Q: What do the numbers mean?

Q: What should my blood pressure be?

A: Medical guidelines state that a normal blood pressure for most adults is less than 120/80 mm Hg. However, You should talk to your doctor about establishing a blood pressure goal that's right for you.

Q: Which is more important, the bottom or the top number?

A: Both numbers are very important. In general, the top number is most often high – and the top number (Systolic pressure) becomes increasingly important as you get older.

Q: As you get older is it still necessary to get your blood pressure below 140/85mmHg?

A: No matter what age you are – you need to keep your blood pressure UNDER 120/80 and you need to be on medications if your blood pressure ever reaches 140/90

Q: Can high blood pressure be cured?

A: You should think of resolving your high blood pressure situation as "controlled" rather than "cured".  If you have high blood pressure, you will, most likely need to control it for the rest of your life.

It is important to do what it takes to keep your numbers below 120/80 because any time your blood pressure goes above those numbers your internal organs are being damaged, and you are increasing your risk of heart attack or stroke.  If your blood pressure is only pre-hypertensive (meaning, between 140/90 and 120/80) you may be able to make lifestyle changes like exercise and lowering salt intake, to control your blood pressure.  If it is above 140/90, your doctor may suggest certain medications that can control your blood pressure.

Q: What is a dangerously high blood pressure?

A: When your blood pressure is greater than 120/80, the pressure is damaging your arteries. When your pressure reaches 140/90, see your doctor to ask about help with medication; the pressure is certainly creating damage to the blood vessels and organs throughout your body. This is dangerous although not an “emergency”. Keep in mind, every increment of 20/10 higher than “normal”; your chances of having a heart attack or stroke DOUBLES.

Q: How high does it have to be before you have a stroke or a heart attack?

A: High Blood pressure is ONE important factor in you having a heart attack or stroke. Other factors include your age, your family history, smoking, cholesterol and diabetes. In general, the higher your blood pressure – the more likely you are to have a heart attack or stroke. Your chances DOUBLE for every elevation of 20/10 higher than 115/75.

A: If your lower number (diastolic) is 80 or less, but your top number (systolic) is over 120 – you have high blood pressure. If your top number is 140 or more, you may need medication to reduce your blood pressure even if your bottom number is “normal”.

A: High Blood Pressure can cause things like Heart Attacks, Strokes, Kidney Failure, and Aneurysms. All of these conditions are deadly.

A: You should think of resolving your high blood pressure situation as "controlled" rather than "cured".  If you have high blood pressure, you will, most likely need to control it for the rest of your life.

It is important to do what it takes to keep your numbers below 120/80 because any time your blood pressure goes above those numbers your internal organs are being damaged, and you are increasing your risk of heart attack or stroke.  If your blood pressure is only pre-hypertensive (meaning, between 140/90 and 120/80) you may be able to make lifestyle changes like exercise and lowering salt intake, to control your blood pressure.  If it is above 140/90, your doctor may suggest certain medications that can control your blood pressure.

Q: What tests should I have done if I am found to have high blood pressure?

A: When you are diagnosed with High Blood Pressure, your physician will most likely evaluate your overall “cardiovascular risk” by taking other tests. These tests may include Cholesterol levels, an EKG or Stress Test, Kidney function tests as well as others. If you are found to have blood pressure over 140/90, medical guidelines recommend you begin medication to stop damaging the inside of your arteries. If your blood pressure is higher than 120/80 but not yet as high as 140/90, then you can begin lifestyle modifications which include weight loss, eating less salt and other diet changes.

Q: Can high blood pressure give you headaches?

A: It is now estimated that 73 million Americans have high blood pressure (hypertension). Often, people who have hypertension, do not realize it because the disease does not typically have warning signs or symptoms. You may have heard it referred to as the "silent killer". Still, a few people do experience symptoms like headache, back or leg pain and even nosebleeds.

Unchecked hypertension can deduct 15-20 years from your life. Do not wait for symptoms to have your blood pressure checked.

Q: I have diabetes, does my blood pressure have to be lower than that of other people?

A: When you have diabetes – you are at high risk for kidney disease. High Blood pressure ALSO causes kidney damage. Therefore, people who have diabetes are at HIGH risk for kidney disease and kidney failure. Therefore, you need to work together with your physician to make SURE that your blood pressure is aggressively monitored. Medical guidelines recommend non-diabetics begin medication if their blood pressure is over 140/90. Folks with diabetes need to begin blood pressure medication if their blood pressure is over 130/80. There are particular types of blood pressure medication that are especially helpful in diabetic patients.

Q: I am very fit and healthy and have no family history of high blood pressure, so why do I have it?

A: Most of the time, Blood Pressure is said to be “idiopathic”. This means, you have it and we don’t know the exact cause. In other words, you can be overweight and get high blood pressure, OR you can be perfectly healthy and a triathlon athlete and STILL have high blood pressure. Nevertheless, IF you are young and healthy and fit and you are diagnosed with high blood pressure, your physician will look for “secondary causes” of your blood pressure elevation.

When something goes wrong in one part of your body, a ripple effect can create problems elsewhere — such as high blood pressure (hypertension). In fact, according to the American Heart Association, 5 to 10 percent of hypertension cases are caused by an underlying condition.

Proper treatment can often control or cure both the underlying condition and the high blood pressure, which reduces the risk of serious complications — including heart disease, kidney failure and stroke.

Q: How often should I be doing readings?

A: If you haven't checked your numbers in a year or two, you should check immediately just to see if you are in the normal range.  (120/80 or below)

If you have shown to be pre-hypertensive you should check your blood pressure at least once a month.  If you are hypertensive, talk with a physician about how often he or she recommends you check your blood pressure.  Many times, a doctor will recommend patients monitor their blood pressure daily, especially if you are on medications or recently changed prescriptions/dose.   Ideally, monitor your blood pressure at the same time everyday.

Q: Should I be monitoring my blood pressure at home?

A: Yes, monitoring your blood pressure at home is the BEST way to keep tabs on your blood pressure. When you take your blood pressure with your home monitor – you should be seated quietly for 5 minutes in a chair with your feet on the floor and your arm resting on a support at heart level.

Q: Can I ever stop taking medication once I start taking them?

A: Some people will begin taking medication because their pressure is over 140/90; and with weight loss or lifestyle modification, their blood pressure medication can eventually be stopped for good. However, MOST people who have hypertension will need to take blood pressure pills for life. The good news is that many patients can work with their doctors to find a Blood Pressure medication that causes NO side effects and can be taken only once/day.

Q: Does it matter what time of day I take my medication?

A: This question depends on what type of medication you’re taking, what OTHER medications you take, and what types of medical problems you have. Work with your pharmacist and physician to make sure you know when you should be taking your medication.

Q: My medication is not working - what can I do?

A: If you’re on Blood Pressure medication and your pressure remains high (over 140/90), then you should work with your physician on one of three options:

1. Increase the current dose of the medicine you’re on
2. Change to a different BP medication
3. Continue your medication and add another BP medicine.

Many patients with hypertension will require two or more blood pressure medications to achieve a “safe” blood pressure.

Q: Is high blood pressure more likely in people who are very nervous or highly strung?

A: NO; Anxiety and being “high strung” people are just as likely to have high blood pressure as folks who seem “laid back”.

Q: Will changing my lifestyle really make much difference?

A: Yes. Lifestyle modification CAN lower your blood pressure significantly and keep you from having to start blood pressure medication in many cases. Lifestyle modifications include the “DASH” eating plan ("DASH" stands for "Dietary Approaches to Stop Hypertension,") which is rich in potassium and calcium and low in sodium, physical activity, making sure alcohol consumption is moderate or less etc. The “DASH” eating plan can have a similar BP lowering effectiveness as taking a blood pressure medication. Lifestyle modifications can reduce your blood pressure, enhance the effectiveness of BP medication, and decrease your risk of having a stroke or heart attack.

Too much salt, saturated fat and calories, combined with not enough fruits and vegetables can be a recipe for hypertension. Many times, people who are pre-hypertensive can lower their blood pressure with lifestyle changes. (get more information from the lifestyle page of this web site).

Lifestyle modifications include: exercise, consuming less salt, lowering the amount of saturated fat in your diet and even making sure potassium and calcium are a part of your weekly diet regiment.

Q: How much salt do I need to cut out of my diet?

A: According to the CDC, you should limit your sodium to 1,600mg per day. View the dash diet here »

Q: Do relaxation techniques and yoga help to lower blood pressure?

A: Your doctor may suggest lifestyle changes to lower your blood pressure.  Many times, that includes an exercise program, quitting smoking and learning stress-reduction and relaxation techniques. For more than 40 years, doctors and researchers have believed that our body’s “fight or flight” response to stress can be dangerous if not controlled.

Fight or flight is what the body does as it prepares to deal with danger.  But trouble starts when this response is constantly provoked by day-to-day events, such as economic problems, traffic, job issues or family problems.  Health problems are one result. A prime example is high blood pressure, a major risk factor for heart disease.  We can’t avoid all sources of stress in our lives but we can develop healthier ways of responding to them.  According to studies done at Harvard University over the past 30 years, one way is to invoke a relaxation response -  state of profound rest that can be elicited in several ways, including meditation, yoga, deep abdominal breathing and progressive muscle relaxation.

Q: Is it true that there are certain cold medicines I shouldn't take if I have high blood pressure?

A: When you have high blood pressure, you must be cautious when you take other medication, including “over the counter” medications. Many medications that you can buy over the counter will have decongestants and other ingredients that can cause your blood pressure to elevate. ALWAYS tell the local pharmacist that you have high blood pressure and ask them if the medicine you’re about to purchase will increase your blood pressure.

Q: My blood pressure seems to vary day by day. How do I know which number is correct?

A: Make sure you’re taking your blood pressure correctly: When you take your blood pressure you should be seated quietly for 5 minutes in a chair with your feet on the floor and your arm resting on a support at heart level. Take 2 blood pressure measurements on each arm. The 2nd measurement is usually the most accurate. By taking your pressure this way, it’s much more accurate than if you’re standing up, or in a hurry, or you’ve just exercised etc… Also, you should bring your home blood pressure monitor with you to your next physician visit – so that you can be sure your home monitor is giving you the same number as your physician measures.

Q: What effect does hypertension have on my body?

A: High Blood Pressure is also called “Hypertension”. Inside the arteries of your body, your blood and plasma exert a pressure against the inside walls of the arteries. If the pressure is too high, it’s called High Blood Pressure. High Blood Pressure damages the inside walls of your arteries – which can lead to Stroke, Heart Attack, Blindness, Kidney disease and other serious medical conditions.

Q: Does it matter which arm I use to measure my blood pressure?

A: Generally you can take a BP measurement using either arm; however, If one of your arms typically reads higher than the other, the arm with the higher numbers should be used to determine your blood pressure reading. If you are measuring using a home monitor it is recommended that you be seated quietly for 5 minutes in a chair with your feet on the floor and your arm resting on a support at heart level.