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What are the numbers for high blood pressure, what do they mean and how can you lower them?

High blood pressure left untreated can lead to heart failure and stroke, but it can often be treated by improved diet, exercise and lifestyle changes.

By Andrew Smith, MD
February 7, 2018

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Being diagnosed with high blood pressure can be scary – and it’s a diagnosis that nearly half of American adults will get at some point in their lives. But it helps to understand what it means to have high blood pressure and that it can often be treated without medication.

What does blood pressure tell you?

Blood pressure measures the force of your blood pushing against the walls of your arteries, or blood vessels. Your heart pumps blood into your arteries. And the arteries carry that blood to the rest of your body.

The top number of your blood pressure reading tells you the force of the blood against artery walls when your heart beats. It is called systolic pressure. The bottom number tells you what your blood pressure is when your heart is at rest between heartbeats. It is called diastolic pressure.

What numbers mean high blood pressure? What numbers mean normal blood pressure?

Normal blood pressure is at or under 120 over 80.

In November 2017, blood pressure guidelines were modified. Any blood pressure measurement at or above 130 over 80 is now considered high. And that’s what we in the medical community call hypertension. These numbers are down from the old recommendation of 140 over 90.

In the past, many people in the United States were considered “prehypertension.” The new recommendations get rid of that category, and now almost half of U.S. adults fall into the category of hypertension. That could seem shocking. But patients who are in this category should already be discussing their blood pressure numbers with their primary care doctor. If they aren’t, now is a good time to connect with their medical provider and come up with a plan for treatment.

What causes high blood pressure?

High blood pressure is something we see in patients of all ages. It is often linked to inactivity, poor diet and obesity. But in as many as 95 percent of reported cases, we aren't able to determine an underlying cause. Family history, genetics, age and ethnicity can also all play a role. So can some drugs that are taken for other conditions, but don't stop taking any prescribed medication without talking to your doctor.

What does high blood pressure feel like?

High blood pressure often doesn't have any symptoms, so you usually don't feel it.

Hypertension is usually diagnosed by a health care professional during a routine checkup. The average person should get a blood pressure reading at least once a year. As a cardiologist, I think it’s important for everyone to know their numbers. That means knowing what your blood pressure is. And it also means knowing your blood sugar level, cholesterol and body mass index. When you know your numbers, you can work with your doctor to make a plan to reduce any risks.

Blood pressure is even more important to pay attention to, though, if you have a close relative with hypertension or other risk factors. And know that if your blood pressure is extremely high, you may have unusually strong headaches, chest pain, difficulty breathing or get easily worn out by workouts. If you have any of these symptoms, see your doctor right away.

Can you die from high blood pressure?

High blood pressure left untreated can be dangerous. It forces your heart to work harder to get blood out to the rest of the body. And it can lead to a number of serious and potentially deadly conditions, including:

  • Hardening of the arteries
  • Stroke
  • Kidney disease
  • Development of heart failure

What are ways to lower blood pressure?

The best treatment for high blood pressure is often diet, exercise and lifestyle changes. Those changes include reducing stress, quitting smoking or cutting back on how much alcohol you drink. Getting treated for sleep apnea has also been shown to help.

There are also a variety of medicines that can be prescribed for high blood pressure. As is true with any medication, these drugs can have side effects.

Some common side effects of high blood pressure drugs include:

  • Headache, weakness and low potassium (Common with diuretics)
  • Dry persistent cough, diarrhea and high potassium (Common with ACE inhibitors)
  • Dizziness and nausea (Common with angiotensin receptor blockers, beta-blockers, calcium channel blockers and alpha-blockers)

About Andrew Smith, MD

Dr. Andrew Smith is a cardiologist who treats patients at Methodist Hospital in St. Louis Park, Minnesota. Through a focus on good communication, he works to help simplify cardiac issues and help patients achieve the best outcomes possible. Dr. Smith understands that cardiac tests and exams seem very complex and even intimidating. He believes it is his responsibility to help people understand the reason for these procedures and what the results mean. The goal of his approach is to bring patient and doctor together to establish the best plan for moving forward.

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