High Blood Pressure, New, Begin Treatment  

Your blood pressure was high enough today to start treatment with medicines. Often healthcare providers don’t know what causes high blood pressure (hypertension). But it can be controlled with lifestyle changes and medicines. High blood pressure usually has no symptoms. But it can sometimes cause headache, dizziness, blurred vision, a rushing sound in your ears, chest pain, or shortness of breath. But even without symptoms, high blood pressure that’s not treated raises your risk for heart attack, heart failure, kidney disease, vascular disease, and stroke. High blood pressure is a serious health risk and shouldn’t be ignored.

Image of a man taking his blood pressure using an automatic blood pressure machine.

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 categorized as normal, elevated, or stage 1 or stage 2 high blood pressure:

  • Normal blood pressure is systolic of less than 120 and diastolic of less than 80 (120/80)

  • Elevated blood pressure is systolic of 120 to 129 and diastolic less than 80

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

  • Stage 2 high blood pressure is when systolic is 140 or higher or the diastolic is 90 or higher

Home care

If you have high blood pressure, do what's listed below to 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.

  • Begin 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.

    • Review food labels to track how much salt is in prepared foods.

    • When eating out, ask that no additional salt be added to your food order.

    • Ask your provider about the DASH diet or the DASH (dietary approaches to stop hypertension) eating plan.

  • 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 have heart stimulants. 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 purchasing any over-the-counter medicines or supplements, always ask the pharmacist about the product's potential interaction with your high blood pressure and your high blood pressure medicines.

  • Stimulants such as amphetamine or cocaine could be lethal 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. Enroll in a stop-smoking program to make it more likely that you will quit for good. Or, talk with your healthcare provider about nicotine replacements or medicines that can help.

  • Learn how to handle stress. This is an important part of any program to lower blood pressure. Learn about relaxation methods like 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 or doses, check with your healthcare provider or pharmacist about what to do.

  • Limit alcohol. Drinking too much alcohol can raise blood pressure. Men should have no more than 2 drinks a day. Women should have no more than 1. A drink is equal to 1 beer, or a small glass of wine, or a shot of liquor..

  • Consider buying an automatic blood pressure machine so you can check your blood pressure regularly at home. Your provider can make a recommendation. You can get one of these at most pharmacies.

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

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

  • Go to the bathroom before the test.

  • Relax for 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 (like 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 recommends.

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

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

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

  • Note: If blood pressure reaches a systolic (top number) of 180 or higher OR diastolic (bottom number) of 120 or higher, seek emergency medical treatment.

Follow-up care

Because a new blood pressure medicine was started today, it’s important that you have your blood pressure rechecked. This is to make sure that the medicine is working and that you have no serious side effects. Keep all your follow up appointments. Write down medicine and blood pressure questions and bring them to your next appointment. If you have pressing concerns about your new medicine or your blood pressure, call your provider. Unless told otherwise, follow up with your healthcare provider within the next 3 days.

When to seek medical care

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

  • Blood pressure reaches a systolic (top number) of 180 or higher, OR diastolic (bottom number) of 120 or higher, seek emergency medical treatment.

  • Chest pain or shortness of breath

  • Severe headache

  • Throbbing or rushing sound in the ears

  • Nosebleed

  • Sudden severe pain in your belly (abdomen)

  • Extreme drowsiness, confusion, or fainting

  • Dizziness or dizziness with a spinning sensation (vertigo)

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

  • You have problems speaking or seeing 

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