp\u003eNo special preparations are necessary to have your blood pressure checked. You might want to wear a short-sleeve shirt to your appointment so that the blood pressure cuff can fit around your arm properly. You might want to avoid caffeinated food and drinks right before your test. You should also use the toilet before having your blood pressure measured. \u003c/p\u003e\u003cp\u003eBecause some medications \u0026mdash; such as over-the-counter cold medicines, antidepressants, birth control pills and others \u0026mdash; can raise your blood pressure, it might be a good idea to bring a list of medications and supplements you take to your doctor's appointment. Don't stop taking any prescription medications that you think may affect your blood pressure without your doctor's advice. \u003c/p\u003e\u003cp\u003eBecause appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor. \u003c/p\u003e\u003ch3\u003eWhat you can do\u003c/h3\u003e\u003cul\u003e    \u003cli\u003e\u003cstrong\u003eWrite down any symptoms you're experiencing.\u003c/strong\u003e High blood pressure seldom has symptoms, but it is a risk factor for heart disease. Letting your doctor know if you have symptoms like chest pains or shortness of breath can help your doctor decide how aggressively your high blood pressure needs to be treated.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eWrite down key personal information,\u003c/strong\u003e including a family history of high blood pressure, high cholesterol, heart disease, stroke or diabetes, and any major stresses or recent life changes.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eMake a list of all medications,\u003c/strong\u003e vitamins or supplements that you're taking.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eTake a family member or friend along,\u003c/strong\u003e if possible. Sometimes it can be difficult to soak up all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eBe prepared to discuss\u003c/strong\u003e your diet and exercise habits. If you don't already follow a diet or exercise routine, be ready to talk to your doctor about any challenges you might face in getting started.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eWrite down questions to ask\u003c/strong\u003e your doctor.\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eYour time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For high blood pressure, some basic questions to ask your doctor include: \u003c/p\u003e\u003cul\u003e    \u003cli\u003eWhat kinds of tests will I need?\u003c/li\u003e    \u003cli\u003eDo I need any medications?\u003c/li\u003e    \u003cli\u003eWhat foods should I eat or avoid?\u003c/li\u003e    \u003cli\u003eWhat's an appropriate level of physical activity?\u003c/li\u003e    \u003cli\u003eHow often do I need to schedule appointments to check my blood pressure?\u003c/li\u003e    \u003cli\u003eShould I monitor my blood pressure at home?\u003c/li\u003e    \u003cli\u003eWhat are the alternatives to the primary approach that you're suggesting?\u003c/li\u003e    \u003cli\u003eI have other health conditions. How can I best manage them together?\u003c/li\u003e    \u003cli\u003eAre there any restrictions that I need to follow?\u003c/li\u003e    \u003cli\u003eShould I see a specialist?\u003c/li\u003e    \u003cli\u003eIs there a generic alternative to the medicine you're prescribing for me?\u003c/li\u003e    \u003cli\u003eAre there any brochures or other printed material that I can take home with me?\u003c/li\u003e    \u003cli\u003eWhat websites do you recommend visiting?\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eIn addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something. \u003c/p\u003e\u003ch3\u003eWhat to expect from your doctor\u003c/h3\u003e\u003cp\u003eYour doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask: \u003c/p\u003e\u003cul\u003e    \u003cli\u003eDo you have a family history of high cholesterol, high blood pressure or heart disease?\u003c/li\u003e    \u003cli\u003eWhat are your diet and exercise habits like?\u003c/li\u003e    \u003cli\u003eDo you drink alcohol? How many drinks do you have in a week?\u003c/li\u003e    \u003cli\u003eDo you smoke?\u003c/li\u003e    \u003cli\u003eWhen did you last have your blood pressure checked? What was your blood pressure measurement then?\u003c/li\u003e\u003c/ul\u003e\u003ch3\u003eWhat you can do in the meantime\u003c/h3\u003e\u003cp\u003eIt's never too early to make healthy lifestyle changes, such as quitting smoking, eating healthy foods and becoming more physically active. These are primary lines of defense against high blood pressure and its complications, including heart attack and stroke. \u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class='section'\u003e\u003cdiv class='SectionHead'\u003eTests and diagnosis\u003c/div\u003e\u003cdiv class='SectionHTML'\u003e\u003cp\u003eBlood pressure is measured with an inflatable arm cuff and a pressure-measuring gauge. A blood pressure reading, given in millimeters of mercury (mm Hg), has two numbers. The first, or upper, number measures the pressure in your arteries when your heart beats (systolic pressure). The second, or lower, number measures the pressure in your arteries between beats (diastolic pressure).\u003c/p\u003e\u003cp\u003eBlood pressure measurements fall into four general categories: \u003c/p\u003e\u003cul\u003e    \u003cli\u003e\u003cstrong\u003eNormal blood pressure.\u003c/strong\u003e Your blood pressure is normal if it's below 120/80 mm Hg. However, some doctors recommend 115/75 mm Hg as a better goal. Once blood pressure rises above 115/75 mm Hg, the risk of cardiovascular disease begins to increase. \u003c/li\u003e    \u003cli\u003e\u003cstrong\u003ePrehypertension.\u003c/strong\u003e Prehypertension is a systolic pressure ranging from 120 to 139 mm Hg or a diastolic pressure ranging from 80 to 89 mm Hg. Prehypertension tends to get worse over time. \u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eStage 1 hypertension.\u003c/strong\u003e Stage 1 hypertension is a systolic pressure ranging from 140 to 159 mm Hg or a diastolic pressure ranging from 90 to 99 mm Hg. \u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eStage 2 hypertension.\u003c/strong\u003e More severe hypertension, stage 2 hypertension is a systolic pressure of 160 mm Hg or higher or a diastolic pressure of 100 mm Hg or higher. \u003c/li\u003e\u003c/ul\u003e\u003cp\u003eBoth numbers in a blood pressure reading are important. But after age 50, the systolic reading is even more significant. Isolated systolic hypertension \u0026mdash; when diastolic pressure is normal but systolic pressure is high \u0026mdash; is the most common type of high blood pressure among people older than 50. \u003c/p\u003e\u003cp\u003eYour doctor will likely take two to three blood pressure readings each at two or more separate appointments before diagnosing you with high blood pressure. This is because blood pressure normally varies throughout the day \u0026mdash; and sometimes specifically during visits to the doctor, a condition called white-coat hypertension. Your doctor may ask you to record your blood pressure at home and at work to provide additional information. \u003c/p\u003e\u003cp\u003eIf you have any type of high blood pressure, your doctor may recommend routine tests, such as a urine test (urinalysis), blood tests and an electrocardiogram (ECG) \u0026mdash; a test that measures your heart's electrical activity. Your doctor may also recommend additional tests, such as a cholesterol test, to check for more signs of heart disease. \u003c/p\u003e\u003ch3\u003eTaking your blood pressure at home\u003c/h3\u003e\u003cp\u003eAn important way to check if your blood pressure treatment is working, or to diagnose worsening high blood pressure, is to monitor your blood pressure at home. Home blood pressure monitors are widely available, and you don't need a prescription to buy one. Talk to your doctor about how to get started. \u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class='section'\u003e\u003cdiv class='SectionHead'\u003eTreatments and drugs\u003c/div\u003e\u003cdiv class='SectionHTML'\u003e\u003cp\u003eYour blood pressure treatment goal depends on how healthy you are. \u003c/p\u003e\u003ctable\u003e    \u003ctbody\u003e        \u003ctr\u003e            \u003cth colspan=\"2\"\u003eBlood pressure treatment goals* \u003c/th\u003e        \u003c/tr\u003e        \u003ctr\u003e            \u003ctd\u003e140/90 mm Hg or lower \u003c/td\u003e            \u003ctd\u003eIf you are a healthy adult \u003c/td\u003e        \u003c/tr\u003e        \u003ctr\u003e            \u003ctd\u003e130/80 mm Hg or lower \u003c/td\u003e            \u003ctd\u003eIf you have chronic kidney disease, diabetes or coronary artery disease or are at high risk of coronary artery disease \u003c/td\u003e        \u003c/tr\u003e        \u003ctr\u003e            \u003ctd\u003e120/80 mm Hg or lower \u003c/td\u003e            \u003ctd\u003eIf your heart isn't pumping as well as it should (left ventricular dysfunction or heart failure) or you have severe chronic kidney disease \u003c/td\u003e        \u003c/tr\u003e    \u003c/tbody\u003e\u003c/table\u003e\u003cp\u003e*Although 120/80 mm Hg or lower is the ideal blood pressure goal, doctors are unsure if you need treatment (medications) to reach that level. \u003c/p\u003e\u003cp\u003eIf you're an adult age 80 or older and your blood pressure is very high, your doctor may set a target blood pressure goal for you that's slightly higher than 140/90 mm Hg. \u003c/p\u003e\u003cp\u003eChanging your lifestyle can go a long way toward controlling high blood pressure. But sometimes lifestyle changes aren't enough. In addition to diet and exercise, your doctor may recommend medication to lower your blood pressure. Which category of medication your doctor prescribes depends on your stage of high blood pressure and whether you also have other medical problems. \u003c/p\u003e\u003ch3\u003eMedications to treat high blood pressure\u003c/h3\u003e\u003cul\u003e    \u003cli\u003e\u003cstrong\u003eThiazide diuretics.\u003c/strong\u003e Diuretics, sometimes called water pills, are medications that act on your kidneys to help your body eliminate sodium and water, reducing blood volume. Thiazide diuretics are often the first \u0026mdash; but not the only \u0026mdash; choice in high blood pressure medications. If you're not taking a diuretic and your blood pressure remains high, talk to your doctor about adding one or replacing a drug you currently take with a diuretic.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eBeta blockers.\u003c/strong\u003e These medications reduce the workload on your heart and open your blood vessels, causing your heart to beat slower and with less force. When prescribed alone, beta blockers don't work as well in blacks or in older adults \u0026mdash; but they're effective when combined with a thiazide diuretic.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eAngiotensin-converting enzyme (ACE) inhibitors.\u003c/strong\u003e These medications help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eAngiotensin II receptor blockers (ARBs).\u003c/strong\u003e These medications help relax blood vessels by blocking the action \u0026mdash; not the formation \u0026mdash; of a natural chemical that narrows blood vessels.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eCalcium channel blockers.\u003c/strong\u003e These medications help relax the muscles of your blood vessels. Some slow your heart rate. Calcium channel blockers may work better for blacks and older adults than do ACE inhibitors or beta blockers alone. A word of caution for grapefruit lovers, though. Grapefruit juice interacts with some calcium channel blockers, increasing blood levels of the medication and putting you at higher risk of side effects. Talk to your doctor or pharmacist if you're concerned about interactions.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eRenin inhibitors.\u003c/strong\u003e Aliskiren (Tekturna) slows down the production of renin, an enzyme produced by your kidneys that starts a chain of chemical steps that increases blood pressure. Tekturna works by reducing the ability of renin to begin this process. Due to a risk of serious complications, including stroke, you shouldn't take aliskiren with ACE inhibitors or ARBs.\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eIf you're having trouble reaching your blood pressure goal with combinations of the above medications, your doctor may prescribe: \u003c/p\u003e\u003cul\u003e    \u003cli\u003e\u003cstrong\u003eAlpha blockers.\u003c/strong\u003e These medications reduce nerve impulses to blood vessels, reducing the effects of natural chemicals that narrow blood vessels.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eAlpha-beta blockers.\u003c/strong\u003e In addition to reducing nerve impulses to blood vessels, alpha-beta blockers slow the heartbeat to reduce the amount of blood that must be pumped through the vessels.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eCentral-acting agents.\u003c/strong\u003e These medications prevent your brain from signaling your nervous system to increase your heart rate and narrow your blood vessels.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eVasodilators.\u003c/strong\u003e These medications work directly on the muscles in the walls of your arteries, preventing the muscles from tightening and your arteries from narrowing.\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eOnce your blood pressure is under control, your doctor may have you take a daily aspirin to reduce your risk of cardiovascular disorders. \u003c/p\u003e\u003cp\u003eTo reduce the number of daily medication doses you need, your doctor may prescribe a combination of low-dose medications rather than larger doses of one single drug. In fact, two or more blood pressure drugs often work better than one. Sometimes finding the most effective medication \u0026mdash; or combination of drugs \u0026mdash; is a matter of trial and error. \u003c/p\u003e\u003ch3\u003eLifestyle changes to treat high blood pressure\u003c/h3\u003e\u003cp\u003eNo matter what medications your doctor prescribes to treat your high blood pressure, you'll need to make lifestyle changes to lower your blood pressure. These changes usually include eating a healthier diet with less salt (the Dietary Approaches to Stop Hypertension, or DASH, diet), exercising more, quitting smoking and losing weight. \u003c/p\u003e\u003ch3\u003eResistant hypertension: When your blood pressure is difficult to control\u003c/h3\u003e\u003cp\u003eIf your blood pressure remains stubbornly high despite taking at least three different types of high blood pressure drugs, one of which should be a diuretic, you may have resistant hypertension. Resistant hypertension is blood pressure that's resistant to treatment. People who have controlled high blood pressure but are taking four different types of medications at the same time to achieve that control also are considered to have resistant hypertension. \u003c/p\u003e\u003cp\u003eHaving resistant hypertension doesn't mean your blood pressure will never get lower. In fact, if you and your doctor can identify what's behind your persistently high blood pressure, there's a good chance you can meet your goal with the help of treatment that's more effective. \u003c/p\u003e\u003cp\u003eYour doctor or hypertension specialist can evaluate whether the medications and doses you're taking for your high blood pressure are appropriate. You may have to fine-tune your medications to come up with the most effective combination and doses. \u003c/p\u003e\u003cp\u003eIn addition, you and your doctor can review medications you're taking for other conditions. Some medications, foods or supplements can worsen high blood pressure or prevent your high blood pressure medications from working effectively. Be open and honest with your doctor about all the medications or supplements you take. \u003c/p\u003e\u003cp\u003eIf you don't take your high blood pressure medications exactly as directed, your blood pressure can pay the price. If you skip doses because you can't afford the medication, because you have side effects or because you simply forget to take your medications, talk to your doctor about solutions. Don't change your treatment without your doctor's guidance. \u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class='section'\u003e\u003cdiv class='SectionHead'\u003eLifestyle and home remedies\u003c/div\u003e\u003cdiv class='SectionHTML'\u003e\u003cp\u003eLifestyle changes can help you control and prevent high blood pressure \u0026mdash; even if you're taking blood pressure medication. Here's what you can do: \u003c/p\u003e\u003cul\u003e    \u003cli\u003e\u003cstrong\u003eEat healthy foods.\u003c/strong\u003e Try the Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fruits, vegetables, whole grains and low-fat dairy foods. Get plenty of potassium, which can help prevent and control high blood pressure. Eat less saturated fat and total fat.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eDecrease the salt in your diet.\u003c/strong\u003e A lower sodium level \u0026mdash; 1,500 milligrams (mg) a day \u0026mdash; is appropriate for people 51 years of age or older, and individuals of any age who are African-American or who have hypertension, diabetes or chronic kidney disease. Otherwise healthy people can aim for 2,300 mg a day or less. While you can reduce the amount of salt you eat by putting down the saltshaker, you should also pay attention to the amount of salt that's in the processed foods you eat, such as canned soups or frozen dinners.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eMaintain a healthy weight.\u003c/strong\u003e If you're overweight, losing even 5 pounds (2.3 kilograms) can lower your blood pressure.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eIncrease physical activity.\u003c/strong\u003e Regular physical activity can help lower your blood pressure and keep your weight under control. Strive for at least 30 minutes of physical activity a day.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eLimit alcohol.\u003c/strong\u003e Even if you're healthy, alcohol can raise your blood pressure. If you choose to drink alcohol, do so in moderation \u0026mdash; up to one drink a day for women and everyone older than age 65, and two drinks a day for men.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eDon't smoke.\u003c/strong\u003e Tobacco injures blood vessel walls and speeds up the process of hardening of the arteries. If you smoke, ask your doctor to help you quit.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eManage stress.\u003c/strong\u003e Reduce stress as much as possible. Practice healthy coping techniques, such as muscle relaxation and deep breathing. Getting plenty of sleep can help, too.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eMonitor your blood pressure at home.\u003c/strong\u003e Home blood pressure monitoring can help you keep closer tabs on your blood pressure, show if medication is working, and even alert you and your doctor to potential complications. If your blood pressure is under control, you may be able to make fewer visits to your doctor if you monitor your blood pressure at home.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003ePractice relaxation or slow, deep breathing.\u003c/strong\u003e Practice taking deep, slow breaths to help relax. There are some devices available that can help guide your breathing for relaxation; however, it's questionable whether these devices have a significant effect on lowering your blood pressure.\u003c/li\u003e\u003c/ul\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class='section'\u003e\u003cdiv class='SectionHead'\u003eAlternative medicine\u003c/div\u003e\u003cdiv class='SectionHTML'\u003e\u003cp\u003eAlthough diet and exercise are the best tactics to lower your blood pressure, some supplements also may help decrease it. These include: \u003c/p\u003e\u003cul\u003e    \u003cli\u003eAlpha-linolenic acid\u003c/li\u003e    \u003cli\u003eBlond psyllium\u003c/li\u003e    \u003cli\u003eCalcium\u003c/li\u003e    \u003cli\u003eCocoa\u003c/li\u003e    \u003cli\u003eCod-liver oil\u003c/li\u003e    \u003cli\u003eCoenzyme Q10\u003c/li\u003e    \u003cli\u003eOmega-3 fatty acids\u003c/li\u003e    \u003cli\u003eGarlic\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eWhile it's best to include these supplements in your diet as foods, you can also take supplement pills or capsules. Talk to your doctor before adding any of these supplements to your blood pressure treatment. Some supplements can interact with medications, causing harmful side effects, such as an increased bleeding risk that could be fatal. \u003c/p\u003e\u003cp\u003eYou can also practice relaxation techniques, such as yoga or deep breathing, to help you relax and reduce your stress level. These practices can temporarily reduce your blood pressure. \u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class='section'\u003e\u003cdiv class='SectionHead'\u003eCoping and support\u003c/div\u003e\u003cdiv class='SectionHTML'\u003e\u003cp\u003eHigh blood pressure isn't a problem that you can treat and then ignore. It's a condition you need to manage for the rest of your life. To keep your blood pressure under control: \u003c/p\u003e\u003cul\u003e    \u003cli\u003e\u003cstrong\u003eTake your medications properly.\u003c/strong\u003e If side effects or costs pose problems, don't stop taking your medications. Ask your doctor about other options.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eSchedule regular doctor visits.\u003c/strong\u003e It takes a team effort to treat high blood pressure successfully. Your doctor can't do it alone, and neither can you. Work with your doctor to bring your blood pressure to a safe level \u0026mdash; and keep it there.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eAdopt healthy habits.\u003c/strong\u003e Eat healthy foods, lose excess weight and get regular physical activity. Limit alcohol. If you smoke, quit.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eManage stress.\u003c/strong\u003e Say no to extra tasks, release negative thoughts, maintain good relationships, and remain patient and optimistic.\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eSticking to lifestyle changes can be difficult \u0026mdash; especially if you don't see or feel any symptoms of high blood pressure. If you need motivation, remember the risks associated with uncontrolled high blood pressure. It may help to enlist the support of your family and friends as well. \u003c/p\u003e\u003c/div\u003e\u003c/div\u003e","doc_id":"CON-20019580","object_id":"900bc2fb-b3d9-4860-b7ec-4736d77a5e20","updated_at":"2012-07-03","meta_keywords":"","benefit_summary":"","sections":{"Definition":"\u003cp\u003eHigh blood pressure is a common condition in which the force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease. \u003c/p\u003e\u003cp\u003eBlood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure. \u003c/p\u003e\u003cp\u003eYou can have high blood pressure (hypertension) for years without any symptoms. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke. \u003c/p\u003e\u003cp\u003eHigh blood pressure typically develops over many years, and it affects nearly everyone eventually. Fortunately, high blood pressure can be easily detected. And once you know you have high blood pressure, you can work with your doctor to control it. \u003c/p\u003e","Symptoms":"\u003cp\u003eMost people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels. \u003c/p\u003e\u003cp\u003eAlthough a few people with early-stage high blood pressure may have dull headaches, dizzy spells or a few more nosebleeds than normal, these signs and symptoms typically don't occur until high blood pressure has reached a severe \u0026mdash; even life-threatening \u0026mdash; stage. \u003c/p\u003e\u003ch3\u003eWhen to see a doctor\u003c/h3\u003e\u003cp\u003eYou'll likely have your blood pressure taken as part of a routine doctor's appointment. \u003c/p\u003e\u003cp\u003eAsk your doctor for a blood pressure reading at least every two years starting at age 18. He or she will likely recommend more frequent readings if you've already been diagnosed with high blood pressure or other risk factors for cardiovascular disease. Children age 3 and older will usually have their blood pressure measured as a part of their yearly checkups. \u003c/p\u003e\u003cp\u003eIf you don't regularly see your doctor, you may be able to get a free blood pressure screening at a health resource fair or other locations in your community. You can also find machines in some stores that will measure your blood pressure for free, but these machines can give you inaccurate results. \u003c/p\u003e","Causes":"\u003cp\u003eThere are two types of high blood pressure. \u003c/p\u003e\u003ch3\u003ePrimary (essential) hypertension\u003c/h3\u003e\u003cp\u003eFor most adults, there's no identifiable cause of high blood pressure. This type of high blood pressure, called essential hypertension or primary hypertension, tends to develop gradually over many years. \u003c/p\u003e\u003ch3\u003eSecondary hypertension\u003c/h3\u003e\u003cp\u003eSome people have high blood pressure caused by an underlying condition. This type of high blood pressure, called secondary hypertension, tends to appear suddenly and cause higher blood pressure than does primary hypertension. Various conditions and medications can lead to secondary hypertension, including: \u003c/p\u003e\u003cul\u003e    \u003cli\u003eKidney problems\u003c/li\u003e    \u003cli\u003eAdrenal gland tumors\u003c/li\u003e    \u003cli\u003eCertain defects in blood vessels you're born with (congenital)\u003c/li\u003e    \u003cli\u003eCertain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs\u003c/li\u003e    \u003cli\u003eIllegal drugs, such as cocaine and amphetamines\u003c/li\u003e\u003c/ul\u003e","Risk factors":"\u003cp\u003eHigh blood pressure has many risk factors, including: \u003c/p\u003e\u003cul\u003e    \u003cli\u003e\u003cstrong\u003eAge.\u003c/strong\u003e The risk of high blood pressure increases as you age. Through early middle age, high blood pressure is more common in men. Women are more likely to develop high blood pressure after menopause.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eRace.\u003c/strong\u003e High blood pressure is particularly common among blacks, often developing at an earlier age than it does in whites. Serious complications, such as stroke and heart attack, also are more common in blacks.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eFamily history.\u003c/strong\u003e High blood pressure tends to run in families.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eBeing overweight or obese.\u003c/strong\u003e The more you weigh, the more blood you need to supply oxygen and nutrients to your tissues. As the volume of blood circulated through your blood vessels increases, so does the pressure on your artery walls.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eNot being physically active.\u003c/strong\u003e People who are inactive tend to have higher heart rates. The higher your heart rate, the harder your heart must work with each contraction \u0026mdash; and the stronger the force on your arteries. Lack of physical activity also increases the risk of being overweight.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eUsing tobacco.\u003c/strong\u003e Not only does smoking or chewing tobacco immediately raise your blood pressure temporarily, but the chemicals in tobacco can damage the lining of your artery walls. This can cause your arteries to narrow, increasing your blood pressure. Secondhand smoke also can increase your blood pressure.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eToo much salt (sodium) in your diet.\u003c/strong\u003e Too much sodium in your diet can cause your body to retain fluid, which increases blood pressure.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eToo little potassium in your diet.\u003c/strong\u003e Potassium helps balance the amount of sodium in your cells. If you don't get enough potassium in your diet or retain enough potassium, you may accumulate too much sodium in your blood.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eToo little vitamin D in your diet.\u003c/strong\u003e It's uncertain if having too little vitamin D in your diet can lead to high blood pressure. Vitamin D may affect an enzyme produced by your kidneys that affects your blood pressure.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eDrinking too much alcohol.\u003c/strong\u003e Over time, heavy drinking can damage your heart. Having more than two drinks a day can raise your blood pressure.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eStress.\u003c/strong\u003e High levels of stress can lead to a temporary, but dramatic, increase in blood pressure. If you try to relax by eating more, using tobacco or drinking alcohol, you may only increase problems with high blood pressure.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eCertain chronic conditions.\u003c/strong\u003e Certain chronic conditions also may increase your risk of high blood pressure, including high cholesterol, diabetes, kidney disease and sleep apnea.\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eSometimes pregnancy contributes to high blood pressure, as well. \u003c/p\u003e\u003cp\u003eAlthough high blood pressure is most common in adults, children may be at risk, too. For some children, high blood pressure is caused by problems with the kidneys or heart. But for a growing number of kids, poor lifestyle habits \u0026mdash; such as an unhealthy diet and lack of exercise \u0026mdash; contribute to high blood pressure. \u003c/p\u003e","Complications":"\u003cp\u003eThe excessive pressure on your artery walls caused by high blood pressure can damage your blood vessels, as well as organs in your body. The higher your blood pressure and the longer it goes uncontrolled, the greater the damage. \u003c/p\u003e\u003cp\u003eUncontrolled high blood pressure can lead to: \u003c/p\u003e\u003cul\u003e    \u003cli\u003e\u003cstrong\u003eHeart attack or stroke.\u003c/strong\u003e High blood pressure can cause hardening and thickening of the arteries (atherosclerosis), which can lead to a heart attack, stroke or other complications.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eAneurysm.\u003c/strong\u003e Increased blood pressure can cause your blood vessels to weaken and bulge, forming an aneurysm. If an aneurysm ruptures, it can be life-threatening.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eHeart failure.\u003c/strong\u003e To pump blood against the higher pressure in your vessels, your heart muscle thickens. Eventually, the thickened muscle may have a hard time pumping enough blood to meet your body's needs, which can lead to heart failure.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eWeakened and narrowed blood vessels in your kidneys.\u003c/strong\u003e This can prevent these organs from functioning normally.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eThickened, narrowed or torn blood vessels in the eyes.\u003c/strong\u003e This can result in vision loss.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eMetabolic syndrome.\u003c/strong\u003e This syndrome is a cluster of disorders of your body's metabolism \u0026mdash; including increased waist circumference, high triglycerides, low high-density lipoprotein (HDL), or \"good,\" cholesterol, high blood pressure, and high insulin levels. If you have high blood pressure, you're more likely to have other components of metabolic syndrome. The more components you have, the greater your risk of developing diabetes, heart disease or stroke.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eTrouble with memory or understanding.\u003c/strong\u003e Uncontrolled high blood pressure may also affect your ability to think, remember and learn. Trouble with memory or understanding concepts is more common in people who have high blood pressure.\u003c/li\u003e\u003c/ul\u003e","Preparing for your appointment":"\u003cp\u003eIf you think you may have high blood pressure, make an appointment with your family doctor to have your blood pressure checked. \u003c/p\u003e\u003cp\u003eNo special preparations are necessary to have your blood pressure checked. You might want to wear a short-sleeve shirt to your appointment so that the blood pressure cuff can fit around your arm properly. You might want to avoid caffeinated food and drinks right before your test. You should also use the toilet before having your blood pressure measured. \u003c/p\u003e\u003cp\u003eBecause some medications \u0026mdash; such as over-the-counter cold medicines, antidepressants, birth control pills and others \u0026mdash; can raise your blood pressure, it might be a good idea to bring a list of medications and supplements you take to your doctor's appointment. Don't stop taking any prescription medications that you think may affect your blood pressure without your doctor's advice. \u003c/p\u003e\u003cp\u003eBecause appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor. \u003c/p\u003e\u003ch3\u003eWhat you can do\u003c/h3\u003e\u003cul\u003e    \u003cli\u003e\u003cstrong\u003eWrite down any symptoms you're experiencing.\u003c/strong\u003e High blood pressure seldom has symptoms, but it is a risk factor for heart disease. Letting your doctor know if you have symptoms like chest pains or shortness of breath can help your doctor decide how aggressively your high blood pressure needs to be treated.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eWrite down key personal information,\u003c/strong\u003e including a family history of high blood pressure, high cholesterol, heart disease, stroke or diabetes, and any major stresses or recent life changes.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eMake a list of all medications,\u003c/strong\u003e vitamins or supplements that you're taking.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eTake a family member or friend along,\u003c/strong\u003e if possible. Sometimes it can be difficult to soak up all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eBe prepared to discuss\u003c/strong\u003e your diet and exercise habits. If you don't already follow a diet or exercise routine, be ready to talk to your doctor about any challenges you might face in getting started.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eWrite down questions to ask\u003c/strong\u003e your doctor.\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eYour time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For high blood pressure, some basic questions to ask your doctor include: \u003c/p\u003e\u003cul\u003e    \u003cli\u003eWhat kinds of tests will I need?\u003c/li\u003e    \u003cli\u003eDo I need any medications?\u003c/li\u003e    \u003cli\u003eWhat foods should I eat or avoid?\u003c/li\u003e    \u003cli\u003eWhat's an appropriate level of physical activity?\u003c/li\u003e    \u003cli\u003eHow often do I need to schedule appointments to check my blood pressure?\u003c/li\u003e    \u003cli\u003eShould I monitor my blood pressure at home?\u003c/li\u003e    \u003cli\u003eWhat are the alternatives to the primary approach that you're suggesting?\u003c/li\u003e    \u003cli\u003eI have other health conditions. How can I best manage them together?\u003c/li\u003e    \u003cli\u003eAre there any restrictions that I need to follow?\u003c/li\u003e    \u003cli\u003eShould I see a specialist?\u003c/li\u003e    \u003cli\u003eIs there a generic alternative to the medicine you're prescribing for me?\u003c/li\u003e    \u003cli\u003eAre there any brochures or other printed material that I can take home with me?\u003c/li\u003e    \u003cli\u003eWhat websites do you recommend visiting?\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eIn addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something. \u003c/p\u003e\u003ch3\u003eWhat to expect from your doctor\u003c/h3\u003e\u003cp\u003eYour doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask: \u003c/p\u003e\u003cul\u003e    \u003cli\u003eDo you have a family history of high cholesterol, high blood pressure or heart disease?\u003c/li\u003e    \u003cli\u003eWhat are your diet and exercise habits like?\u003c/li\u003e    \u003cli\u003eDo you drink alcohol? How many drinks do you have in a week?\u003c/li\u003e    \u003cli\u003eDo you smoke?\u003c/li\u003e    \u003cli\u003eWhen did you last have your blood pressure checked? What was your blood pressure measurement then?\u003c/li\u003e\u003c/ul\u003e\u003ch3\u003eWhat you can do in the meantime\u003c/h3\u003e\u003cp\u003eIt's never too early to make healthy lifestyle changes, such as quitting smoking, eating healthy foods and becoming more physically active. These are primary lines of defense against high blood pressure and its complications, including heart attack and stroke. \u003c/p\u003e","Tests and diagnosis":"\u003cp\u003eBlood pressure is measured with an inflatable arm cuff and a pressure-measuring gauge. A blood pressure reading, given in millimeters of mercury (mm Hg), has two numbers. The first, or upper, number measures the pressure in your arteries when your heart beats (systolic pressure). The second, or lower, number measures the pressure in your arteries between beats (diastolic pressure).\u003c/p\u003e\u003cp\u003eBlood pressure measurements fall into four general categories: \u003c/p\u003e\u003cul\u003e    \u003cli\u003e\u003cstrong\u003eNormal blood pressure.\u003c/strong\u003e Your blood pressure is normal if it's below 120/80 mm Hg. However, some doctors recommend 115/75 mm Hg as a better goal. Once blood pressure rises above 115/75 mm Hg, the risk of cardiovascular disease begins to increase. \u003c/li\u003e    \u003cli\u003e\u003cstrong\u003ePrehypertension.\u003c/strong\u003e Prehypertension is a systolic pressure ranging from 120 to 139 mm Hg or a diastolic pressure ranging from 80 to 89 mm Hg. Prehypertension tends to get worse over time. \u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eStage 1 hypertension.\u003c/strong\u003e Stage 1 hypertension is a systolic pressure ranging from 140 to 159 mm Hg or a diastolic pressure ranging from 90 to 99 mm Hg. \u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eStage 2 hypertension.\u003c/strong\u003e More severe hypertension, stage 2 hypertension is a systolic pressure of 160 mm Hg or higher or a diastolic pressure of 100 mm Hg or higher. \u003c/li\u003e\u003c/ul\u003e\u003cp\u003eBoth numbers in a blood pressure reading are important. But after age 50, the systolic reading is even more significant. Isolated systolic hypertension \u0026mdash; when diastolic pressure is normal but systolic pressure is high \u0026mdash; is the most common type of high blood pressure among people older than 50. \u003c/p\u003e\u003cp\u003eYour doctor will likely take two to three blood pressure readings each at two or more separate appointments before diagnosing you with high blood pressure. This is because blood pressure normally varies throughout the day \u0026mdash; and sometimes specifically during visits to the doctor, a condition called white-coat hypertension. Your doctor may ask you to record your blood pressure at home and at work to provide additional information. \u003c/p\u003e\u003cp\u003eIf you have any type of high blood pressure, your doctor may recommend routine tests, such as a urine test (urinalysis), blood tests and an electrocardiogram (ECG) \u0026mdash; a test that measures your heart's electrical activity. Your doctor may also recommend additional tests, such as a cholesterol test, to check for more signs of heart disease. \u003c/p\u003e\u003ch3\u003eTaking your blood pressure at home\u003c/h3\u003e\u003cp\u003eAn important way to check if your blood pressure treatment is working, or to diagnose worsening high blood pressure, is to monitor your blood pressure at home. Home blood pressure monitors are widely available, and you don't need a prescription to buy one. Talk to your doctor about how to get started. \u003c/p\u003e","Treatments and drugs":"\u003cp\u003eYour blood pressure treatment goal depends on how healthy you are. \u003c/p\u003e\u003ctable\u003e    \u003ctbody\u003e        \u003ctr\u003e            \u003cth colspan=\"2\"\u003eBlood pressure treatment goals* \u003c/th\u003e        \u003c/tr\u003e        \u003ctr\u003e            \u003ctd\u003e140/90 mm Hg or lower \u003c/td\u003e            \u003ctd\u003eIf you are a healthy adult \u003c/td\u003e        \u003c/tr\u003e        \u003ctr\u003e            \u003ctd\u003e130/80 mm Hg or lower \u003c/td\u003e            \u003ctd\u003eIf you have chronic kidney disease, diabetes or coronary artery disease or are at high risk of coronary artery disease \u003c/td\u003e        \u003c/tr\u003e        \u003ctr\u003e            \u003ctd\u003e120/80 mm Hg or lower \u003c/td\u003e            \u003ctd\u003eIf your heart isn't pumping as well as it should (left ventricular dysfunction or heart failure) or you have severe chronic kidney disease \u003c/td\u003e        \u003c/tr\u003e    \u003c/tbody\u003e\u003c/table\u003e\u003cp\u003e*Although 120/80 mm Hg or lower is the ideal blood pressure goal, doctors are unsure if you need treatment (medications) to reach that level. \u003c/p\u003e\u003cp\u003eIf you're an adult age 80 or older and your blood pressure is very high, your doctor may set a target blood pressure goal for you that's slightly higher than 140/90 mm Hg. \u003c/p\u003e\u003cp\u003eChanging your lifestyle can go a long way toward controlling high blood pressure. But sometimes lifestyle changes aren't enough. In addition to diet and exercise, your doctor may recommend medication to lower your blood pressure. Which category of medication your doctor prescribes depends on your stage of high blood pressure and whether you also have other medical problems. \u003c/p\u003e\u003ch3\u003eMedications to treat high blood pressure\u003c/h3\u003e\u003cul\u003e    \u003cli\u003e\u003cstrong\u003eThiazide diuretics.\u003c/strong\u003e Diuretics, sometimes called water pills, are medications that act on your kidneys to help your body eliminate sodium and water, reducing blood volume. Thiazide diuretics are often the first \u0026mdash; but not the only \u0026mdash; choice in high blood pressure medications. If you're not taking a diuretic and your blood pressure remains high, talk to your doctor about adding one or replacing a drug you currently take with a diuretic.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eBeta blockers.\u003c/strong\u003e These medications reduce the workload on your heart and open your blood vessels, causing your heart to beat slower and with less force. When prescribed alone, beta blockers don't work as well in blacks or in older adults \u0026mdash; but they're effective when combined with a thiazide diuretic.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eAngiotensin-converting enzyme (ACE) inhibitors.\u003c/strong\u003e These medications help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eAngiotensin II receptor blockers (ARBs).\u003c/strong\u003e These medications help relax blood vessels by blocking the action \u0026mdash; not the formation \u0026mdash; of a natural chemical that narrows blood vessels.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eCalcium channel blockers.\u003c/strong\u003e These medications help relax the muscles of your blood vessels. Some slow your heart rate. Calcium channel blockers may work better for blacks and older adults than do ACE inhibitors or beta blockers alone. A word of caution for grapefruit lovers, though. Grapefruit juice interacts with some calcium channel blockers, increasing blood levels of the medication and putting you at higher risk of side effects. Talk to your doctor or pharmacist if you're concerned about interactions.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eRenin inhibitors.\u003c/strong\u003e Aliskiren (Tekturna) slows down the production of renin, an enzyme produced by your kidneys that starts a chain of chemical steps that increases blood pressure. Tekturna works by reducing the ability of renin to begin this process. Due to a risk of serious complications, including stroke, you shouldn't take aliskiren with ACE inhibitors or ARBs.\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eIf you're having trouble reaching your blood pressure goal with combinations of the above medications, your doctor may prescribe: \u003c/p\u003e\u003cul\u003e    \u003cli\u003e\u003cstrong\u003eAlpha blockers.\u003c/strong\u003e These medications reduce nerve impulses to blood vessels, reducing the effects of natural chemicals that narrow blood vessels.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eAlpha-beta blockers.\u003c/strong\u003e In addition to reducing nerve impulses to blood vessels, alpha-beta blockers slow the heartbeat to reduce the amount of blood that must be pumped through the vessels.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eCentral-acting agents.\u003c/strong\u003e These medications prevent your brain from signaling your nervous system to increase your heart rate and narrow your blood vessels.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eVasodilators.\u003c/strong\u003e These medications work directly on the muscles in the walls of your arteries, preventing the muscles from tightening and your arteries from narrowing.\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eOnce your blood pressure is under control, your doctor may have you take a daily aspirin to reduce your risk of cardiovascular disorders. \u003c/p\u003e\u003cp\u003eTo reduce the number of daily medication doses you need, your doctor may prescribe a combination of low-dose medications rather than larger doses of one single drug. In fact, two or more blood pressure drugs often work better than one. Sometimes finding the most effective medication \u0026mdash; or combination of drugs \u0026mdash; is a matter of trial and error. \u003c/p\u003e\u003ch3\u003eLifestyle changes to treat high blood pressure\u003c/h3\u003e\u003cp\u003eNo matter what medications your doctor prescribes to treat your high blood pressure, you'll need to make lifestyle changes to lower your blood pressure. These changes usually include eating a healthier diet with less salt (the Dietary Approaches to Stop Hypertension, or DASH, diet), exercising more, quitting smoking and losing weight. \u003c/p\u003e\u003ch3\u003eResistant hypertension: When your blood pressure is difficult to control\u003c/h3\u003e\u003cp\u003eIf your blood pressure remains stubbornly high despite taking at least three different types of high blood pressure drugs, one of which should be a diuretic, you may have resistant hypertension. Resistant hypertension is blood pressure that's resistant to treatment. People who have controlled high blood pressure but are taking four different types of medications at the same time to achieve that control also are considered to have resistant hypertension. \u003c/p\u003e\u003cp\u003eHaving resistant hypertension doesn't mean your blood pressure will never get lower. In fact, if you and your doctor can identify what's behind your persistently high blood pressure, there's a good chance you can meet your goal with the help of treatment that's more effective. \u003c/p\u003e\u003cp\u003eYour doctor or hypertension specialist can evaluate whether the medications and doses you're taking for your high blood pressure are appropriate. You may have to fine-tune your medications to come up with the most effective combination and doses. \u003c/p\u003e\u003cp\u003eIn addition, you and your doctor can review medications you're taking for other conditions. Some medications, foods or supplements can worsen high blood pressure or prevent your high blood pressure medications from working effectively. Be open and honest with your doctor about all the medications or supplements you take. \u003c/p\u003e\u003cp\u003eIf you don't take your high blood pressure medications exactly as directed, your blood pressure can pay the price. If you skip doses because you can't afford the medication, because you have side effects or because you simply forget to take your medications, talk to your doctor about solutions. Don't change your treatment without your doctor's guidance. \u003c/p\u003e","Lifestyle and home remedies":"\u003cp\u003eLifestyle changes can help you control and prevent high blood pressure \u0026mdash; even if you're taking blood pressure medication. Here's what you can do: \u003c/p\u003e\u003cul\u003e    \u003cli\u003e\u003cstrong\u003eEat healthy foods.\u003c/strong\u003e Try the Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fruits, vegetables, whole grains and low-fat dairy foods. Get plenty of potassium, which can help prevent and control high blood pressure. Eat less saturated fat and total fat.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eDecrease the salt in your diet.\u003c/strong\u003e A lower sodium level \u0026mdash; 1,500 milligrams (mg) a day \u0026mdash; is appropriate for people 51 years of age or older, and individuals of any age who are African-American or who have hypertension, diabetes or chronic kidney disease. Otherwise healthy people can aim for 2,300 mg a day or less. While you can reduce the amount of salt you eat by putting down the saltshaker, you should also pay attention to the amount of salt that's in the processed foods you eat, such as canned soups or frozen dinners.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eMaintain a healthy weight.\u003c/strong\u003e If you're overweight, losing even 5 pounds (2.3 kilograms) can lower your blood pressure.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eIncrease physical activity.\u003c/strong\u003e Regular physical activity can help lower your blood pressure and keep your weight under control. Strive for at least 30 minutes of physical activity a day.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eLimit alcohol.\u003c/strong\u003e Even if you're healthy, alcohol can raise your blood pressure. If you choose to drink alcohol, do so in moderation \u0026mdash; up to one drink a day for women and everyone older than age 65, and two drinks a day for men.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eDon't smoke.\u003c/strong\u003e Tobacco injures blood vessel walls and speeds up the process of hardening of the arteries. If you smoke, ask your doctor to help you quit.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eManage stress.\u003c/strong\u003e Reduce stress as much as possible. Practice healthy coping techniques, such as muscle relaxation and deep breathing. Getting plenty of sleep can help, too.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eMonitor your blood pressure at home.\u003c/strong\u003e Home blood pressure monitoring can help you keep closer tabs on your blood pressure, show if medication is working, and even alert you and your doctor to potential complications. If your blood pressure is under control, you may be able to make fewer visits to your doctor if you monitor your blood pressure at home.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003ePractice relaxation or slow, deep breathing.\u003c/strong\u003e Practice taking deep, slow breaths to help relax. There are some devices available that can help guide your breathing for relaxation; however, it's questionable whether these devices have a significant effect on lowering your blood pressure.\u003c/li\u003e\u003c/ul\u003e","Alternative medicine":"\u003cp\u003eAlthough diet and exercise are the best tactics to lower your blood pressure, some supplements also may help decrease it. These include: \u003c/p\u003e\u003cul\u003e    \u003cli\u003eAlpha-linolenic acid\u003c/li\u003e    \u003cli\u003eBlond psyllium\u003c/li\u003e    \u003cli\u003eCalcium\u003c/li\u003e    \u003cli\u003eCocoa\u003c/li\u003e    \u003cli\u003eCod-liver oil\u003c/li\u003e    \u003cli\u003eCoenzyme Q10\u003c/li\u003e    \u003cli\u003eOmega-3 fatty acids\u003c/li\u003e    \u003cli\u003eGarlic\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eWhile it's best to include these supplements in your diet as foods, you can also take supplement pills or capsules. Talk to your doctor before adding any of these supplements to your blood pressure treatment. Some supplements can interact with medications, causing harmful side effects, such as an increased bleeding risk that could be fatal. \u003c/p\u003e\u003cp\u003eYou can also practice relaxation techniques, such as yoga or deep breathing, to help you relax and reduce your stress level. These practices can temporarily reduce your blood pressure. \u003c/p\u003e","Coping and support":"\u003cp\u003eHigh blood pressure isn't a problem that you can treat and then ignore. It's a condition you need to manage for the rest of your life. To keep your blood pressure under control: \u003c/p\u003e\u003cul\u003e    \u003cli\u003e\u003cstrong\u003eTake your medications properly.\u003c/strong\u003e If side effects or costs pose problems, don't stop taking your medications. Ask your doctor about other options.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eSchedule regular doctor visits.\u003c/strong\u003e It takes a team effort to treat high blood pressure successfully. Your doctor can't do it alone, and neither can you. Work with your doctor to bring your blood pressure to a safe level \u0026mdash; and keep it there.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eAdopt healthy habits.\u003c/strong\u003e Eat healthy foods, lose excess weight and get regular physical activity. Limit alcohol. If you smoke, quit.\u003c/li\u003e    \u003cli\u003e\u003cstrong\u003eManage stress.\u003c/strong\u003e Say no to extra tasks, release negative thoughts, maintain good relationships, and remain patient and optimistic.\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eSticking to lifestyle changes can be difficult \u0026mdash; especially if you don't see or feel any symptoms of high blood pressure. If you need motivation, remember the risks associated with uncontrolled high blood pressure. It may help to enlist the support of your family and friends as well. \u003c/p\u003e"},"has_flash":false,"flash_content_url":null,"flash_content_height":null,"flash_content_width":null}