It’s called the silent killer — and for good reason. High blood pressure, also known as hypertension, can cause a host of serious health issues without you even knowing it.
“Studies over the past few decades show that untreated hypertension over time leads to an increased risk of stroke, heart failure, ischemic cardiovascular disease and kidney disease,” explains Dr. Matthew Rivara, a physician at the Hypertension Clinic at Harborview Medical Center.
What’s perhaps even more troubling is how many people this affects. According to the American Heart Association, more than 100 million Americans — that’s about half the adult population — have high blood pressure.
If that statistic is stressful enough to make your blood pressure rise, take heart. There are numerous ways to manage hypertension and lower your blood pressure, Rivara says, both with and without medication. Here’s what he wants you to know about your blood pressure and your health.
What is blood pressure?
While you’ve likely had your blood pressure checked before — either at your doctor’s office, a pharmacy or at home — you may not know exactly what blood pressure is or what those numbers stand for.
“Blood pressure is basically a combination of how hard the heart is pumping blood to the rest of the body and how much the blood vessels in your body are constricting,” Rivara explains.
Every blood pressure measurement has two numbers: The top number (systolic) is your blood pressure when your heart is contracting, while the bottom number (diastolic) is your blood pressure when your heart is relaxing between beats.
The other tricky thing about blood pressure is that while research shows it’s linked to cardiovascular and kidney disease, most patients don’t have any symptoms.
“The only way it comes to light is if you have your blood pressure checked,” Rivara says.
What’s a normal blood pressure?
Remember those systolic and diastolic numbers? They help doctors figure out if your blood pressure is healthy or not.
Although some medical organizations refer to slightly different guidelines, Rivara says there are three main blood pressure categories you should know about: normal (less than 120/80), elevated (120-129/less than 80) and hypertension (130/80 or higher).
If your blood pressure is above 130/80, your doctor will further categorize you into stage 1 hypertension (130-139/80-89), stage 2 hypertension (140/90 or higher) or hypertensive crisis (180/120 or higher).
There’s a catch to all this, though. Various factors like stress — and sometimes even anxiety about seeing a doctor — can temporarily raise your blood pressure, which isn’t exactly helpful in terms of getting an accurate reading.
That’s why a doctor will only diagnose you with hypertension if your blood pressure measures in the high range on more than one occasion.
“A single elevated blood pressure doesn’t mean you necessarily have hypertension,” Rivara explains. “If we measure it once, we’ll have you come back in a couple of weeks or a month to see if we can confirm you have a high blood pressure.”
Who’s at risk for high blood pressure?
The other sneaky thing about the silent killer is that it can affect just about anyone.
Age, weight, diet and lifestyle can contribute to hypertension, as well as certain conditions like chronic kidney disease. High blood pressure can also run in families, so it could be something you have even if you don’t experience other risk factors.
“We know high blood pressure is probably due to the influence of many genes and a combination of lifestyle, diet and environment,” Rivara says.
On the flip side, certain conditions like pregnancy, infection and endocrine problems can result in abnormally low blood pressure, which can lead to symptoms like dizziness, nausea and fainting. These are specific circumstances, though, and not something you should be concerned about when it comes to your overall blood pressure health.
“Unless you’re experiencing symptoms of low blood pressure, in general, the lower the numbers, the better,” Rivara says.
How can you lower your blood pressure?
Let’s say you’ve been diagnosed with hypertension or elevated blood pressure. While you might be concerned about what this means for your overall health, Rivara says there are several things you can try to naturally lower your numbers.
“Unless the blood pressure is very elevated, often the first step is to focus on non-medication therapies,” he explains.
Revamp your diet
Healthy dietary changes can have a huge impact, reducing your blood pressure by anywhere from five to 10 points. Rivara recommends a three-pronged approach: limiting sodium, limiting alcohol and increasing fruits, vegetables and whole grains.
To do this, try to stick to no more than 2,400 milligrams of sodium per day. If tracking nutritional content isn’t exactly your thing, you can make wholesale changes like cutting out processed frozen food and fast food meals that are high in salt.
When it comes to alcohol, follow the guidelines for moderate drinking: Women should have no more than one alcoholic beverage per day, while men should have no more than two per day.
In terms of fresh fruits, vegetables and whole grains, planning to cook more at home is an easy way to incorporate these healthy foods into your meals. You can also make simple adjustments like swapping refined white breads and pastas for whole-wheat options instead.
Get to a healthy weight
If you’re overweight or obese, which is a risk factor for hypertension, getting to a healthier weight can also make a noticeable difference in your next blood pressure measurement.
“Even modest weight loss can result in substantial blood pressure improvement,” Rivara explains. “In round numbers, you can reduce your blood pressure by up to one point for every one kilogram — around two to three pounds — of weight lost.”
Increase your aerobic exercise
Another non-medication therapy that’s proven to help lower blood pressure is good old exercise.
Adding in 30-minute bouts of aerobic exercise — activities like jogging, cycling or swimming that get your heart rate up and make your heart stronger — three to four times a week can knock an elevated blood pressure down by as much as five points.
That amount may not seem like a ton, but it’s pretty significant if you’re on the bubble between having normal, elevated or hypertensive blood pressure.
When is blood pressure medication right for you?
There are situations, however, when your doctor might recommend medication to help treat and manage your high blood pressure.
“We think about medications for two main reasons,” Rivara says. “One would be if someone with mild hypertension has not had an improvement with non-medication therapies. The other is if someone starts with stage 2 hypertension, in general, we recommend starting medication therapy. But if someone feels strongly about working on lifestyle changes first, we’ll work with them to do that.”
If you decide to start blood pressure medication, you and your doctor can discuss potential side effects and future plans (like if you’re planning to get pregnant) to figure out what might work best for you. As you get older or your condition changes, you may need to consider changing or adding medications, too.
“Medication therapy for hypertension has been shown to improve health outcomes for patients,” Rivara says. “For anyone with hypertension, it’s more important than ever to maintain regular contact with your primary care provider to get help monitoring your blood pressure and health.”