Established High Blood Pressure

High blood pressure (hypertension) is a long-term (chronic) disease. Often healthcare providers don’t know what causes it. But it can be caused by certain health conditions and medicines.

If you have high blood pressure, you may not have any symptoms. If you do have symptoms, they may include:

  • Headache

  • Dizziness

  • Changes in your vision

  • Chest pain

  • Shortness of breath

But even without symptoms, high blood pressure that’s not treated raises your risk for heart attack, heart failure, kidney disease, and stroke. High blood pressure is a serious health risk and shouldn’t be ignored.

Blood pressure measurements are given as 2 numbers. Systolic blood pressure is the upper number. This is the pressure when the heart contracts. Diastolic blood pressure is the lower number. This is the pressure when the heart relaxes between beats. You will see your blood pressure readings written together. For example, a person with a systolic pressure of 118 and a diastolic pressure of 78 will have 118/78 written in the medical record.

Blood pressure is classified as normal, raised (elevated) or stage 1 or stage 2 high blood pressure:

  • Normal blood pressure. Systolic of less than 120 and diastolic of less than 80 (120/80).

  • Elevated blood pressure. Systolic of 120 to 129 and diastolic less than 80.

  • Stage 1 high blood pressure. Systolic is 130 to 139 or diastolic between 80 to 89.

  • Stage 2 high blood pressure. Systolic is 140 or higher or the diastolic is 90 or higher.

Home care

If you have high blood pressure, follow these home care guidelines to help lower your blood pressure. If you are taking medicines for high blood pressure, these methods may reduce or end your need for medicines in the future.

  • Start a weight-loss program if you are overweight.

  • Cut back on how much salt you get in your diet. Here’s how to do this:

    • Don’t eat foods that have a lot of salt. These include olives, pickles, smoked meats, and salted potato chips.

    • Don’t add salt to your food at the table.

    • Use only small amounts of salt when cooking.

  • Start an exercise program. Talk with your healthcare provider about the type of exercise program that would be best for you. It doesn't have to be hard. Even brisk walking for 20 minutes 3 times a week is a good form of exercise.

  • Don’t take medicines that stimulate the heart. This includes many over-the-counter cold and sinus decongestant pills and sprays, as well as diet pills. Check the warnings about high blood pressure on the label. Before buying any over-the-counter medicines or supplements, always ask the pharmacist about the product's possible interaction with your high blood pressure and your high blood pressure medicines.

  • Stimulants such as amphetamine or cocaine could be deadly for someone with high blood pressure. Never take these.

  • Limit how much caffeine you get in your diet. Switch to caffeine-free products.

  • Stop smoking. If you are a long-time smoker, this can be hard. Talk with your healthcare provider about medicines and nicotine replacement options to help you. Also join a stop-smoking program. This makes it more likely that you will quit for good.

  • Learn how to handle stress. This is an important part of any program to lower blood pressure. Learn about relaxation methods such as meditation, yoga, or biofeedback.

  • If your provider prescribed medicines, take them exactly as directed. Missing doses may cause your blood pressure to get out of control.

  • If you miss a dose, check with your healthcare provider or pharmacist about what to do.

  • Think about buying an automatic blood pressure machine to check your blood pressure at home. Ask your provider for a recommendation. You can get one of these at most pharmacies.

Using a home blood pressure monitor

Arm resting on table with blood pressure cuff on upper arm. Other hand is pushing start button on blood pressure machine.

The American Heart Association advises the following guidelines for home blood pressure monitoring:

  • Don't smoke or drink coffee for 30 minutes before taking your blood pressure.

  • Go to the bathroom before the test.

  • Relax for at least 5 minutes before taking the measurement.

  • Sit with your back supported (don't sit on a couch or soft chair). Keep your feet on the floor uncrossed. Place your arm on a solid flat surface (such as a table) with the upper part of the arm at heart level. Place the middle of the cuff directly above the bend of the elbow. Check the monitor's instruction manual for an illustration.

  • Take multiple readings. When you measure, take 2 to 3 readings one minute apart and record all of the results.

  • Take your blood pressure at the same time every day, or as your healthcare provider advises.

  • Record the date, time, and blood pressure reading.

  • Take the record with you to your next healthcare appointment. If your blood pressure monitor has a built-in memory, just take the monitor with you to your next appointment.

  • Call your provider if you have several high readings. Don't be frightened by one high blood pressure reading. But if you get a few high readings, check in with your healthcare provider.

Follow-up care

You will need to see your healthcare provider regularly. This is to check your blood pressure and to make changes to your medicines. Make a follow-up appointment as directed. Bring the record of your home blood pressure readings to the appointment.

Call 911

Call 911 if you have any of these:

  • Blood pressure of 180/120 or higher and any other symptoms linked to organ damage. These include:

    • Unusual chest pain or shortness of breath

    • Weakness of an arm or leg or one side of the face

    • Problems speaking or seeing

    • Severe headache

    • Sudden severe pain in your belly (abdomen) or back

    • Extreme drowsiness, confusion, or fainting

    • Passing out or seizures

    • Severe dizziness or spinning feeling (vertigo) that doesn't go away



When to get medical advice

Call your healthcare provider right away if any of these occur:

  • Blood pressure of 180/120 or higher, without other symptoms

  • Throbbing or rushing sound in the ears

  • Nosebleed

  • Mild or intermittent dizziness or spinning feeling (vertigo)

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