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)
The fact that there are so many drugs to choose from means at least two things. First, it means there is no “best” drug for hypertension, that is, there is no drug that works well for almost everyone without causing unacceptable adverse effects. If there were, drug companies would have stopped their efforts to develop new antihypertensive drugs long ago—and the list of approved drugs would be much shorter.
While medication can lower blood pressure, it may cause side effects such as leg cramps, dizziness, and insomnia. The good news is that most people can bring their numbers down naturally without drugs. “Lifestyle changes are an important part of prevention and treatment of high blood pressure,” says Brandie D. Williams, MD, FACC, a cardiologist at Texas Health Stephenville and Texas Health Physicians Group.
A blood pressure reading measures both the systolic and diastolic forces, with the systolic pressure listed first. The numbers show your pressure in units of millimeters of mercury (mm Hg)—how high the pressure inside your arteries would be able to raise a column of mercury. For example, a reading of 120/80 mm Hg means a systolic pressure of 120 mm Hg and diastolic pressure of 80 mm Hg.
"Blood pressure guidelines are not updated at regular intervals. Instead, they are changed when sufficient new evidence suggests the old ones weren't accurate or relevant anymore," says Dr. Paul Conlin, an endocrinologist with Harvard-affiliated VA Boston Healthcare System and Brigham and Women's Hospital. "The goal now with the new guidelines is to help people address high blood pressure — and the problems that may accompany it like heart attack and stroke — much earlier."
Your doctor can help you measure and track your blood pressure to confirm whether it’s too high. You may need to start taking medications if your blood pressure doesn’t improve after one month of following a healthy lifestyle, especially if you’re already at high risk for heart disease. If you’re at lower risk, your doctor may want to follow up in three to six months after you’ve adopted more healthy habits.
Monitor your blood pressure at home. Home blood pressure monitoring can help you keep closer tabs on your blood pressure, show if medication is working, and even alert you and your doctor to potential complications. Home blood pressure monitoring isn't a substitute for visits to your doctor, and home blood pressure monitors may have some limitations. Even if you get normal readings, don't stop or change your medications or alter your diet without talking to your doctor first.
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.
6. Cultivate stress management. You don’t need a meta-analysis of cohort studies to prove stress can raise blood pressure, but they exist. You can’t eliminate stress, but you can minimize its impact. Research shows yoga and meditation create effective strategies to manage stress and blood pressure. If those aren’t your thing, consider other stress-relieving tactics including deep breathing or practicing mindfulness.
If your blood pressure is always on the low side and you do not have any of the above symptoms, there is usually no cause for concern. Similarly, if you have a single at-home blood pressure reading that is abnormally low without any symptoms, you probably do not need to see your doctor. It is normal for your blood pressure to rise and fall over time, and your body is usually able to get your blood pressure back to normal.
Over a 12-year period, 174 patients diagnosed with mild to severe high blood pressure were seen at the Center for Conservative Therapy and were placed on a medically-supervised, water-only fasting regime. The treatment procedure included an average water-only fasting period of 10.6 days, followed by a supervised refeeding period of about one week with a whole, natural foods diet. The results of the study are summarized in Figure 2.
The new guidelines note that blood pressure should be measured on a regular basis and encourage people to use home blood pressure monitors. Monitors can range from $40 to $100 on average, but your insurance may cover part or all of the cost. Measure your blood pressure a few times a week and see your doctor if you notice any significant changes. Here are some tips on how to choose and use a monitor.
Don’t get too excited. Turns out that dark chocolate (at least 50% to 70% cocoa) can give you a boost of a plant compound called flavanol. As with garlic, this antioxidant can raise your nitric oxide levels and widen blood vessels. That can make your blood pressure drop a notch. It goes without saying that a little bit of chocolate is all you need.
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.