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What to Do When Your Blood Pressure Is Too High

High Blood Pressure

High blood pressure is often referred to as the silent killer. Despite its severe risk to your health and well-being, it often doesn’t come with symptoms of the damage it’s doing to your body. But the risks of high blood pressure are significant. Over time, it can contribute to a heart attack, a stroke, heart failure, kidney problems, memory problems and more. It also affects more than 100 million Americans and leads to almost 80,000 deaths in the United States each year, according to the American Heart Association.

The importance of getting a blood pressure reading

Considering the lack of symptoms presented by high blood pressure, it’s critical to know your reading and get it checked regularly if you’re at risk for high blood pressure. Your blood pressure can be checked at your doctor’s office, at home or even in kiosks at drug stores and other retail locations. If your doctor determines that you should check your blood pressure more regularly, he or she may prescribe you with a blood pressure cuff to use at home. Then you can track your blood pressure regularly and keep a record of your progress over time.

Checking your blood pressure involves a routine, painless test performed using a blood pressure cuff that is wrapped around the top part of your arm, the Mayo Clinic explains. You may feel a slight squeezing sensation as the cuff is inflated. Once the test is complete and you know your current blood pressure, you can decide on the next steps.

Understanding your reading

Your blood pressure reading is made up of two numbers that are often presented like a fraction. The top number, known as the systolic pressure, is the pressure in your arteries when your heart beats and blood is moving through your veins, the Mayo Clinic says. The bottom number in your blood pressure reading, the diastolic pressure, is the resting pressure in your arteries between heartbeats. It's typically lower than the systolic blood pressure.

Different blood pressure readings can mean different things for your health. The ranges below may help you understand what your number actually means:

  • Low blood pressure: systolic is below 90 and diastolic is below 60
  • Normal blood pressure: systolic is below 120 and diastolic is below 80
  • Elevated blood pressure: systolic is 120 to 129 and diastolic is below 80
  • Stage 1 hypertension: systolic is 130 to 139 or diastolic is 80 to 89
  • Stage 2 hypertension: systolic is 140 or higher or diastolic is 90 or higher
  • Hypertensive crisis: systolic is 180 or higher or diastolic is 120 or higher

When blood pressure is an emergency

While all blood pressure readings above 120 over 80 are cause for action and lifestyle changes, the final category on the list above is an emergency medical situation, the Mayo Clinic warns. If you have a blood pressure reading that yields a top number (systolic) of 180 or higher or a bottom number (diastolic) of 120 or higher, you should seek medical attention right away.

The American Heart Association notes that there are two types of hypertensive crises:

  • Hypertensive urgency: This is when you get the 180/120 reading, but it’s not accompanied by any other concerning symptoms. In this situation, you can check your reading again in five minutes to see if it has gone down at all. You should still contact your doctor if you experienced a reading that high, but it may just require an adjustment in medications, rather than hospitalization.
  • Hypertensive emergency: This is a reading of 180/120 accompanied by symptoms such as shortness of breath, numbness, weakness, a change in vision, back pain, chest pain or difficulty speaking. These symptoms should prompt an immediate call for emergency help.

If you want to lower your blood pressure quickly

If your blood pressure is very high, the best advice is to contact your doctor and follow his or her instructions closely. Your doctor will likely start with a thorough medical history and physical exam to determine if what you are experiencing is a hypertensive urgency situation with no symptoms, or a hypertensive emergency with noticeable symptoms.

In many cases, the primary response to very high blood pressure is a monitored 30-minute rest period. The American Academy of Family Physicians (AAFP) notes that this will lower blood pressure to an acceptable level in 30 percent of people. Other cases of hypertensive crisis may require a change in medication or new medications. However, this process will be done with caution, as lowering high blood pressure too quickly can also be dangerous. The AAFP adds that your doctor should recommend attempting to lower your high blood pressure gradually over the course of several days.

Forming a sustainable blood pressure plan

If you have chronic (long-lasting) high blood pressure or have experienced a hypertensive crisis, then the stakes are high both for your heart and overall health. Over time, the effect of increased pressure on the heart and blood vessels can inflict damage not only to your cardiovascular system, but all over your body.

The key is to have a long-term plan for managing high blood pressure and bringing it back down to a healthy level. This can involve some combination of medications and lifestyle changes, the Mayo Clinic notes, although many people find that they can reduce their reliance on medications or even avoid them altogether by making serious changes to their overall lifestyle. Here are some steps that can help you:

  • Eat healthy. A diet known as Dietary Approaches to Stop Hypertension, or DASH, has proven its ability to lower blood pressure by an average of 11 points in people who stick to it. The basic tenets of the diet include plentiful fruits and vegetables, whole grains and lean sources of protein with lower amounts of saturated fat and cholesterol. Low sodium is also a key component of the DASH diet.
  • Exercise more. Regular exercise is another key lifestyle change with a proven impact on blood pressure, lowering it by an average of five to eight points. It's fine to make a simple start — even basic things like regular walking can make a big difference.
  • Limit problematic substances. Smoking has been shown to raise blood pressure each time you light up, and caffeine may also raise blood pressure, although this effect is diminished if you drink caffeine regularly. Alcohol can actually reduce blood pressure if you limit it to a drink or two a day, but overuse of alcohol raises blood pressure.
  • Watch stress levels. If you can find a way to keep daily stress in check, this can also have a positive effect on your blood pressure.
  • Lose weight. If you get down to a healthy weight through some of the other steps on this list, the net impact can be a one-point drop in blood pressure for every 2.2 pounds of weight you lose.
  • Follow your doctor’s orders on medication. A number of medications can also help with blood pressure management. Make sure to use them carefully, according to your doctor’s directions, to keep your blood pressure at a healthy level.

The last word on blood pressure management

There’s no magic bullet for keeping blood pressure under control, but making any changes you can to manage it is critically important, particularly if your blood pressure levels shift from high to crisis levels. Fortunately, there are a number of steps you can take to bring blood pressure quickly under control and keep it there. This usually involves a combination of both medications and healthy lifestyle changes.

Article references

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  2. High blood pressure (Hypertension), Mayo Clinic, 2019, https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/diagnosis-treatment/drc-20373417
  3. More than 100 million Americans have high blood pressure, AHA says, American Heart Association, 2018, https://www.heart.org/en/news/2018/05/01/more-than-100-million-americans-have-high-blood-pressure-aha-says
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