High Blood Pressure: Fighting the “silent killer”

High blood pressure (hypertension) affects nearly one in three adults, and more than half of people over age 60. It can increase the risk of heart disease and stroke. Fortunately, there are many things you can do to help reduce your blood pressure. For some people, a better diet and more exercise will be enough. For others, medications are needed. This brochure can help you understand your risk and follow a plan to reduce your blood pressure to a safer level.

What is high blood pressure?

In people with high blood pressure, the force of the blood pumping through your blood vessels is higher than it should be. It is sometimes called the “silent killer” because it usually doesn’t cause any symptoms at all. In most people, we don’t know what causes the blood pressure to go up. The condition usually can’t be cured, but you can do many things to control it.

Why is blood pressure important?

Untreated high blood pressure can cause a heart attack or stroke, two of the most common causes of death in the United States. Because you may not know that you have high blood pressure, it’s important to get it checked regularly. It’s also important to follow your doctor’s instructions about how to treat it.

What does your blood pressure mean?

Blood pressure is measured as two numbers. The top (higher) number is called the “systolic” blood pressure; this is the force of the blood pushing against your blood vessel walls when your heart beats. The lower number is the “diastolic” blood pressure; that’s the pressure in your blood vessels between heartbeats, when your heart is at rest.

What should your blood pressure be?

The chart below shows different levels of blood pressure. Pre-hypertension is not a disease, but can identify people at risk for developing high blood pressure later on.

Know your blood pressure level

You should have your blood pressure checked regularly – at least once a year if it’s normal, and more often if it’s elevated. Rest for a few minutes before having it measured. You can also check your own blood pressure using home monitors and machines at stores.

What can you do to control high blood pressure?

The good news is that you can do many things to help control high blood pressure. Exercise, healthy eating, and weight loss are a great start. They can improve your blood pressure and reduce your risk of heart disease. Useful information about what you can do to control your blood pressure is offered by the American Heart Association at: http://www.americanheart.org/presenter.jhtml?identifier=2114.

Diet

You can reduce high blood pressure by making a few changes to the way you eat. Limit salt. Salt (sodium) causes your body to hold extra fluid, which can raise blood pressure and make your heart work harder. To eat less sodium:

Limit salt. Salt (sodium) causes your body to hold extra fluid, which makes your heart work harder. To eat less sodium:

• use less salt in cooking
• don't automatically add salt at the table
• eat fewer processed foods, such as canned soup, boxed snacks, or frozen dinners
• make healthy choices when eating at restaurants; beware that restaurants often use a lot of salt
• look for sodium on food labels, and avoid high-sodium products

Reduce saturated fats and cholesterol. High-fat food can make you gain weight and increase your risk for high blood pressure and heart disease. To eat less fat:

• cook with less oil, fat, and creams
• cut back on red meats, and replace with lean meat, fish, or skinless poultry
• replace high-fat dairy products, such as ice cream and cream cheese, with healthier options such as sorbets and reduced fat cream cheese
• eat more fresh fruits and vegetables
• choose foods that are roasted, boiled, or grilled, instead of breaded and fried

Limit alcohol. Alcohol can also raise blood pressure. If you drink more than about two drinks a day, you may need to cut back.

The “DASH Eating Plan” is a healthy diet that has been shown to lower high blood pressure. For more information, visit the National Institutes of Health website at: www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf.

Exercise

Regular, moderate activity can lower blood pressure, help control weight, and reduce your risk of heart disease, diabetes, high cholesterol, and stroke.

• First, ask your doctor if you should begin physical activity
• Set goals for yourself so you can measure your progress and celebrate your success.
• Plan an exercise schedule, and choose a time of day that works best for you.
• Do activities you like, such as walking, swimming, or riding a bike.
• Begin slowly, and when you can, try more challenging activities.
• Stay motivated by exercising with friends and family, doing a variety of activities, joining a gym or exercise class, and signing up for special events that involve exercise.

YOUR GOAL: Be physically active…

• at least 30 minutes
• most, if not all days of the week

Stop smoking

If you smoke, you should quit. Smoking increases your risk of having a heart attack or stroke (in addition to many kinds of cancer).

When are prescription drugs needed?

If lifestyle changes aren’t enough to reach your blood pressure goal, you may need a prescription from your doctor. It is very important to take your medication every day as prescribed, or it won’t work well. If you feel the need to stop taking your medication for any reason, call your doctor to talk about it.

Many kinds of medicines can control blood pressure and reduce the risk of heart attacks and strokes. For most patients, a “thiazide diuretic” should be the first choice. These medications are as effective and safe as other blood pressure medications, and are also available in very inexpensive generic forms. Common thiazide diuretics include hydrochlorothiazide and chlorthalidone.

If you have other medical problems in addition to hypertension, your doctor may recommend drugs that work well for your specific conditions. For example, for patients with heart failure, diabetes, and kidney problems, medications known as “ACE inhibitors” or “angiotensin receptor blockers” are usually a good choice for treating hypertension. For patients with heart disease, “beta-blockers” are generally used. Many patients will need more than one medication to effectively reduce their blood pressure. Some drugs can cause side effects, such as fatigue, cough, headache, and others. If you think you are having side effects related to your medication, talk to your doctor about it. In most cases, you should talk to your doctor before you stop taking your medicine.