Nearly half of adults (47%) in the United States have high blood pressure, or hypertension, but it often doesn’t cause symptoms.
“That’s why it’s sometimes called the silent killer, because people can have it for a long time,” explains John F. Keaney Jr., MD, director of the cardiology clinical service at Mass General Brigham, and a cardiologist who treats patients at Brigham and Women’s Hospital. In this article, Dr. Keaney describes how to achieve and maintain your target blood pressure.
Blood pressure measures the force of blood pushing against the walls of your arteries, which bring blood from your heart to the rest of your body. It’s measured in two numbers:
According to the American Heart Association, normal blood pressure is 120/80 mmHg, or 120 systolic over 80 diastolic. The unit used to measure blood pressure is millimeters of mercury or mmHg.
Hypertension is when your blood pressure is consistently higher than normal. Guidelines do vary, but the American Heart Association defines hypertension as when a patient has a blood pressure reading of 130 mm Hg or higher systolic, or 80 mm Hg or higher diastolic.
“Hypertension is incredibly common. It becomes more common as you get older, and is more common in people with diabetes and obesity,” says Dr. Keaney. If left untreated, it can cause serious health problems like heart attack, stroke, and arrhythmias. “It’s been proven without a doubt that if you’re able to get your blood pressure down, those things become less of a problem,” says Dr. Keaney.
Many organ systems are affected by high blood pressure. If hypertension is left untreated, it can lead to serious health problems like:
If you’re diagnosed with high blood pressure, your doctor may order other tests to look for the cause, including:
It’s helpful to measure your blood pressure at home on a regular basis, especially if you already have hypertension. Blood pressure readings can be higher in the doctor’s office, due to nerves or anxiety. “If you are able to bring blood pressure readings to your doctor under your normal living conditions, that's extremely valuable,” Dr. Keaney says. Blood pressure monitoring devices can be found at pharmacies or online. In some cases, your doctor may ask you to monitor your blood pressure remotely.
“One of the best ways you can get your blood pressure down is through lifestyle modification,” says Dr. Keaney. Here are changes you can make to your everyday habits:
Lifestyle changes don’t have to be extreme to make a difference. “You don’t have to join a gym, you don’t have to buy any special equipment. If you can walk briskly 30 minutes a day, 5 times a week, you can get all the benefit you need from exercise. You don’t have to start marathon running,” Dr. Keaney explains.
Some patients may still need medication to manage their blood pressure. “If you have more complicated high blood pressure, such as you also have diabetes, you may need to be on more than one medicine,” says Dr. Keaney. Medications can lower blood pressure in several different ways:
Even with medication, lifestyle changes are always recommended. “Lifestyle modification makes it easier to reach the goal, even if you have you use medication,” Dr. Keaney explains. “You’ll get more bang for the buck for your medications.”