Hypertension (HTN), or high blood pressure, is a common condition. The Centers for Disease Control and Prevention report that only one in four people have hypertension (HTN) under control and estimate that 34 million adults are recommended to begin taking blood pressure medications. Whether you are on medication or not for hypertension, it is essential to modify your lifestyle. Lifestyle modifications can have a positive effect on high blood pressure.
If you have been diagnosed with hypertension, you are not alone! This article is the fourth in a series that will focus on explaining how our cardiovascular system works, understanding blood pressure readings, taking your readings correctly, the causes of hypertension, lifestyle changes, and the treatment and management of the condition.
I Have High Blood Pressure: Do I Need Medication?
Often, the first question after being diagnosed with hypertension is, “Do I have to take medication?” Your health care provider is the best person to answer that question and the factors below should be part of the discussion:
- The stage of elevation as indicated by the American Heart Association “Blood Pressure Categories” chart.
- Causes and risk factors such as a family history of high blood pressure, diet, exercise, smoking, age, and other factors.
- Any existing or underlying health conditions you may have.
- Medications and supplements you may be taking.
- Your lifestyle, which includes your diet, exercise, and social behaviors such as smoking or drinking.
What More Can I Do to Lower My High Blood Pressure?
Lifestyle changes are a big part of lowering your blood pressure. Making changes in your daily life will truly make a long-lasting difference not only in reducing your blood pressure but in your overall health.
Develop a Healthy Eating Plan Low in Salt
Many Americans have acquired a taste for a high-salt diets. Our bodies need a small amount of sodium to function, but most Americans consume higher amounts than recommended. The Food and Drug Administration recommends that adults consume a minimum of 1500 mg and less than 2300 mg per day of salt, equal to one teaspoon. If you were to examine the types of foods you consume in a day, without even measuring, you would realize the amount of salt far exceeds the recommended guidelines. Attempting to cut back by 1,000 mg daily can improve your blood pressure.
Developing a healthy eating plan can play a key role in reducing your blood pressure, but before we discuss a healthy eating plan, it is important to talk about salt and sodium chloride. Many use the words interchangeably, but they are different. Sodium is a mineral that naturally occurs in many foods and is vital for organ support. Salt is a combination of sodium and chloride. When watching your salt consumption, it is important to note the sodium listed on nutrition labels. Knowing how much sodium is in salt can help you take measures to control your intake.
- 1/4 teaspoon salt = 575 mg sodium
- 1/2 teaspoon salt = 1,150 mg sodium
- 3/4 teaspoon salt = 1,725 mg sodium
- 1 teaspoon salt = 2,300 mg sodium
A healthy eating plan is one that gives your body the nutrients it needs while reducing the intake of foods high in fat, saturated fats, trans-fats, cholesterol, and salt. Foods that should be incorporated into your diet include:
- Canola or olive oils and soft margarine in moderate amounts
- Eggs in moderate amounts or egg whites
- Fat-free and low-fat dairy products – low in salt
- High-fiber foods such as whole grains, breads, and cereals
- Lean meat, fish, and poultry
- Nuts that are unsalted or lightly salted, paying attention to serving size
- Fresh vegetables.
Learning how to read food and nutrition labels will help you stock your kitchen with foods that can aid in lowering your blood pressure. Avoid food high in salt. See the Food and Drug Administration’s guide on understanding nutrition labels.
Dining out may seem to present some challenges but they can be overcome.
- Research the restaurant’s menu ahead of time. Most restaurants place their menus online.
- Some restaurants offer low-calorie or low-salt meals.
- Many sauces, gravy and salad dressings have a high salt content. Ask for these items on the side.
- If you drink, be mindful of your alcohol consumption.
- Have water instead of soda or other carbonated beverages.
- Don’t use table salt. Ask the server to take it off the table or place it out of view.
Looking beyond the saltshaker, the following items contain salt and some in excess:
- Many pre-packaged and frozen foods are high in salt. It is important to read the nutrition label and limit or eliminate these foods from your diet. These items include pudding, pre-packaged potatoes, reduced-calorie meals, seasoned fish or meats, ketchup, and salad dressings.
- Soup is high in salt. Look for low-salt or low-sodium options but still review the salt content.
- Processed meats such as deli meats, sausage, ham, and hotdogs are high in salt. Some deli brands offer low-sodium options, but they still contain salt so limit your consumption of these meats.
- It is important to read the nutrition labels of all juices and sodas. Drinks such as soda and vegetable juices contain high levels of salt.
- Limit the intake of cookies, crackers, chips and pretzels.
- Other foods high in salt include cottage cheese, pizza, tomato sauces and canned vegetables and beans.
- Some over-the-counter drugs have high sodium content, as does some prescription medications.
The 2020–2025 Dietary Guidelines for Americans state that adults of legal drinking age can limit their alcohol intake to two drinks or less in a day for men and one drink or less in a day for women. Drinking causes a temporary rise in blood pressure but drinking excessively over long periods of time results in sustained high blood pressure. Alcohol should be avoided if you suffer from high blood pressure and are taking medications that interact with alcohol.
Developing a healthy, low-salt eating plan combined with physical activity can lower your blood pressure. It is important to always check with your physician before beginning a physical activity routine. Age, health conditions, and surgical or testing procedures can affect your exercise routines or capabilities.
The American Heart Association recommends:
- At least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, or a combination of both, preferably spread throughout the week.
- Add moderate- to high-intensity muscle-strengthening activity (such as resistance or weights) on at least two days per week.
- Spend less time sitting. Even light-intensity activity can offset some of the risks of being sedentary.
- Gain even more benefits by being active at least 300 minutes (five hours) per week.
- Increase amount and intensity gradually over time.
Stress is a part of everyday life but the consequences of exposure to long-term stress can be high blood pressure and cardiac episodes. The National Library of Medicine reports that stress can cause hypertension through repeated blood pressure elevations as well as by stimulation of the nervous system to produce large amounts of vasoconstricting hormones that increase blood pressure. Factors affecting blood pressure through stress can include:
- White coat hypertension
- Job strain
- Social environment
- Emotional distress.
If risk factors for high blood pressure are present and are then combined with stress factors, the effect on blood pressure is multiplied. If you are experiencing stress and have risk factors for high blood pressure, medication is not your only option for relief. Activities such as meditation, acupressure, biofeedback, and music therapy have been shown to relieve stress levels. Exercise has also been shown to relieve stress. It is important to discuss the stress you are experiencing with your health care provider. They can be a valuable resource for help and information.
Maintain a Healthy Weight
Weight management is another tool for keeping your blood pressure under control. Regular monitoring of your weight is key to maintaining your weight. Items to remember when maintaining a healthy weight include:
- Be aware of social or environmental cues encouraging undesired behaviors. For example, you may learn that you are more likely to overeat when watching TV, especially foods high in salt.
- Take cues from your body by recognizing when you are full.
- Choose fresh fruits and foods low in fats and salt for snacks.
- Continue your exercise routine and change it up to incorporate fun activities like dancing.
- Seek encouragement and check in with your healthcare provider.
- Celebrate your accomplishments with your family and friends.
Smoking Raises Blood Pressure
While smoking is a proven risk factor for heart attack and stroke, its connection to high blood pressure is still being determined, as reported by the American Heart Association. However, every time you smoke, it causes a temporary increase in blood pressure, and both smoking and exposure to secondhand smoke increase the risk for the buildup of plaque inside the arteries, a process that high blood pressure is known to accelerate. When you combine smoking with other risk factors or a concrete diagnosis of high blood pressure, it is strongly recommended that you quit.
Quitting can be difficult, especially with nicotine being an addictive substance. There are resources to assist you in quitting. The Centers for Disease Control and Prevention offer a free and confidential quit line – 1-800-QUIT-NOW or you can visit Quit Guide.
The American Lung Association offers tips and resources for success.
- Focus on your motivators.
- Build confidence.
- Stress management is key.
- It’s never too late to quit.
- Learn from past experiences.
- You don’t have to quit alone.
- Medications are safe and effective and will help you quit and stay quit when used properly.
- Every smoker can quit.
It is Important to Take Your Medications and Work with Your Health Care Provider
Treating high blood pressure requires time, patience, and care by both you and your provider. The important thing is for you to communicate with your health care provider and follow their course of treatment.
- Keep all your medical appointments.
- Always discuss any medication choices with your health care professional.
- Take medications for high blood pressure exactly as prescribed, for as long as required.
- If you experience any side effects from your blood pressure medication, alert your provider immediately.
- You may need more than one prescription. Because different drugs do different things in the body, you may need more than one medication to properly manage your blood pressure.
- If you are having a hard time affording your medications, talk to your health care professional or pharmacist. They have knowledge and access to various low-cost and assistance programs.
- Make your health care professional aware of all over the counter (including supplements) and prescription drugs you are taking.
- If you’re working with a primary care health care professional and a specialist, make sure that each knows what the other has prescribed. Using one pharmacy for all your prescriptions also helps avoid dangerous drug interactions.
- Expect to treat high blood pressure for life.
- Even if you’re feeling fine, NEVER cut back or quit taking the prescribed medication.
It is important to speak with your health care provider and address a treatment plan for any stage of hypertension, but it is imperative to seek medical attention for blood pressure that exceeds 180/120 mm Hg. With blood pressure this high, you could also experience chest pain, shortness of breath, back pain, numbness or weakness, changes in vision, or difficulty speaking. DO NOT WAIT TO SEE YOUR PHYSICIAN. CALL 911 IMMEDIATELY.
As part of living a healthier life, RPM Healthcare offers remote patient monitoring and care coaching services for those with high blood pressure and other health conditions. This weekly series on hypertension, the RPM365 platform, and care coaches are aimed at working with you to achieve a healthy lifestyle and prevent heart attack, stroke, and other health conditions that can affect your everyday life.