- To control high blood pressure, most adults should aim to get 150 minutes of moderate exercise – like brisk walking, swimming, or biking – a week.
- Other steps you can take are cutting back on salt and eating more fruits, vegetables, whole grains, and healthful fats.
- If none of these strategies work, it might be time to seek medication.
- This article was reviewed by John Osborne, MD, PhD, and the Director of Cardiology for Dallas-based State of the Heart Cardiology.
- This story is a part of Insider’s guide to High Blood Pressure.
When left untreated, high blood pressure (also known as hypertension) can result in serious health problems like heart disease and stroke. But you can get it under control with changes to your eating and exercise habits, taking prescription medication, or a combination of both.
Here are some practical tips to help you control your blood pressure levels, along with expert advice on when to seek medication.
Monitor your blood pressure at home
The first step in controlling high blood pressure is knowing your blood pressure readings and understanding what’s considered normal or high. Proper awareness can help you track your blood pressure over time and detect any changes or patterns.
Your blood pressure reading has two numbers and looks like a fraction, with systolic pressure on top and diastolic pressure on the bottom. It is measured in millimetres of mercury, or mm Hg:
- Systolic pressure, or the top number, measures the amount of pressure in the arteries when your heart muscle contracts.
- Diastolic pressure, or the bottom number, refers to the amount of pressure in the arteries in between heart beats.
Generally speaking, blood pressure readings lower than 120/80 mm Hg are considered normal.
The chart below outlines blood pressure ranges, as outlined by the American Heart Association:
Home blood pressure monitoring is vital for anyone who’s been diagnosed with high blood pressure or people starting high blood pressure treatment, but it should not be seen as a replacement for in-person doctor visits.
Make mindful lifestyle changes
If you’re concerned about your blood pressure levels, the next step is making sure your numbers don’t climb too high. This can be done with positive lifestyle changes including regular physical activity, diet adjustments, and keeping your stress in check.
1. Walk and exercise regularly
When setting goals for exercise or diet, M. Wesley Milks, MD, a cardiologist at The Ohio State Wexner Medical Centre, offers a few guidelines. For example, most adults should aim to get at least 150 minutes of moderate exercise each week. Milks recommends:
- Brisk walking
- Active yoga
2. Eat less salt.
As for diet, there is one change that research has found can make a huge difference not just for controlling high blood pressure but also lowering it: Reduce the amount of sodium in your diet.
“Increased salt intake results in elevated blood pressure,” says Milks. “Breads, soups, cheeses, canned foods, and processed meats are just a few examples of the many ways that sodium infiltrates our diet.”
In fact, 75% of our dietary sodium comes from eating packaged and restaurant foods, while only 11% comes from adding salt to food.
In general, people concerned with their blood pressure should follow a diet of fruits, vegetables, whole grains, and healthful fats. Medical professionals highly recommend the DASH diet for the majority of people with high blood pressure.
3. Control your stress and anxiety.
While everyone experiences some level of anxiety and stress at some point in their lives, long-term, sustained stress can increase your risk of hypertension.
More importantly, chronic stress often leads to unhealthy habits like smoking, drinking alcohol, and overeating.
Managing stress looks different for everyone, but it’s all about what’s realistic to you, and understanding what brings you pleasure. Whether it’s practicing gratitude, trying out relaxation techniques like mindful breathing, or improving your sleep hygiene, being able to take control of the stressors in your life can help keep your blood pressure down to a normal level.
Learn more about what you can do to lower your blood pressure without medication.
When you need medication to control high blood pressure
If, after making lifestyle changes, your blood pressure is still climbing higher, it may be time to consider medication, says Robert Greenfield, MD, Medical Director of Non-Invasive Cardiology & Cardiac Rehabilitation at MemorialCare Heart & Vascular Institute.
There are a variety of ways to control high blood pressure with medication:
- ACE, orangiotensin-converting enzyme inhibitors, act on a hormone system called the renin-angiotensin system, which mainly resides in the kidney. They prevent the production of an enzyme responsible for narrowing blood vessels and are often the first line of treatment for individuals struggling to control blood pressure.
- ARB, or angiotensin receptor blockers, also act on the renin-angiotensin system. Typically, these have been used as an alternative to ACE inhibitors. But some research has suggested that because ARBs are associated with fewer complications, they may be preferable to ACE inhibitors.
- Calcium Channel Blockers dilate blood vessels and decrease heart rate, which can help control blood pressure. They are a popular choice for treating stage 1 hypertension and are used in combination with other medications for stage 2 hypertension.
- Diuretics remove excess fluid and make the arterial walls less stiff, which can lower blood pressure. These are often prescribed alongside other popular medications like ACE inhibitors or ARBs, according to Greenfield.
Because there are many types of medication available, and prescription decisions are made on an individualized basis, Milks says that any initiations or changes should be made under the supervision of your doctor.
Greenfield also says that medication can be necessary when dealing with the combination of high blood pressure and another disease. According to the American College of Cardiology, all of the medications listed above have been found safe and effective in controlling blood pressure for patients with hypertension and diabetes.
But for those who have hypertension and a history of stroke, choosing medication is incredibly complex.
Hypertension combined with certain forms of heart disease also requires a specialised approach. In these cases, pharmacological treatment, or changes from one medical treatment to another, should be discussed extensively with a specialist.
Related stories from Health Reference:
- How hypertension, heart disease, and stroke are related
- What causes high blood pressure and how to know if you have hypertension
- What is a good resting heart rate, for adults and kids
- What is tachycardia, and when a high heart rate is dangerous
- How to lower cholesterol with the right diet and exercise regimens
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