The dangers of hypertension, or high blood pressure, are well known.
Though you may have no signs or symptoms, this so-called silent killer can be wreaking havoc in your body, damaging your arteries and taxing your heart.
In the United States in 2013, high blood pressure resulted in almost 1,000 deaths every day, according to the Centers for Disease Control and Prevention (CDC). Unfortunately, the first sign may be a stroke or a heart attack, because about one in five U.S. adults with high blood pressure don’t know they have it until it seriously damages the heart or weakens blood vessels in the brain.
So how do you know if you’re in the danger zone? And how do you avoid becoming 1 of 70 million Americans the CDC says have prehypertension, or blood pressure higher than normal but not yet in the high blood pressure range?
Blood pressure is measured with two numbers, in millimeters of mercury (mm Hg). The top number reflects systolic pressure, the highest pressure reached when the heart contracts; the bottom number reflects diastolic pressure, the lowest pressure reached just before the heart contracts again.
Hypertension is defined as blood pressure of 140/90 or higher. Prehypertension is in the range of 120 to 139 systolic and 80 to 89 diastolic.
Most medical professionals agree on those numbers, and on the serious consequences of hypertension: heart disease, stroke, kidney damage, and vision-robbing eye disease.
Beyond that, things get more complicated, and consensus is harder to come by.
What’s the Right Way to Measure Blood Pressure?
If you’ve ever tested your blood pressure at home, you’ve probably discovered that you don’t get a consistent number. Numbers can jump up or down 20, 30, or even 40 points in one day — sometimes in just a few minutes. It’s different at different times of the day, and no two days are the same. So if your systolic pressure goes from 150 in the doctor’s office to 120 at home, do you have hypertension? Prehypertension? Neither of these? How do you know?
If you monitor your blood pressure at home, you might also discover that many doctors don’t follow the guidelines for properly taking blood pressure readings. Guidelines featured in a video by the American Academy of Family Physicians instruct home measurers to follow these steps:
- Don’t eat or use caffeine, alcohol, or tobacco products 30 minutes before measuring your blood pressure.
- Go to the bathroom and empty your bladder before measuring your blood pressure.
- Rest for 3 to 5 minutes before measuring your blood pressure. Do not talk.
- Sit in a comfortable position, with your legs and ankles uncrossed and your back supported.
- Place your left arm, raised to the level of your heart, on a table or a desk, and sit still.
- Wrap the cuff smoothly and snugly around the upper part of your bare arm. The cuff should fit snugly, but there should be enough room for you to slip one fingertip under the cuff.
- Check to see that the bottom edge of the cuff is 1 inch above the crease of your elbow.
If you question your primary care doctor about measuring your own blood pressure, as I did, you might be told not to worry about it or to stop checking so often. Or you may suffer from white-coat hypertension, in which blood pressure spikes when measured in the doctor’s office.
How Do You Know if You Have High Blood Pressure?
Among the uncertainties about blood pressure, there is a reliable option in the quest to discover a number you can trust: It’s called ambulatory monitoring. If your physician advises this option, you’ll wear a device that measures your blood pressure at half-hour intervals for 24 hours. According to the United States Preventive Services Task force, a federally sponsored group that draws up medical guidelines, 12 to 48 hour monitoring is the preferred way to determine a diagnosis of high blood pressure. “We all know treating hypertension is good, but we don’t know how aggressive we should be,” Michael Lauer, MD, director of the Division of Cardiovascular Sciences at the National Heart, Lung, and Blood Institute (NHLBI) told The New York Times in 2015.
In an effort to reduce deaths from cardiovascular disease, the NHLBI initiated a study calledSprint to answer the question, “Will lower blood pressure reduce the risk of heart and kidney disease, stroke, or age-related declines in memory and thinking?” Sprint researchers are following 9,000 adults with high blood pressure; half are expected to get their systolic blood pressure below 120, and the other half below 140. Study results should be out in 2017.
In the meantime, the optimal blood pressure number is still somewhat of a mystery.
What You Can Do to Lower Your Blood Pressure
What isn’t a mystery is that lifestyle changes can play a big part in reducing and controlling blood pressure levels. These include cutting back on dietary salt, quitting smoking, eating a plant-based diet, exercising regularly, losing excess weight, and managing stress.
Here are a few simple suggestions from 500 Time-Tested Home Remedies and the Science Behind Them for enhancing your diet and managing stress.
Eat Fish. The omega-3 fatty acids in fish oil from fatty fish such as sardines, mackerel, and salmon have been shown to reduce blood pressure in people with mild hypertension. Here’s an easy recipe for a quick snack or lunch that’ll provide omega-3s:
1 can (8- to 12-count) oil-packed sardines
12-16 whole-grain crackers
Lemon wedges
Sprigs of parsley
Spread each cracker with half a sardine. Squeeze lemon juice on top. Add parsley to garnish.
YIELD: 4 Servings
Eat Apples. Apple peels are rich in the cholesterol-lowering fiber pectin and in flavonoids that inhibit angiotensin-converting enzyme, which indirectly increases blood pressure by causing blood vessels to constrict.
Be Mindful. Studies show that a regular meditation practice can help manage hypertension. So create your own practice: Mindfully brush your hair or rub lotion on your arms and legs. Or simply repeat a mantra with your eyes closed and your body in a relaxed posture. Being mindful means focusing on all of the sensations of the present moment (touch, smell, and sound), such as movement of a brush through your hair.
