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The Lowdown on High Blood Pressure

High blood pressure is called "the silent killer" for a good reason: You can have it and not even know it. And you would not be alone. According to the American Heart Association, around 75 million Americans ages 20 years and older have high blood pressure (also known as hypertension), yet many people don't know they have it. If you have high blood pressure, you need to know, so you can control it. If you don't, you increase your risk for serious illness.

High blood pressure has no symptoms. So, if you don't have your blood pressure checked regularly, the first sign of high blood pressure could come in the form of a heart attack, a stroke, heart failure, or kidney failure.

High blood pressure is easily detected, and it can be controlled. But it is up to you to take action. Here is how to control high blood pressure.

Be aware: Get checked

The easiest way to detect high blood pressure (also called hypertension) is to have your blood pressure checked. Blood pressure is made up of two measurements. The first is the force of your blood pushing against artery walls when your heart beats and pumps blood. This is called systolic pressure. The second is the pressure between heartbeats, which is lower. This is called diastolic pressure.

A normal blood pressure reading is less than 120/80. If your blood pressure is higher than 120/80, it means your heart is working harder than it should. A systolic blood pressure of 120 to 139, or a diastolic blood pressure of 80 to 89, is called prehypertension. It is a risk factor for developing high blood pressure. High blood pressure is a reading of 140/90 or higher.

No one knows what causes most cases of high blood pressure. In some cases, it may be related to a medical condition, such as obesity or an abnormal kidney. What we do know is that your gender, race, and family history play a role in whether you develop high blood pressure. Age is also a factor. In people older than 35, blood pressure can increase. Older people often have other medical problems, and high blood pressure can put them at risk for cardiovascular complications.

You can't control your age, heredity, or race. But you can do something about your diet, activity level, stress, weight, and whether you smoke. Studies show that lifestyle changes lower blood pressure in many people. Following more than one lifestyle change will have an even greater effect on lowering your blood pressure.

Eating for a healthy beat

If you have high blood pressure, but are otherwise healthy, your doctor may suggest that you make some lifestyle changes to try to lower your blood pressure. One place to start is by eating healthy.

Consider following the “Dietary Approaches to Stop Hypertension” (DASH) diet plan. Studies show this helps lower blood pressure. It doesn't require special foods. It’s a plan that includes a certain number of servings from a variety of food groups: vegetables, fruits, fat-free or low-fat milk, whole grains, fish, poultry, beans, seeds, and nuts. It also provides a combination of foods rich in minerals, such as calcium, magnesium, potassium, and vitamins, limiting intake of saturated fats and cholesterol.

The American Heart Association recommends that everyone — no matter what age, ethnic background, or medical condition — consumes less than 1,500 mg of sodium a day. Following the DASH eating plan and keeping salt intake to 1,500 mg a day has shown the biggest benefit for blood pressure reduction in people with high blood pressure. Talk with your health care provider to learn more about DASH and what is best for you.

When shopping, check food labels for the words "sodium-free," "low-sodium" or "reduced-sodium." Sodium or salt is used as a flavor enhancer and preservative in many canned and packaged foods. You can easily decrease the amount of salt you eat by avoiding these foods and by cooking meals without adding salt. Take your salt shaker off the table so you don't add salt to food before you eat it. Try using herbs and spices for more flavor.

Exercise for your heart

Even a moderate amount of exercise can help you lose weight and lower your blood pressure. Walking is a good choice. It is easy to do and is easy on your body.

Before you begin exercising, talk with your doctor. Keep these guidelines in mind:

  • Begin slowly, and slowly increase the amount you exercise.

  • Drink a lot of water, even if you do not feel thirsty.

  • Always warm up before exercising and cool down after.

  • Try to exercise moderately for 30 to 60 minutes most days of the week.

In addition, try to increase your activity level. When possible, use your feet instead of your car to go places. Add variety with activities such as swimming, golfing, or gardening.

Other lifestyle changes

Lowering your stress level can also help lower your blood pressure. Exercise can help you reduce your stress. So will relaxation techniques, meditation, yoga, and breathing exercises.

Smoking is another risk factor that you can control. It isn't easy, but kicking the habit is one of the best things you can do to lower your blood pressure — and improve your overall health. Older adults tend to stay off cigarettes once they do quit. Ask your doctor for advice on how to stop smoking.

When you need medication

If lifestyle changes are not enough, or if you have other health problems, such as cardiovascular disease, it may be necessary to manage your high blood pressure with medication.

Health care providers use more than 50 medicines to treat high blood pressure. Most medicines fall into one of these categories: diuretics, beta blockers, angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers, and angiotensin II receptor blockers (ARBs).

There are several things to remember when taking medicine for high blood pressure:

  • Always follow your doctor's instructions. Ask questions if you're not sure what to do.

  • Make sure your pills are properly labeled and stored.

  • Make sure your health care providers know about any prescription and over-the-counter drugs that you take.

  • Try to be patient. It may take a few tries to find the best medicine and dosage for you. Some people need more than one medicine to control their blood pressure.

  • Never stop taking a medicine without your doctor's approval. If you have side effects, talk with your doctor.

  • Never skip a dose. Keep taking your medicine even when you feel well.

  • Keep in shape. Eating healthy foods and getting regular exercise will also help your medicines do their job.

High blood pressure will not go away on its own, and if you return to your old habits or stop taking medication, it can go back up. Controlling your high blood pressure is something you need to continue forever. But you can do it. It's a lifelong task that can make your life longer.

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