How has your blood pressure been lately? Knowing your number is incredibly important, which is why the National Heart, Lung, and Blood Institute has designated May as National Blood Pressure Education Month. The higher your BP gets, the more at risk you are for future health problems, such as heart disease, cardiac arrest, aneurysm, or a stroke.
And don’t think you can figure it out on your own, without a test. You can’t.
“There are often few or no symptoms associated with high blood pressure, which is why it is called the ‘silent killer,’” says Sondra DePalma, a cardiac physician assistant at PinnacleHealth CardioVascular Institute with UPMC Pinnacle in Harrisburg, Pennsylvania.
You may have heard that you can tell if your blood pressure is high because you’re dizzy, getting nosebleeds, sweating, or feeling flushed. But the American Heart Association says those “symptoms” are just myths, and you shouldn’t be relying on bodily indicators to know when to get checked.
You can purchase a blood pressure monitor to use at home, visit your doctor for a check-up, or even find a pharmacy with a station. You’ll be measuring systolic blood pressure (the first number) and the diastolic blood pressure (the second number). A normal reading should be less than 180/20.
If you do discover that you have high blood pressure, also called hypertension, the first step is talking to a doctor. “Taking medications and following a healthy diet not only reduces [hypertension],” DePalma says, “but it significantly decreases the risk of heart disease, stroke, and other complications of hypertension. A healthcare provider will recommend a medication that has the most benefit with the fewest potential side effects.”
And while the most important thing you can do is take your medication as prescribed, you can make a few other lifestyle changes to lower your blood pressure even more.
Exercise is important to keep your blood pressure in check. If you don’t already, start introducing regular physical activity into your daily routine. That includes aerobic, dynamic resistance, and isometric exercise. DePalma says even if you lose only one kilogram (about 2.2 pounds), that will help reduce systolic blood pressure.
Change your diet
Eating well is a big part of leading a healthy lifestyle, which in turn will help lower your blood pressure. Introduce more fruits, vegetables, whole grains, and low-fat dairy products into your diet while trying to avoid saturated and trans fats. These are mostly found in fried foods, baked goods, meat, and dairy products.
And put down the saltshaker; you should only be consuming up to 1,500 mg of sodium per day (though most of us are getting upward of 3,600 mg). To put that in context, one serving of Lay’s potato chips (about 15 chips) has 170 mg of sodium, and a single veggie burger is nearing 400 mg. Look for fresh fruit and veggies instead of canned, dried beans or canned ones that say low- or no-sodium, and unsalted butters, oils, and dressings.
If lowering your sodium intake to 1,500 mg per day seems too difficult to start, DePalma advises that adults should try to reduce their current daily intake by at least 1,000 mg.
Finally, boost your potassium levels as well; you should aim for between 3,500 and 5,000 mg per day. You can increase your intake with foods like avocados, bananas, and spinach. Avoid potassium supplements, though, unless they’re prescribed. (Too much can lead to potentially deadly side effects.)
Be mindful of your other medications
Just because you’re taking medication to treat your high blood pressure doesn’t mean it won’t ever go up again. It can fluctuate with different medications and substances—and depending on what you’re taking, your blood pressure medication may not work as well.
Those interactions include some over-the-counter medications (like decongestants and nonsteroidal anti-inflammatories such as ibuprofen), some supplements (including ephedra and St. John’s Wort), some prescriptions (like birth control pills, systemic corticosteroids, and immunosuppressants), and other substances like alcohol, caffeine, and recreational drugs.
It’s important to speak with your doctor about anything you may be taking, and DePalma recommends taking over-the-counter medications at the lowest dose possible and for the shortest duration.
Tackle your vices
It’s best to kick that caffeine, smoking, or drinking habit now, as all of these can increase your blood pressure. Moderation is best (although you might want to stop smoking completely, for a multitude of reasons). For alcohol, DePalma recommends men have two or fewer drinks a day and women have only one. Caffeine should be limited to 400 mg per day—which is roughly four cups of coffee.
No matter how you decide to manage your hypertension and medication, though, remember that it’s most important to follow the directions of your prescription appropriately.
“Just because someone isn’t having symptoms, doesn’t mean they can stop taking their medication,” DePalma said.
Luckily, pre-hypertension can be reversed—but if you cross the line into official consistent high blood pressure, you’ll have to control it with medication and lifestyle changes for the rest of your life.