Many people don’t take high blood pressure (ie., hypertension) very seriously. After all, blood pressure is just a number. You can’t feel your blood pressure, and you can walk around with high blood pressure for a very long time before something bad happens. What you may not realize is that keeping high blood pressure under control is one of the most important things you can do for your long term health. Here’s why.


Blood pressure is generally reported as two numbers, which represent the pressure in your large arteries (aorta) during different parts of the heartbeat, measured in millimeters of mercury (mmHg).
  • Systolic Blood Pressure (the top number): the pressure in your arteries while the heart is pumping blood out.
  • Diastolic Blood Pressure (the bottom number): the pressure in your arteries while your heart is filling between beats.
Everybody’s blood pressure goes up and down throughout the day depending on things like physical activity, emotional stress, and even time of day. Problems do not develop unless the blood pressure is chronically elevated. This is called hypertension.
In November, 2017, the American College of Cardiology and American Heart Association lowered the cutoffs for hypertension to 130 systolic and 80 diastolic. They did this because recent research shows that lowering the blood pressure below these levels decreases the risk of heart attacks and all-cause mortality. In fact, a person with a systolic pressure of 135 has double the risk of heart disease as someone with a systolic pressure of 115. The same goes for a diastolic pressure of 85 vs 75.
Based on the new guidelines 46% of the US adult population has hypertension. Only about half of all people with hypertension have it well controlled.


In short, we care about hypertension because it kills.
Blood pressure is not just a number. The real reason we care about chronically elevated blood pressure is because it increases the risks of some major diseases including heart disease, stroke, congestive heart failure, chronic kidney disease, aortic aneurysm, and retinopathy (eye disease). Heart disease and stroke are two of the top five causes of death in the US. In fact, the Center for Disease Control (CDC) reports that hypertension was at least partially responsible for 410,000 deaths in the US in 2014.


Given that hypertension is so common and contributes to so many deaths, it’s nice to know that treatment is very effective. The first thing, of course, is knowing if you have it. You can check your blood pressure for free at many pharmacies nationwide. Studies show that measurements outside the doctor’s office are at least as accurate at those in the office, provided that the equipment is working well. If you find that a few measurements are above the target numbers, you should see a healthcare provider to get evaluated. Your doctor may order blood and urine tests, an EKG, and special tests when appropriate.
Depending on how high your blood pressure is, as well as your risk for heart attack and stroke, you may need medication to reduce your blood pressure. In addition, there are many lifestyle changes that have been proven to lower blood pressure.
  • Weight loss: weight loss of at least 10 lbs has been shown to lower blood pressure significantly.
  • The DASH (Dietary Approaches to Stop Hypertension) diet: eating a diet that is high in fruits and vegetables and low fat dairy and low in fat and saturated fat has been shown to lower blood pressure about as much as adding one blood pressure medication. Other dietary changes that positively impact blood pressure include reducing sodium, increasing potassium, and moderate alcohol intake (no more than 2 drinks daily for men and one drink daily for women).
  • Exercise: Both endurance and resistance exercise have been shown to lower blood pressure. A minimum of 90 minutes per week is recommended, but start where you are and increase slowly over time.
Each of these interventions alone has a modest effect on blood pressure, but the effects are additive. For example: losing 10 lbs, adding exercise, and implementing the DASH diet can be as effective as 2 blood pressure medications.
Over time, many people who are committed to making lifestyle changes can reduce or eliminate their need for blood pressure medication and still reduce their risks of heart attack stroke, and early death.

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