When blood pressure rises and stays high for a long time, a person has a condition called high blood pressure (HBP). The medical name for high blood pressure is hypertension.
Blood pressure is measured with 2 numbers. The first (top) number measures systolic pressure. This is the maximum pressure against the artery walls while the heart is pumping blood. The second (bottom) number measures diastolic pressure. This is the pressure between heartbeats when the heart refills. The results are given as systolic over diastolic pressure, such as 120/80 millimeters of mercury (mm Hg).
Blood Pressure Levels for Adults
Normal blood pressure:
Less than 120 systolic AND
Less than 80 diastolic
Elevated blood pressure:
120-129 systolic AND
Less than 80 diastolic
High blood pressure:
130 or higher systolic OR
80 or higher diastolic
These are general guidelines. Your doctor may recommend lower blood pressure targets if you have additional risk factors. Discuss your personal blood pressure goals with your doctor.
Blood Pressure Measuring tips
Don’t drink coffee or caffeinated drinks, exercise, eat a meal, or smoke 30 minutes before having your BP read.
Go to the bathroom before you get it checked.
Before the test, sit for 5 minutes.
Wear short sleeves so your arm is exposed.
When you get tested: Sit; keep your back and arm supported; keep your arm at heart level; and keep your feet uncrossed and flat on the floor.
An average of 2 readings from BP tests taken at least 5 minutes apart should be done.
Blood Pressure Record
Write your blood pressure readings in the spaces below.
Date Blood Pressure
Signs & Symptoms
High blood pressure (HBP) is a “silent disease.” Often there are no signs or symptoms. Adults over 40 or those with increased risk should get their blood pressure checked every year or as often as your doctor advices. When the top number is 180 or higher or the bottom number is 120 or higher, signs of a hypertensive crisis may occur:
Severe pain in chest, back, or abdomen
Severe headache with confusion and blurred vision
Severe anxiety
Shortness of breath
Health Problems
High blood pressure plays a major role in these health problems:
Stroke. Dementia.
Brain damage
Heart disease. A person with HBP is at a higher risk to have a heart attack. It can also cause the heart to enlarge. This could cause heart failure.
Aneurysm (bulges in artery walls)
Chronic kidney disease
Vision loss or blindness
Causes & Risk Factors
The exact cause is not known.
Risk factors include:
Family history of HBP
Aging. Also increasing in children and teens.
Smoking cigarettes and using tobacco
Race. African American and Hispanic adults are at greater risk.
Gender. Men are more likely to have HBP than women (until women reach menopause).
Being inactive
Obesity
Lack of quality sleep or untreated obstructive sleep apnea
Drinking too much alcohol or caffeine. Unhealthy diet and too much sodium intake.
Too much stress
High blood pressure could be caused by another health problem or be a side effect of some medicines. This is called secondary hypertension, and can usually be reversed when the problem is treated.
Diagnosis
A health care professional measures blood pressure during an office visit with a manual or automated device called a sphygmomanometer. The numbers on the gauge measure blood pressure in millimeters of mercury (mm Hg).
You should get 2 or more readings and at different times.
To confirm a diagnosis, your doctor may have you wear a device that records your blood pressure every 20-30 minutes over a period of 24 to 48 hours. This is called ambulatory blood pressure monitoring (ABPM).
During an office visit, a short-term rise in blood pressure can occur. Getting blood pressure readings over 1-2 days during normal activity and sleep may give a more accurate measurement of your blood pressure.
Self-Care/Prevention
Get your blood pressure checked as often as your doctor advises, based on your age and other risk factors.
Aim for a healthy weight. Even losing 5-10% of weight if you are overweight or obese can improve blood pressure.
Don’t use tobacco products.
Limit alcohol to 2 drinks or less a day if you are male and 1 drink or less a day if you are female or age 65 or older.
Limit caffeine to 400 mg/day.
Exercise. Try to do at least 150 minutes a week.
Limit sodium to 2,300 milligrams (mg) per day; 1,500 mg if you have HBP, or are African American.
Manage stress. Learn relaxation techniques. Talk to a counselor or find a support group, if needed.
Get enough quality sleep.
Take medicine as prescribed. Tell your doctor if you have any side effects, such as dizziness, faintness, or a dry cough without having a cold. Don’t stop taking your prescribed medicine or change the dose(s) unless your doctor tells you.
Before taking antihistamines and decongestants, discuss all prescribed and over-the-counter medicines with your doctor and pharmacist to avoid harmful drug interactions.
If advised by your doctor, keep track of your blood pressure using a home testing device.
The DASH Eating Plan for 2,000 and 1,600 Calories/Day
Follow the “DASH” (Dietary Approaches to Stop Hypertension) Eating Plan. Doing this and lowering the amount of salt you eat have been shown to lower blood pressure and may help prevent high blood pressure.
Food Group
Grains and grain products
Vegetables
Fruits
Low-fat or fat-free dairy foods
Meats, poultry, and fish
Nuts, seeds, and dry beans
Fats and oils
Sweets and added sugars
Daily Servings
2,000 1,600
7-8 6
4-5 3-4
4-5 4
2-3 2-3
2 or 1-2
less
4-5 per 3 per
week week
2-3 2
5 per 3
week
Serving Sizes
1 slice bread
1 ounce dry cereal
1/2 cup cooked rice or pasta
1 cup raw leafy vegetable
1/2 cup cooked vegetable
6 ounces vegetable juice
1 medium fruit
1/4 cup dried fruit
1/2 cup fresh or frozen fruit
6 ounces fruit juice
8 ounces milk
1 cup yogurt
1-1/2 oz. cheese
3 ounces cooked meat, poultry, or fish
1/3 cup or 1-1/2 ounces nuts
2 Tbsp. or 1/2 ounce seeds
1/2 cup cooked dry beans
1 tsp. vegetable oil
1 tsp. soft margarine
1 Tbsp. low-fat mayonnaise
2 Tbsp. light salad dressing
1 Tbsp. sugar
1 Tbsp. jelly or jam
1/2 ounce jelly beans
8 ounces lemonade
Examples & Notes
Whole-grain breads and cereals. English muffins. Pita breads. Bagels. Grits. Crackers. Unsalted pretzels and popcorn.
Tomatoes. Potatoes. Carrots. Green peas. Squash. Broccoli. Turnip greens. Collards. Kale. Spinach. Green beans. Lima beans.
Maple syrup. Sugar. Jelly. Jam. Fruit-flavored gelatin. Jelly beans. Hard candy. Fruit punch. Sorbet. Ices.
Benefits
Major source of energy and fiber
Rich in fiber, potassium & magnesium
Rich in fiber, potassium & magnesium
Major sources of calcium and protein
Rich sources of protein & magnesium
Rich in fiber, magnesium, potassium & protein
DASH has 27% of calories as fat.
Sweets should be low in fat.
Medical Treatment
High blood pressure usually lasts a lifetime, but can be treated and controlled. If you are diagnosed with high blood pressure, follow your doctor’s advice.
Medical treatment includes:
A physical exam and lab tests. These check for damage to your heart, kidneys, and other organs. They also identify risk factors you have for heart, kidney, and other diseases. Your treatment plan is based on your needs.
Follow-up blood pressure checks and other tests as needed.
When healthy lifestyle changes alone do not control or lower high blood pressure, your doctor may prescribe blood pressure medicine.
Medications. When prescribed, most persons need more than 1 medicine to treat high blood pressure.
Your doctor will base your medications on your blood pressure level, age, race, other conditions you have, heart disease risk factors, etc. Common medicines used to treat HBP are:
Diuretics (water pills)
Calcium channel blockers
ACE inhibitors
Angiotensin II receptor blockers
Alpha and beta blockers
Nervous system inhibitors
Vasodilators
Reasons to Get Medical Care
You have signs or symptoms of a hypertensive crisis. Get emergency care right away.
You have adverse side effects from taking medicine(s) to lower blood pressure. Examples are:
You feel lightheaded or dizzy.
You feel weak, sleepy, and/or drowsy.
Your heart races.
You get a skin rash.
You need to schedule office visit appointments to get your blood pressure checked. Do this as often as your doctor advises.
