The best evidence indicates that high blood pressure does not cause headaches or nosebleeds, except in the case of hypertensive crisis, a medical emergency when blood pressure is 180/120 mm Hg or higher. If your blood pressure is unusually high AND you have headache or nosebleed and are feeling unwell, wait five minutes and retest. If your reading remains at 180/120 mm Hg or higher, call 9-1-1.  
If your blood pressure remains high for a long period of time, you run the risk of damaging your blood vessels. Your stroke risk rises significantly, too. And because your heart is working harder to push blood through your system, that very valuable muscle can become overworked and grow thicker. An enlarged heart causes further complications, including heart failure. Medications and special implantable pumps can help boost heart function. But if you can manage your blood pressure before it gets too high and puts your heart at risk, you may be able to avoid a lot of complications down the road.
Blood pressure is assessed using two parameters -- the systolic and diastolic pressures -- which measure, respectively, the maximum pressure exerted in the arteries as the heart contracts, and the minimum pressure in those vessels between cardiac contractions. In adults, blood pressure is considered normal if the top number (systolic pressure) is between 90 and 120 and the bottom number (diastolic) is between 60 and 80.
High blood pressure, also known as hypertension, is a condition where the pressure of the blood flowing through the arteries is higher than normal. This elevated level of pressure can lead to many risks throughout the body and can lead to the disruption of many processes and can ultimately increase the risk of many conditions such as coronary artery disease, stroke, heart failure, peripheral vascular disease, vision loss and chronic kidney disease.
Instead of an arbitrary goal to “lose weight,” talk with your doctor about a healthy weight for you. The Centers for Disease Control and Prevention (CDC) recommends a weight loss goal of one to two pounds a week. That means starting off eating 500 calories less per day than what you normally eat. Then decide on what physical activity you can start in order to reach that goal. If exercising five nights a week is too hard to work into your schedule, aim for one more night than what you’re doing right now. When that fits comfortably into your schedule, add another night.

Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71(19):e127-e248. PMID: 29146535 www.ncbi.nlm.nih.gov/pubmed/29146535.


The new guidelines stem from the 2017 results of the Systolic Blood Pressure Intervention Trial (SPRINT), which studied more than 9,000 adults ages 50 and older who had systolic blood pressure (the top number in a reading) of 130 mm Hg or higher and at least one risk factor for cardiovascular disease. The study's aim was to find out whether treating blood pressure to lower the systolic number to 120 mm Hg or less was superior to the standard target of 140 mm Hg or less. The results found that targeting a systolic pressure of no more than 120 mm Hg reduced the chance of heart attacks, heart failure, or stroke over a three-year period.
Instead of an arbitrary goal to “lose weight,” talk with your doctor about a healthy weight for you. The Centers for Disease Control and Prevention (CDC) recommends a weight loss goal of one to two pounds a week. That means starting off eating 500 calories less per day than what you normally eat. Then decide on what physical activity you can start in order to reach that goal. If exercising five nights a week is too hard to work into your schedule, aim for one more night than what you’re doing right now. When that fits comfortably into your schedule, add another night.
What these scientists found was that while drug treatments for mild hypertension may be effective at lowering blood pressure, they were not effective in reducing overall mortality. Put more bluntly, hypertension patients in these studies died at about the same rate whether they took medication or not. These findings reaffirm an important health principle: Treating the symptoms of disease is not the same thing as causing health.
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.
An important part of a high blood pressure treatment plan is to stick to a healthy diet, including limiting sodium intake. The 2015-2020 Dietary Guidelines for Americans recommend consuming less than 2,300 milligrams (mg) of sodium per day (2). People with high blood pressure may need to restrict sodium intake even more. The American Heart Association (AHA) recommends an ideal limit of no more than 1,500 mg per day for adults with hypertension. (3)
If you suddenly find yourself with high blood pressure (hypertension) under the new guidelines from the American Heart Association and the American College of Cardiology, you might be wondering what to do. The guidelines, which were released in November, lowered the definition for high blood pressure to 130/80 from 140/90 millimeters of mercury (mm Hg), meaning more women now meet the criteria for stage 1 hypertension.
Guanadrel (Hylorel)* or guanethidine (Ismelin)* may cause some diarrhea, which may persist in some people. This side effect usually becomes less of a problem if you continue treatment. These drugs reduce blood pressure more when you stand. Consequently, you may get dizzy and lightheaded and feel weak when you get out of bed in the morning or stand up suddenly. If you notice any of these reactions and if they persist for more than a minute or two, contact your doctor. He/she may instruct you to reduce or omit the next dose of the medication.

Some research on watermelon extract and high blood pressure suggests the amino acid citrulline found in the fruit may help manage high blood pressure. One study found those who took watermelon extract showed reduced blood pressure specifically in the ankles and arm arteries. Other studies on mice also show watermelon’s positive effect. Although more research is needed to determine the specifics, eating fruit like watermelon isn’t going to hurt.
The kidneys produce renin when they detect low blood pressure. Renin stimulates the production of angiotensin I, a protein which is converted to angiotensin II by angiotensin-converting enzyme (ACE) in the lungs. Angiotensin II is a powerful constrictor of blood vessels, and constricting blood vessels increases blood pressure. Angiotensin II also causes the secretion of an additional blood pressure elevating hormone in the adrenal glands called aldosterone, which helps the body retain sodium. Aliskiren blocks the effects of renin and angiotensin so that blood pressure does not increase.
Most doctors have been taught that once a diagnosis of “high blood pressure” has been made, blood pressure medication is the treatment of choice. As a result, many physicians believe that the current definition of “high” blood pressure is also the same level of blood pressure at which drug treatments are worthwhile. Unfortunately, this is not the case.
Many kids and teens with high blood pressure have an unhealthy lifestyle — a bad diet, excess weight, stress, and too little physical activity. So the health care provider might recommend weight loss, exercise, reduced screen time (time spent watching TV, or using a computer or mobile devices), dietary changes, and even relaxation techniques. Teens with hypertension should not smoke because it can make the long-term associated heart problems worse.
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.
Again, foods that lower blood pressure are usually high in potassium and similar nutrients. Famously rich in blood pressure-lowering potassium, one banana contains about 420 milligrams, or 11 percent of the 4,700 milligrams the American Heart Association recommends people consume daily. Surprisingly, however, many veggies are actually higher in potassium than these popular fruits. A cup of Swiss chard boasts 960 milligrams, a cup of cooked white beans has nearly 1,200 milligrams, and a whole avocado has 975 milligrams.

In “guessing” on the best initial single drug to try, most experts now recommend beginning either with either a thiazide diuretic (usually chlorthalidone or hydrochlorothiazide), a long-acting calcium blocker, or an ACE inhibitor. ARBs are generally thought of as substitutes for ACE inhibitors, and generally, are used only when ACE inhibitors are poorly tolerated.
Too much booze is known to raise blood pressure. But having just a little bit could do the opposite. Light to moderate drinking (defined as one drink or fewer per day) is associated with a lower risk for hypertension in women, according to research from Boston’s Brigham and Women’s Hospital. Moderate drinking could play a role in heart disease prevention too, studies show.
Consider once again the analogy of the garden hose. If you turn on the water “harder,” there is more pressure in the hose. Excessive salt in the diet can result in excessive fluid volume in the blood, which results in elevated blood pressure. This cause, too, is reversible, as a plant-based diet of whole, natural foods, devoid of added salt, is naturally low in sodium chloride.

If you think eggs are not heart healthy, you should know that past studies have shown that yolks don’t raise heart disease risk. Now, recent research has found that egg whites deserve a place on the list of foods to lower blood pressure, according to a study presented at a meeting of the American Chemical Society. As MensHealth.com reported, when rats with high blood pressure were fed a protein found in egg whites, they experienced a drop in blood pressure that was comparable to a low dose of Captopril, a blood-pressure-lowering medication. Although more research is needed, eggs are a solid source of protein, vitamin D, and other healthy nutrients.
Hypertension in African-Americans tends to occur earlier in life and tends to be more severe. Plus, some medications that work to lower blood pressure in other ethnicities may have limited effect on African-Americans. Thiazide diuretics (such as HCTZ) or a calcium channel blocker are recommended first choices along with the possible add-on of a second drug from either the ACE inhibitor class or the angiotensin II receptor blocker group.
How the heart pumps blood into the arteries with enough force to push blood to the far reaches of each organ from the top of the head to the bottom of the feet. Blood pressure can be defined as the pressure of blood on the walls of the arteries as it circulates through the body. Blood pressure is highest as its leaves the heart through the aorta and gradually decreases as it enters smaller and smaller blood vessels (arteries, arterioles, and capillaries). Blood returns in the veins leading to the heart, aided by gravity and muscle contraction.
Health care providers measure blood pressure with a sphygmomanometer (sfig-mo-muh-NAH-muh-ter), which has a cuff that's wrapped around the upper arm and pumped up to create pressure. When the cuff is inflated, it squeezes a large artery in the arm, stopping the blood flow for a moment. Blood pressure is measured as air is gradually let out of the cuff, which allows blood to flow through the artery again.
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