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'Silent Killer': How to Lower Your Blood Pressure, Decrease Health Risks

Heart Health
Author name: Lee Health


Blood pressure graphic

More than half of adult Americans have high blood pressure. So if you’re talking with a friend and they don’t have high blood pressure, the odds are you do.

Makes your heart skip a beat, doesn’t it? Even more concerning, you may not know you have high blood pressure because it often has no symptoms. Yet, this “silent killer” puts you at an increased risk for heart disease, heart failure and stroke.

In observance of National Blood Pressure Month, Dr. Ravi Ramaswami, a family care physician with Lee Physician Group, shares tips on what you can do to prevent high blood pressure and lower your risk for heart disease and stroke.

Dr. Ramaswami says the only way to know if you have high blood pressure is to have your blood pressure tested.

What is high blood pressure?

As blood travels throughout your body, it pushes against the walls of your blood vessels. This "push" is your blood pressure. Your blood pressure normally rises and falls throughout the day.

If blood vessels narrow or your heart pumps more blood through them, blood pressure rises. High blood pressure, or hypertension, means blood pressure that is consistently above the normal range.

What do the numbers mean?

“The key to controlling your high blood pressure is understanding the results,” Dr. Ramaswami says. “This way, you can make an informed decision to modify your diet and exercise regimen and consult with your doctor. Studies have shown that monitoring your blood pressure at home is more reliable than just getting a single reading at your doctor’s office.”  

Blood pressure is measured in millimeters of mercury or mm Hg.

  • Systolic blood pressure is the first, or top number, which measures the pressure in your blood vessels when your heart beats. Systolic pressure is the higher of the two numbers.
  • Diastolic blood pressure is the second, or bottom number, which measures blood pressure in your arteries between heartbeats. The bottom number is the lower of the two numbers.

Readings between 120/80 mm Hg and 129/89 mm Hg are considered pre-hypertension, according to Dr. Ramaswami. “If your readings are in these ranges, your blood pressure isn’t as low as it should be, but you’re not considered to have high blood pressure.”

You may not have high blood pressure—yet. More than 75 percent of adult Americans ages 65 and over have high blood pressure, reports the AHA.

“Many people develop high blood pressure in their late 30s or early 40s, and it occurs more frequently as people get older,” Dr. Ramaswami notes. “However, because of the obesity epidemic, more children are also developing high blood pressure.”

So, get those numbers checked. And here’s what they mean, according to the AHA, which recognizes five stages of blood pressure:

  • Normal: If your BP reading is 120/80 or lower, you have normal or healthy blood pressure.
  • Elevated: If your BP numbers consistently range from 120-129 systolic and less than 80 diastolic, you have elevated blood pressure. According to the AHA, you’re likely to develop high blood pressure unless you take steps to control the condition. Talk with your doctor.
  • Hypertension stage 1: If your numbers consistently read between 130-139/80-89, you have stage 1 hypertension. “Your doctor may suggest you modify your lifestyle in a few areas, such as improving your diet and getting more exercise,” Dr. Ramaswami says. “Your doctor may also recommend blood pressure medication depending on your risk of atherosclerotic cardiovascular disease (ASCVD), which can lead to heart attack or stroke.”
  • Hypertension stage 2: If your numbers consistently read at 140/90 or higher, your doctor will likely prescribe blood pressure medications and lifestyle changes.
  • Hypertensive crisis: This stage of high blood pressure requires medical attention. If your blood pressure reading suddenly exceeds 180/120, the AHA suggests you wait five minutes and then test your blood pressure again. If your readings are still in this range, contact your doctor immediately. You could be experiencing a hypertensive crisis.

What are the signs and symptoms of high blood pressure?

Usually none—and that’s what makes having high blood pressure so dangerous. This “silent killer” typically has no warning signs or symptoms.

“Measuring your blood pressure, especially at home with a home blood pressure device, is the only way to know if you’re hypertensive,” Dr. Ramaswami says.

What causes high blood pressure?

High blood pressure usually develops over time.  “Causes can include unhealthy lifestyle choices such as smoking or overeating, health conditions such as diabetes and obesity, and other factors,” Dr. Ramaswami notes. “High blood pressure can also happen during pregnancy.”

Regularly measuring your blood pressure

Measuring your blood pressure is an important step toward keeping a healthy blood pressure. Talk with your healthcare team about how often you should have your blood pressure measured or when to measure it yourself. People who have high blood pressure may need to measure their blood pressure more often than people who do not have high blood pressure.

As Dr. Ramaswami suggests, you can measure your blood pressure at home with a home blood pressure monitor. Let your healthcare team know you’re interested in self-measured blood pressure (SMBP) monitoring.

“SMBP means you regularly use a personal blood pressure measurement device away from a doctor’s office or hospital—usually at home,” Dr. Ramaswami says. “These blood pressure monitors are easy and safe to use and more reliable than a random measurement at the provider’s office.”

Evidence shows that people with high blood pressure are more likely to lower their blood pressure if they use SMBP combined with support from their healthcare team than if they don’t use SMBP.

What is the correct way to measure blood pressure?

Learn the correct way to have your blood pressure taken, whether you’re having it checked at the doctor’s office, your home, or at a pharmacy, that has a digital blood pressure measurement machine.

Here’s what to do:

Don’t eat or drink anything 30 minutes before you take your blood pressure.

  • Empty your bladder before your reading.
  • Sit in a comfortable chair with your back supported for at least 5 minutes before your reading.
  • Put both feet flat on the ground and keep your legs uncrossed.
  • Rest your arm with the cuff on a table at chest height.
  • Make sure the blood pressure cuff is snug but not too tight. The cuff should be against your bare skin, not over clothing.
  • Do not talk while your blood pressure is being measured.

Source: Centers for Disease Control and Prevention

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