Blood Pressure: How to Manage It

Do not wait until it is too late

High blood pressure has no symptoms, but it can lead to serious health problems. Over time, high blood pressure can damage the heart, blood vessels, eyes, and other organs, and it increases your risk for having a heart attack or stroke.

Did you know that one in three Americans has high blood pressure? And another 1 in 3 has prehypertension-blood pressure levels that are higher than normal but not yet in the “high” range.

What is high blood pressure?

Blood pressure is the force in the arteries when the heart beats (systolic pressure) and when the heart is at rest (diastolic pressure). It is measured in millimeters of mercury (mm Hg). High blood pressure (or hypertension) is defined in an adult as a blood pressure greater than or equal to 140 mm Hg systolic pressure, or greater than or equal to 90 mm Hg diastolic pressure.

Do I have high blood pressure?

< = less than, > = greater than

If you have one high blood pressure test, your doctor will repeat the test to confirm a diagnosis of high blood pressure (hypertension). If you blood pressure is 140/90 or higher over time, you doctor will likely diagnose you with high blood pressure.

Am I at risk?

You may be at extra risk for high blood pressure if you:

• Are overweight
• Have a family history of high blood pressure
• Eat foods high in sodium and low in potassium
• Do not exercise regularly
• Smoke
• Drink a lot of alcohol (more than two drinks per day for men or more than one drink per day for women)
• Have diabetes

Family history

”We can’t change the cards we’re dealt, just how we play the hand.”—Randy Pausch

However, you can take steps to manage blood pressure and protect your heart, no matter what your family history is!

What can you do?

Step 1: Practice weight management

If you are overweight, just losing 5 - 10% of your weight can significantly reduce your blood pressure. To lose weight, control the calories you consume and increase your physical activity. Cutting back just 500 calories per day and increasing exercise is usually enough to promote weight loss. What does 500 calories look like? One 20-fluid-ounce (fl oz) bottle of regular cola plus one regular-sized candy bar equals approximately 500 calories.

Step 2: Do not smoke

What are the benefits over time when smokers quit?

(Modified from American Cancer Society. Guide to quitting smoking. http://www.cancer.org/healthy/stayawayfromtobacco/guidetoquittingsmoking/guide-to-quitting-smoking-benefits. Accessed September 2, 2015.)

Cigarette smokers have a 70% greater chance of dying of heart disease than nonsmokers.

Step 3: Exercise regularly

Aim for 30 minutes of moderate intensity aerobic activity on most days of the week. To know if you are working at a moderate intensity, rate your exercise on a scale from 1 to 10, where 1 is very easy and 10 is extremely hard. If you are working between a 4 and 7, then you are working at moderate intensity. Three 10-minute bouts of physical activity, such as walking, can have many of the same benefits as one 30-minute bout.

Step 4: Reduce your salt intake

What does salt have to do with anything? Sodium is the main ingredient in salt that regulates body fluids and blood pressure. Sodium is a mineral that travels with water in the body. The more sodium you consume, the more fluid that leaves other places in your body to go into your bloodstream. This increases the volume of blood you have, which increases your blood pressure.

In recent years, the guidelines for sodium intake for good health have been lowered. Health experts recommend limiting sodium intake to less than 2 300 milligrams (mg)/day to help lower or control blood pressure, and to less than 1 500 mg/day for those who are over 50 years of age, African American, or have diabetes, chronic kidney disease, or hypertension. Many Americans eat more than 4 000 mg of sodium a day. Just one teaspoon of salt contains 2 300 mg of sodium! One easy way to reduce the sodium today is to remove the saltshaker from the table.

Note: If buying a convenience food, choose entrees (main course) with less than 800 mg of sodium/serving.

Food labels: Know where to look!

Sodium food label claims

Step 5: Limit alcohol

Step 6: Manage stress

Stress is a normal part of life, and some stress is actually a good thing. Stress motivates us to get things done. Too much bad stress causes a surge of stress hormones in your body. These hormones temporarily increase your blood pressure by causing your heart to beat faster and your blood vessels to narrow.

It is not yet determined if chronic stress causes long-term high blood pressure, but it is possibly a contributing factor, especially if other unhealthy lifestyle factors are causing the stress, such as unhealthy eating, lack of exercise, smoking, drinking alcohol, or not getting adequate sleep.

You can take control of your stress level in many great ways:

• First determine what your main stressors are. Solve the underlying problem, eliminate any unnecessary stressors, or take action to manage the stress you have.
• Practice time management. If you cannot find time for all of the activities that are important to you, maybe it is time to reevaluate how much time you spend on each activity; find out where you are losing time or what activities you can reduce or eliminate.
• Avoid predictably stressful situations. If you cannot remove the stress, remove yourself. Slip away once in a while for some private time. These quiet moments may give you a fresh perspective on your problems. Practicing stress management techniques, such as journaling, deep breathing, progressive muscle relaxation, exercise, and imagery, may not take the stress away, but can help you deal with it better when it strikes.
• Remember you are in control of your thoughts. If a coworker bothers you, you cannot change your coworker, but you can control your thoughts and try to see the good things about that person, instead of always focusing on the negative.

Your diet

Get enough:

• Potassium: fruits, vegetables, dairy, and fish
• Calcium: low-fat dairy
• Magnesium: whole grains, green leafy vegetables, nuts, seeds, and dry peas and beans
• Fish oils

Tips to lower sodium

Choose more:

• Fresh fruits and vegetables
• Whole grains, higher fiber cereals, and whole-grain breads
• Low-fat milk and yogurt
• Fresh meat and poultry

Read labels and look for labels that say:

• Sodium free
• Salt free
• Very low sodium
• Low sodium

Choose salt-free seasonings:

• Do not add salt when cooking or at the table
• Use herbs and spices to add flavor to your foods, but avoid those with salt, such as garlic salt or seasoning salt

Limit or avoid:

• Bacon
• Barbecue sauce
• Cheese spreads
• Condiments, such as ketchup and soy sauce
• Gravies
• Ham
• Hot dogs
• Luncheon meats
• Meat sauces
• Salad dressings
• Salt pork
• Sausage

The following foods are usually high in sodium:

• Bouillon or broth
• Canned sauces
• Canned vegetables or soups
• Fast food
• Frozen dinners
• Packaged noodle or rice mixes
• Packaged potatoes, rice, or stuffing mixes
• Snack foods, such as chips and salted nuts
• Tomato juice and vegetable juices

References and recommended readings

About high blood pressure. American Heart Association website. http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/AboutHighBloodPressure/About-High-Blood-Pressure_UCM_002050_Article.jsp. Updated February 2, 2015. Accessed September2, 2015.

Dietary Guidelines for Americans, 2010. U.S. Department of Health and Human Services website. http://www.health.gov/dietaryguidelines/2010.asp. Published December 2010. Accessed September 2, 2015.

Guide to quitting smoking. American Cancer Society website. http://www.cancer.org/healthy/stayawayfromtobacco/guidetoquittingsmoking/guide-to-quitting-smoking-toc. September 2, 2015.

High blood pressure. Centers for Disease Control and Prevention website. http://www.cdc.gov/bloodpressure/. Updated February 19, 2015. Accessed September 2, 2015.

Shaking the salt habit. American Heart Association website. http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Shaking-the-Salt-Habit_UCM_303241_Article.jsp. Updated May 18, 2015. Accessed September 2, 2015.

Stress and high blood pressure: what’s the connection? Mayo Clinic website. http://mayoclinic.com/health/stress-and-high-blood-pressure/HI00092. Published December 6, 2012. Accessed September 2, 2015.

Your guide to lowering blood pressure. National Heart, Lung, and Blood Institute website. http://www.nhlbi.nih.gov/files/docs/public/heart/hbp_low.pdf. Published May 2003. Accessed September 2, 2015.

Contributed by Shawna Gornick-Ilagan, MS, RD, CWPC
Updated by Nutrition411.com staff
Review Date 8/14/15