How to Lower Your Blood Pressure and Manage Hypertension

Key takeaways for lowering blood pressure

• Exercise regularly. Aim for 150 minutes of moderate activity per week.
• Eat a healthy diet. Reduce sodium and focus on fruits, vegetables, and lean proteins.
• Maintain a healthy weight. Losing even a small amount of weight can make a difference.
• Limit alcohol and quit smoking. These habits significantly impact blood pressure.
• Manage stress. Practice techniques like meditation or deep breathing.

Nearly half of adults (47%) in the United States have high blood pressure, or hypertension according to the American Heart Association (AHA), 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, a Mass General Brigham Heart and Vascular Institute cardiologist at Brigham and Women’s Hospital. In this article, Dr. Keaney describes how to achieve and maintain your target blood pressure.

What is 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:

1. Systolic: The pressure when your heart beats, or contracts
2. Diastolic: The pressure when your heart rests between beats

According to the AHA, 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.

What is a normal blood pressure range?

According to the AHA, a normal blood pressure reading for most adults is less than 120/80 mmHg. This can vary slightly by age or gender. Always consult your doctor if you have questions about what is normal for your body.

What is hypertension?

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.

High blood pressure or hypertension can vary in severity, even resulting in an emergency situation.

If your blood pressure reading is higher than 120/80, talk to your primary care provider (PCP) about ways to manage it.

“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.

If a blood pressure reading at home is higher than 180/120, you may be in a hypertensive emergency. Call 9-1-1 if your blood pressure is higher than 180/120 and you have any of the following symptoms:

• Chest pain
• Shortness of breath
• Back pain
• Numbness
• Weakness
• Change in vision
• Difficulty speaking

What causes high blood pressure (hypertension)?

High blood pressure can be caused by a combination of inherent risk factors and lifestyle choices.

Risk factors that may cause an increased chance of high blood pressure include:

• Increasing age
• Race, notably an increased chance in those of African heritage
• Family history of high blood pressure
• Chronic conditions
• Stress
• Pregnancy (high blood pressure in pregnancy is called preeclampsia and is a serious condition)

There are lifestyle choices that can make you more likely to have high blood pressure, including:

• Smoking and the use of tobacco products
• Not getting enough exercise
• Living a sedentary lifestyle
• Having too much salt and sodium in your diet
• Having obesity
• Drinking too much alcohol

Discuss your risk factors with your doctor, and consider making lifestyle changes to help lower your hypertension risk.

How does hypertension affect your health?

Many organ systems are affected by high blood pressure. If hypertension is left untreated, it can lead to serious health problems like:

• Stroke
• Heart attack
• Heart failure and other forms of heart disease
• Kidney disease or failure
• Peripheral artery disease, which affects your legs and arms
• Vision loss
• Sexual dysfunction

Testing for high blood pressure

If you’re diagnosed with high blood pressure, your doctor may order other tests to look for the cause, including:

• Ambulatory monitoring (checking your blood pressure regularly over an extended period of time)
• Lab tests of your blood and urine
• Echocardiogram (using sound waves to look at the heart)
• Electrocardiogram (also called an ECG or EKG, this measures the heart’s electrical activity)

How to check blood pressure at home

Your doctor may ask you to measure and keep track of your blood pressure at home to monitor how well your treatment is working, or to get a better picture of your blood pressure when you’re not in a medical office.

“If you are able to bring blood pressure readings to your doctor under your normal living conditions, that's extremely valuable,” Dr. Keaney says.

Home blood pressure monitors are available in local stores and online. Before choosing your device, check the American Medical Association’s list of validated blood pressure devices to ensure yours is approved. Doctors typically recommend the type that goes around your upper arm, as they tend to provide more accurate readings than the type that goes around your forearm or wrist.

To take a blood pressure reading at home:

1. Sit quietly for at least 5 minutes to relax yourself. This helps you get an accurate reading.
2. Sit upright with both feet on the floor.
3. Place your arm on a table so it’s relaxed and at the level of your heart.
4. Put the blood pressure cuff on your upper arm.
5. Follow the instructions that came with the blood pressure cuff to take a reading.
6. Write down your blood pressure numbers (both systolic and diastolic) or record them on your phone.

Get more tips and information about taking an accurate blood pressure reading at home in our guide.

Lifestyle changes to control blood pressure

“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:

• Exercise regularly for healthy arteries. Aim for 150 minutes (2 hours and 30 minutes) of moderate-intensity activity a week.
• Maintain a healthy weight.
• Reduce salt intake. Try to get less than 1,500mg of sodium a day.
• Stop smoking.
• Limit alcohol.
• Get enough sleep (aim for at least 7 hours a night).
• Reduce stress.

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. 

If lifestyle changes aren't enough to manage your high blood pressure, your doctor may recommend one or more medications to help lower your blood pressure.

When to take blood pressure medication

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:

• Getting rid of excess water and salt in your body
• Relaxing your heart vessels
• Reducing the force of your heartbeat
• Blocking nerve activity that can constrict your blood vessels

Even with medication, lifestyle changes are always recommended. “Lifestyle modification makes it easier to reach the goal, even if you have to use medication,” Dr. Keaney explains. “You’ll get more bang for the buck for your medications.”