7 lifestyle changes to manage high blood pressure

Doctors call it a silent killer that attacks your heart. It’s high blood pressure — the unnoticeable strain on your heart and blood vessels that raises your risk of heart attack and stroke.

If you have high blood pressure (or think you might), it’s important to take steps to manage the condition. Healthy lifestyle changes can play a big role, says Christopher Marnell, MD, an Atlantic Health cardiologist.

“Medication can help you control your blood pressure. But there’s also so much you can do through lifestyle changes,” he says. “They can help manage the severity of your blood pressure. If you make changes early enough, you may even prevent the condition.”

Here, he offers some insights into how high blood pressure can affect you and how you can make yourself less vulnerable to cardiac events.

What’s blood pressure, and what does your number mean?

Your blood pressure is the force your blood puts on your blood vessels as your heart pumps. That pressure is responsible for getting oxygen-rich blood to your organs. Blood pressure measurements are made up of two numbers:

• Systolic (top number): The pressure when your heart beats and pumps blood out
• Diastolic (bottom number): The pressure when your heart rests between beats

According to the American Heart Association (AHA), normal blood pressure is less than 120/80 mm Hg. Any measurements above that fall into these categories:

• Elevated: A systolic number between 120 and 129 mm Hg and a diastolic number less than 80 mm Hg
• Stage 1 high blood pressure: A systolic number between 130 and 139 mm Hg or a diastolic number between 80 and 89 mm Hg
• Stage 2 high blood pressure: A systolic number between 140 or higher or a diastolic number higher than 90 mm Hg
• Markedly elevated (severe) blood pressure: A systolic number above 180 mm Hg and/or a diastolic number of 120 mm Hg or higher. Blood pressures this high may not produce symptoms. But if they do, they’re considered to be a hypertensive emergency.  

Does high blood pressure ever produce symptoms?

You can have high blood pressure and not know it, Dr. Marnell says. Most people never feel symptoms.

But if you’re experiencing a hypertensive emergency, your symptoms can include:

• Chest pain
• Confusion
• Dizziness
• Nosebleeds
• Severe headaches
• Shortness of breath

If these symptoms appear, you need immediate attention and evaluation, he says. If your blood pressure is higher than 180/120 mm Hg, wait at least one minute and try taking another reading. If it’s still high and you have no new or concerning symptoms, contact your health care provider.

What are the risks of high blood pressure?

High blood pressure is linked to an increased risk of cardiovascular events like heart attack and stroke, according to Dr. Marnell. But it can also cause other problems, including:

• Aortic aneurysm: Pressure on your artery walls causes them to bulge and break open.
• Atherosclerosis: A buildup of cholesterol, fat and plaque damages your artery walls and causes them to harden.
• Heart failure: After working too hard to pump blood, your heart grows too big and isn’t strong enough to pump well.
• Kidney damage: Blood vessel damage in your kidneys leads to kidney failure.
• Vision loss: Blood vessel damage in your eyes can lead to blurred or lost vision.

It’s important to know that low blood pressure can also cause problems, Dr. Marnell says. If your blood pressure is too low (below 90/60 mm Hg), your organs may not get enough oxygen-rich blood.

How can you manage or lower your blood pressure?

A yearly blood pressure screening with your primary care provider or through a community screening program is a vital step. This test can help you catch high blood pressure early before it can cause other problems.

To help reduce the risks associated with hypertension, your doctor may recommend medication to lower your blood pressure. But making changes to your daily activities can help too.

“Diet or lifestyle modifications are very important in helping to lower your blood pressure and can help reduce or even eliminate the need for medication in some cases,” he says. “That’s why adopting healthy behaviors is our first recommendation when we diagnose high blood pressure.”

Dr. Marnell cautions that you shouldn’t stop or change your prescription medications without talking to your doctor first.

Dr. Marnell recommends these lifestyle changes to help manage blood pressure on your own:

1. Follow the DASH diet: Too much sodium makes you retain water, increasing pressure on your blood vessels. The Dietary Approaches to Stop Hypertension (DASH) diet is a diet that emphasizes fruits, lean protein, low-fat dairy, vegetables and whole grains, while limiting sodium and foods high in saturated fat and added sugars.
2. Get a home blood pressure monitor: A home monitor can track your blood pressure every day instead of once a year. It’s a way to track any changes with your condition. The American Medical Association offers guidance to help you choose a reliable home monitor.
3. Increase exercise: Choose a physical activity that you can stick with and enjoy. Aim for 150 minutes of moderate exercise or 75 minutes of intense exercise a week.
4. Limit alcohol: Alcohol can cause sleep apnea and weight gain — two contributing factors to high blood pressure. The AHA recommends avoiding alcohol because even moderate amounts can raise your blood pressure. But if you choose to drink, limit alcohol to no more than one drink daily for women and two for men.
5. Maintain a healthy weight: Extra weight forces your heart to pump harder. It also increases your risk of sleep apnea. Talk with your doctor about steps you can take to reach a healthy weight.
6. Reduce stress: Stress increases hormones that narrow your blood vessels and make your heart pump harder. Activities like deep breathing, meditation, walking and yoga can lower stress levels.
7. Quit smoking: Smoking increases your blood pressure and heart rate almost instantly. It also damages your blood vessels over time. If you quit, your blood pressure starts to return to a normal range, and your risk of cardiac events drops.

High blood pressure can easily go undetected. Taking steps early to manage and reduce it can protect your long-term heart health. Your primary care provider can help.

“High blood pressure is common, and it’s very treatable,” Dr. Marnell says. “Don’t overlook or dismiss these small lifestyle changes. Many things within your control can help you manage your blood pressure.”