Blood pressure readings fall into four general categories, ranging from normal to stage 2 high blood pressure (hypertension). The level of your blood pressure determines what kind of treatment you may need. To get an accurate blood pressure measurement, your doctor should evaluate your readings based on the average of two or more blood pressure readings at three or more office visits.
Medications used to lower blood pressure include diuretics (e.g., hydrochlorothiazide*), beta-blockers (e.g., atenolol, metoprolol), ACE inhibitors (e.g., ramipril, enalapril, lisinopril), calcium channel blockers (e.g., nifedipine, amlodipine), angiotensin II receptor blockers (e.g., losartan, valsartan), and direct renin inhibitors (e.g., aliskiren).
Much of the disease burden of high blood pressure is experienced by people who are not labeled as hypertensive.[87] Consequently, population strategies are required to reduce the consequences of high blood pressure and reduce the need for antihypertensive medications. Lifestyle changes are recommended to lower blood pressure, before starting medications. The 2004 British Hypertension Society guidelines[87] proposed lifestyle changes consistent with those outlined by the US National High BP Education Program in 2002[95] for the primary prevention of hypertension:

During relaxation of the heart (diastole), the left ventricle of the heart fills with blood returning from the lungs. The left ventricle then contracts and pumps blood into the arteries (systole). The blood pressure in the arteries during contraction of the ventricle (systolic pressure) is higher because blood is being actively ejected into the arteries. It is lower during relaxation of the ventricle (diastolic pressure) when no blood is being ejected into the arteries. The pulse we feel when we place our fingers over an artery is caused by the contraction of the left ventricle and the ejection of blood.
Normal systolic blood pressure is 90 to 119 mm of Hg and normal diastolic blood pressure is 60 to 79 mm Hg. Even in this range, the lower blood pressure is better. So even if one has a blood pressure of 118/78 mm Hg, adopting a healthier lifestyle (quitting smoking, reducing alcohol, reducing weight if obese, exercises, reduced salt intake, healthier diet, etc.) is a good choice. However, self-medications to reduce the blood pressure further should never be attempted.
This study will assess whether minocycline, an antibiotic with anti-inflammatory effects, can improve blood pressure control in patients who do not respond to medicines in combination with lifestyle changes, such as physical activity, weight loss, and healthy eating patterns. To participate you must be at least 18 years old and have high blood pressure that does not respond to treatment with three different high blood pressure medicines even when used at the maximum doses. Please note that this study is in Gainesville, Florida.

1. Concentrate on foods that lower blood pressure. Sugary, processed foods contain salt, sugar, damaged fats, and food sensitivities like gluten that contribute to or exacerbate high blood pressure. Shifting to a whole, unprocessed foods diet can dramatically impact your blood pressure. Many whole, unprocessed foods are rich in potassium, a mineral that supports healthy blood pressure. Some research shows that too much sodium and low amounts of potassium – can contribute to high blood pressure. Research shows people with high blood pressure can benefit from increased potassium in foods including avocado, spinach, wild-caught salmon, and sweet potatoes.

In the 19th and 20th centuries, before effective pharmacological treatment for hypertension became possible, three treatment modalities were used, all with numerous side-effects: strict sodium restriction (for example the rice diet[152]), sympathectomy (surgical ablation of parts of the sympathetic nervous system), and pyrogen therapy (injection of substances that caused a fever, indirectly reducing blood pressure).[152][158]


High blood pressure can cause problems for a mother and her baby. High blood pressure can harm a mother’s kidneys and other organs and can cause early birth and low birth weight. If you are thinking about having a baby and have high blood pressure, talk with your doctors so you can take steps to lower or control your high blood pressure before and during the pregnancy.
Blood pressure changes throughout the day and varies from person to person. Various factors affect blood pressure, including your body position, breathing rhythm, stress level, physical activity, medications, what you eat or drink, and the time of the day (blood pressure is usually lowest at night when you sleep and rises when you wake up). In healthy individuals, your body responds and adapts to these changes to keep your blood pressure within a normal range. This ensures that vital organs, such as your brain and kidneys, receive a constant blood flow and nutrient supply.
tilt table test – usually recommended if your doctor suspects you might have orthostatic hypotension or NMH (During this diagnostic test, a person lies on a table and then the table is tilted to raise the upper part of their body. This simulates the change in position from sitting or lying down to standing up. People with orthostatic hypotension or NMH may feel dizzy, lightheaded, or even faint when their position changes.) 

If your systolic and diastolic blood pressure are in two different categories, doctors consider the number that is in the higher category. For example, if your blood pressure is 135/91, your systolic blood pressure is in the prehypertensive range and your diastolic blood pressure is in the range of Stage 1 hypertension. Your measurement or 135/91 would place you in the category of Stage 1 hypertension.
The American College of Cardiology and the American Heart Association certainly grabbed the attention of us busy primary care physicians with the recent release of their updated blood pressure guidelines. These organizations had piqued interest by declaring the release date and labeling it as “highly anticipated.” I pooh-poohed all that drama, but upon reading through the 114-page executive summary PDF with 21 authors and almost a thousand references, I have to say, I am duly impressed.
In Europe hypertension occurs in about 30-45% of people as of 2013.[12] In 1995 it was estimated that 43 million people (24% of the population) in the United States had hypertension or were taking antihypertensive medication.[141] By 2004 this had increased to 29%[142][143] and further to 32% (76 million US adults) by 2017.[7] In 2017, with the change in definitions for hypertension, 46% of people in the United States are affected.[7] African-American adults in the United States have among the highest rates of hypertension in the world at 44%.[144] It is also more common in Filipino Americans and less common in US whites and Mexican Americans.[6][145] Differences in hypertension rates are multifactorial and under study.[146]
People with stage 1 hypertension who don't meet these criteria should be treated with lifestyle modifications. These include: starting the "DASH" diet, which is high in fruit, vegetables and fiber and low in saturated fat and sodium (less than 1,500 mg per day); exercising for at least 30 minutes a day, three times a week; and restricting alcohol intake to less than two drinks a day for men and one drink a day for women, said vice chairman of the new guidelines, Dr. Robert Carey, a professor of medicine and dean emeritus at the University of Virginia Health System School of Medicine. [6 Healthy Habits Dramatically Reduce Heart Disease Risk in Women]
Secondary hypertension results from an identifiable cause. Kidney disease is the most common secondary cause of hypertension.[23] Hypertension can also be caused by endocrine conditions, such as Cushing's syndrome, hyperthyroidism, hypothyroidism, acromegaly, Conn's syndrome or hyperaldosteronism, renal artery stenosis (from atherosclerosis or fibromuscular dysplasia), hyperparathyroidism, and pheochromocytoma.[23][47] Other causes of secondary hypertension include obesity, sleep apnea, pregnancy, coarctation of the aorta, excessive eating of liquorice, excessive drinking of alcohol, and certain prescription medicines, herbal remedies, and illegal drugs such as cocaine and methamphetamine.[23][48] Arsenic exposure through drinking water has been shown to correlate with elevated blood pressure.[49][50]
Your doctor may diagnose you with high blood pressure when you have consistent systolic readings of 140 mm Hg or higher or diastolic readings of 90 mm Hg or higher. Based on research, your doctor may also consider you to have high blood pressure if you are an adult or child age 13 or older who has consistent systolic readings of 130 to 139 mm Hg or diastolic readings of 80 to 89 mm Hg and you have other cardiovascular risk factors.
Your doctor may diagnose you with high blood pressure when you have consistent systolic readings of 140 mm Hg or higher or diastolic readings of 90 mm Hg or higher. Based on research, your doctor may also consider you to have high blood pressure if you are an adult or child age 13 or older who has consistent systolic readings of 130 to 139 mm Hg or diastolic readings of 80 to 89 mm Hg and you have other cardiovascular risk factors.
Unfortunately, a problem doesn’t always announce itself with a fanfare of trumpets. Even the highest blood pressure can be entirely asymptomatic. Similarly, low blood pressure also known as hypotension can occur in your patient despite no symptoms seemingly being present. This is particularly true if the patient is lying still in an unmonitored bed.
Low blood pressure is not always a sign of a problem. But if you have symptoms of low blood pressure, your doctor can diagnose the condition and uncover the cause. Symptoms of dizziness and lightheadedness when you stand up from sitting or lying down -- with a decrease in your blood pressure -- may indicate a condition called postural hypotension. A wide range of underlying conditions may also cause your symptoms. It's important to identify the cause of low blood pressure so appropriate treatment can be given.

There was a time when the high blood pressure medication list was very short indeed. In the 1950s, reserpine was one of the few products on the market to treat hypertension. It is rarely used due to its numerous side effects and drug interactions. The peripheral adrenergic inhibitors work in the brain to block signals that tell blood vessels to constrict. They are mostly used when other high blood pressure medications fail to solve the problem. Guanadrel (Hylorel), guanethidine monosulfate (Ismelin), and reserpine (Serpasil) are peripheral adrenergic inhibitors.


Pulse pressure (the difference between systolic and diastolic blood pressure) is frequently increased in older people with hypertension. This can mean that systolic pressure is abnormally high, but diastolic pressure may be normal or low a condition termed isolated systolic hypertension.[59] The high pulse pressure in elderly people with hypertension or isolated systolic hypertension is explained by increased arterial stiffness, which typically accompanies aging and may be exacerbated by high blood pressure.[60]
Unlike high blood pressure, low blood pressure is defined primarily by signs and symptoms of low blood flow and not by a specific blood pressure number. Some individuals routinely may have blood pressure numbers of 90/50 with no symptoms and therefore do not have low blood pressure. However, others who normally have higher blood pressures may develop symptoms of low blood pressure if their blood pressure drops to 100/60.
There are even more medication types that can lower blood pressure. Some of these are alpha blockers, vasodilators, and central alpha agonists. Your doctor may prescribe these medications if other medications have been ineffective or if you have another condition along with hypertension. Side effects can include fast pulse, palpitations, dizziness, diarrhea, or headaches.
^ Mente, Andrew; O'Donnell, Martin; Rangarajan, Sumathy; Dagenais, Gilles; Lear, Scott; McQueen, Matthew; Diaz, Rafael; Avezum, Alvaro; Lopez-Jaramillo, Patricio; Lanas, Fernando; Li, Wei; Lu, Yin; Yi, Sun; Rensheng, Lei; Iqbal, Romaina; Mony, Prem; Yusuf, Rita; Yusoff, Khalid; Szuba, Andrzej; Oguz, Aytekin; Rosengren, Annika; Bahonar, Ahmad; Yusufali, Afzalhussein; Schutte, Aletta Elisabeth; Chifamba, Jephat; Mann, Johannes F E; Anand, Sonia S; Teo, Koon; Yusuf, S (July 2016). "Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies". The Lancet. 388 (10043): 465–75. doi:10.1016/S0140-6736(16)30467-6. PMID 27216139.

This means whether your parent’s needs are mild or complex, you can work with the elderly home health care services provider to devise a course of care, management, support, and assistance that will help them to stay safe, healthy, comfortable, and happy throughout their later years. Through a highly personalized approach to their care, this home health care provider can help your loved one live the quality of life they desire and deserve, remain as independent as possible, and find meaning and fulfillment in this chapter in their life.
^ Qaseem, A; Wilt, TJ; Rich, R; Humphrey, LL; Frost, J; Forciea, MA; Clinical Guidelines Committee of the American College of Physicians and the Commission on Health of the Public and Science of the American Academy of Family, Physicians. (21 March 2017). "Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older to Higher Versus Lower Blood Pressure Targets: A Clinical Practice Guideline From the American College of Physicians and the American Academy of Family Physicians". Annals of Internal Medicine. 166 (6): 430–437. doi:10.7326/m16-1785. PMID 28135725.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Hypertension with certain specific additional signs and symptoms may suggest secondary hypertension, i.e. hypertension due to an identifiable cause. For example, Cushing's syndrome frequently causes truncal obesity, glucose intolerance, moon face, a hump of fat behind the neck/shoulder (referred to as a buffalo hump), and purple abdominal stretch marks.[23] Hyperthyroidism frequently causes weight loss with increased appetite, fast heart rate, bulging eyes, and tremor. Renal artery stenosis (RAS) may be associated with a localized abdominal bruit to the left or right of the midline (unilateral RAS), or in both locations (bilateral RAS). Coarctation of the aorta frequently causes a decreased blood pressure in the lower extremities relative to the arms, or delayed or absent femoral arterial pulses. Pheochromocytoma may cause abrupt ("paroxysmal") episodes of hypertension accompanied by headache, palpitations, pale appearance, and excessive sweating.[23]
About This Image: Person receiving a blood pressure test. Medical research shows that as we age blood pressure rises slightly to accommodate an increased demand of oxygen and nutrients. It is completely natural for the first number (systolic) to be 100 plus our age. A recent study by a group of UCLA researchers came very close to corroborating Dr. Piette's guide for blood pressure of 100 plus your age for men, subtracting 10 for women, and this is after this rule had been in use for five or more decades. Are we now being taught that Dr. Piette's guide for blood pressure is wrong merely for drug company profit?
Various expert groups have produced guidelines regarding how low the blood pressure target should be when a person is treated for hypertension. These groups recommend a target below the range 140–160 / 90–100 mmHg for the general population.[13][99][100][101][102] Cochrane reviews recommend similar targets for subgroups such as people with diabetes[103] and people with prior cardiovascular disease.[104]
It is important to go to your regular check-ups with your doctor. Hypertension is a common condition and, if caught, can be treated with medication to prevent complications. However, if you experience any of the symptoms of hypertension, such as frequent headaches, recurrent dizziness, nosebleeds, shortness of breath, nausea or vomiting, don't wait—speak to your doctor immediately.
Blood pressure is expressed by two measurements, the systolic and diastolic pressures, which are the maximum and minimum pressures, respectively.[1] For most adults, normal blood pressure at rest is within the range of 100–130 millimeters mercury (mmHg) systolic and 60–80 mmHg diastolic.[7][12] For most adults, high blood pressure is present if the resting blood pressure is persistently at or above 130/80 or 140/90 mmHg.[5][7] Different numbers apply to children.[13] Ambulatory blood pressure monitoring over a 24-hour period appears more accurate than office-based blood pressure measurement.[5][10]
Primary (or essential) hypertension is when the cause is unknown. The majority of hypertension cases are primary. When there is an underlying problem such as kidney disease or hormonal disorders that can cause hypertension, it is called secondary hypertension. When it is possible to correct the underlying cause, high blood pressure usually improves and may even return to normal.

You are considered to have hypertension if your systolic blood pressure measurements are between 130 and 139 or your diastolic measurement falls between 80 and 89. At this level of blood pressure you may not have any symptoms. When blood pressure reaches 180/120 or higher, a serious condition known as a malignant hypertension or hypertension crisis may occur. This can lead to stroke, kidney damage, heart attacks, or loss of consciousness. If you measure your blood pressure and it is this high, rest a few minutes and measure again. If it remains high, call 911.
Your doctor may suggest that you check your blood pressure at home. The easiest way to do this is to use a digital blood pressure monitor. You can get a monitor from your local drug store, hospital, clinic or online. Your doctor can help you find a monitor that is right for you and show you how to use it. Many pharmacies and grocery stores also have in-store monitors that you can use for free.
Hypertension may not produce any symptoms, even if you have had it for years. That's why it is sometimes referred to as a "silent killer." It's estimated that 1 out of every 5 people with high blood pressure aren't aware that they have this major risk factor for strokes and heart attacks. If not properly treated, high blood pressure can damage the heart and circulation, lungs, brain, and kidneys without causing noticeable symptoms. Symptoms of high blood pressure may be present in those who have an extremely high blood pressure. Symptoms of extremely high blood pressure include the following:
High blood pressure is more common in older people. At age 45, more men have hypertension than women. By age 65, this is reversed and more women are affected. People with diabetes have a greater risk of hypertension than those without diabetes. Having a close family member with high blood pressure also increases your risk of developing it. About 60% of all people with diabetes also have hypertension.
Methyldopa, formerly known under the brand name Aldomet, is one of the oldest blood pressure medications still in use. It was first introduced more than 50 years ago. Methyldopa works in the central nervous system to lower blood pressure. While its general use has declined over the years, methyldopa is considered the first-line of treatment for high blood pressure that develops during pregnancy.
Facial flushing: Facial flushing occurs when blood vessels in the face dilate. It can occur unpredictably or in response to certain triggers such as sun exposure, cold weather, spicy foods, wind, hot drinks and skin-care products. Facial flushing can also occur with emotional stress, exposure to heat or hot water, alcohol consumption and exercise — all of which can raise blood pressure temporarily. While facial flushing may occur while your blood pressure is higher than usual, high blood pressure is not the cause of facial flushing.  
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