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Established High Blood Pressure

High blood pressure (hypertension) is a chronic disease. Often, healthcare providers don’t know what causes it. But it can be caused by certain health conditions and medicines.

If you have high blood pressure, you may not have any symptoms.

If you do have symptoms, they may include headache, dizziness, changes in your vision, chest pain, and shortness of breath. But even without symptoms, high blood pressure that’s not treated raises your risk for heart attack and stroke. High blood pressure is a serious health risk and shouldn’t be ignored.
A blood pressure reading is made up of two numbers: a higher number over a lower number. The top number is the systolic pressure. The bottom number is the diastolic pressure. A normal blood pressure is a systolic pressure of  less than 120 over a diastolic pressure of less than 80. You will see your blood pressure readings written together. For example, a person with a systolic pressure of 118 and a diastolic pressure of 78 will have 118/78 written in the medical record. High blood pressure is when either the top number is 140 or higher, or the bottom number is 90 or higher. This must be the result when taking your blood pressure a number of times. The blood pressures between normal and high are called prehypertension.

Home care

If you have high blood pressure, you should do what is listed below to lower your blood pressure. If you are taking medicines for high blood pressure, these methods may reduce or end your need for medicines in the future.

  • Begin a weight-loss program if you are overweight.
  • Cut back on how much salt you get in your diet. Here’s how to do this:
    • Don’t eat foods that have a lot of salt. These include olives, pickles, smoked meats, and salted potato chips.
    • Don’t add salt to your food at the table.
    • Use only small amounts of salt when cooking.
  • Start an exercise program. Talk with your healthcare provider about the type of exercise program that would be best for you. It doesn't have to be hard. Even brisk walking for 20 minutes 3 times a week is a good form of exercise.
  • Don’t take medicines that stimulate the heart. This includes many over-the-counter cold and sinus decongestant pills and sprays, as well as diet pills. Check the warnings about hypertension on the label. Before buying any over-the-counter medicines or supplements, always ask the pharmacist about the product's potential interaction with your high blood pressure and your high blood pressure medicines.
  • Stimulants such as amphetamine or cocaine could be deadly for someone with high blood pressure. Never take these.
  • Limit how much caffeine you get in your diet. Switch to caffeine-free products.
  • Stop smoking. If you are a long-time smoker, this can be hard. Talk to your healthcare provider about medicines and nicotine replacement options to help you. Also, enroll in a stop-smoking program to make it more likely that you will quit for good.
  • Learn how to handle stress. This is an important par of any program to lower blood pressure. Learn about relaxation methods like meditation, yoga, or biofeedback.
  • If your provider prescribed medicines, take them exactly as directed. Missing doses may cause your blood pressure get out of control.
  • If you miss a dose or doses, check with your healthcare provider or pharmacist about what to do.
  • Consider buying an automatic blood pressure machine. Ask your provider for a recommendation. You can get one of these at most pharmacies.

The American Heart Association recommends the following guidelines for home blood pressure monitoring:

  • Don't smoke or drink coffee for 30 minutes before taking your blood pressure.
  • Go to the bathroom before the test.
  • Relax for 5 minutes before taking the measurement.
  • Sit with your back supported (don't sit on a couch or soft chair); keep your feet on the floor uncrossed. Place your arm on a solid flat surface (like a table) with the upper part of the arm at heart level. Place the middle of the cuff directly above the eye of the elbow. Check the monitor's instruction manual for an illustration.
  • Take multiple readings. When you measure, take 2 to 3 readings one minute apart and record all of the results.
  • Take your blood pressure at the same time every day, or as your healthcare provider recommends.
  • Record the date, time, and blood pressure reading.
  • Take the record with you to your next medical appointment. If your blood pressure monitor has a built-in memory, simply take the monitor with you to your next appointment.
  • Call your provider if you have several high readings. Don't be frightened by a single high blood pressure reading, but if you get several high readings, check in with your healthcare provider.

Follow-up care

You will need to see your healthcare provider regularly. This is to check your blood pressure and to make changes to your medicines. Make a follow-up appointment as directed. Bring the record of your home blood pressure readings to the appointment.

When to Seek Medical Advice

Call your healthcare provider right away if ANY of these occur:
  • Blood pressure reaches a systolic (upper number) of 180 or higher OR a diastolic (bottom number) of 110 or higher
  • Chest pain or shortness of breath
  • Severe headache
  • Nosebleed
  • Sudden severe pain in your belly (abdomen)
  • Extreme drowsiness, confusion, or fainting
  • Dizziness or spinning sensation (vertigo)
  • Weakness of an arm or leg or one side of the face
  • You have problems speaking or seeing 
  • Note: When blood pressure reaches a systolic (top number) of 180 or higher OR diastolic (bottom number) of 110 or higher, seek emergency medical treatment.
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