Starting Treatment for New High Blood Pressure

Your blood pressure was high enough today to start treatment with medicines. Often doctors don't know what causes high blood pressure (hypertension). But it can be controlled with lifestyle changes and medicines. High blood pressure usually has no symptoms. But it can sometimes cause headache, dizziness, blurred vision, a rushing sound in your ears, chest pain, or shortness of breath. But even without symptoms, high blood pressure that's not treated raises your risk for heart attack, heart failure, kidney disease, vascular disease, and stroke. High blood pressure is a serious health risk and should not be ignored.

Blood pressure measurements are given as two numbers.

• Systolic blood pressure is the upper number. This is the pressure when the heart contracts.
• Diastolic blood pressure is the lower number. This is the pressure when the heart relaxes between beats.

You will see your blood pressure readings written together. For example, a person with a systolic pressure of 118 and a diastolic pressure of 78 will have 118/78 written in the medical record.

Blood pressure is categorized as normal, elevated, or stage 1 or stage 2 high blood pressure:

• Normal blood pressure is systolic of less than 120 and diastolic of less than 80 (120/80).
• Elevated blood pressure is systolic of 120 to 129 and diastolic less than 80.
• Stage 1 high blood pressure is systolic of 130 to 139 or diastolic between 80 to 89.
• Stage 2 high blood pressure is systolic of 140 or higher or diastolic of 90 or higher.

If you have high blood pressure, do what's listed below to lower your blood pressure. If you are taking medicines for high blood pressure, these methods may reduce or end your need for medicines in the future.

• Begin a weight-loss program if you are overweight.
• Cut back on how much salt you get in your diet. Here's how to do this:
  • Don't eat foods that have a lot of salt. These include olives, pickles, deli and smoked meats, and salted potato chips.
  • Don't add salt to your food at the table.
  • Use only small amounts of salt when cooking.
  • Review food labels to track how much salt is in prepared foods.
  • When eating out, ask that no extra salt be added to your food order.
  • Ask your doctor about the DASH diet or the DASH (dietary approaches to stop hypertension) eating plan.
• Start an exercise program. Talk with your doctor about the type of exercise program that would be best for you. It doesn't have to be hard. Even brisk walking is a good form of exercise.
• Don't take medicines that have heart stimulants. This includes many over-the-counter cold and sinus decongestant pills and sprays, as well as diet pills. Check the warnings about high blood pressure on the label. Before purchasing any over-the-counter medicines or supplements, always ask the pharmacist about the product's potential interaction with your high blood pressure and your high blood pressure medicines.
• Stimulants, such as amphetamine or cocaine, could be lethal for someone with high blood pressure. Never take these.
• Limit how much caffeine you get in your diet. Switch to caffeine-free products.
• Stop smoking. If you are a longtime smoker, this can be hard. Enroll in a stop-smoking program to make it more likely that you will quit for good. Or talk with your doctor about nicotine replacements or medicines that can help.
• Learn how to handle stress. This is an important part of any program to lower blood pressure. Learn about relaxation methods like meditation, yoga, or biofeedback.
• If your doctor prescribed medicines, take them exactly as directed. Missing doses may cause your blood pressure to get out of control.
• If you miss a dose or doses, check with your doctor or pharmacist about what to do.
• Limit alcohol. For some people, it's best to avoid alcohol completely. Drinking too much alcohol can raise blood pressure.
• Consider buying an automatic blood pressure machine so you can check your blood pressure regularly at home. Your doctor can recommend one. You can get this at most pharmacies.

The American Heart Association recommends the following guidelines for home blood pressure monitoring:

• Don't smoke or drink coffee or other caffeinated drinks or exercise for 30 minutes before taking your blood pressure.
• Go to the bathroom before the test.
• Relax for 5 minutes before taking the measurement.
• Sit with your back supported (don't sit on a couch or soft chair). Keep your feet flat on the floor and uncrossed. Place your arm on a solid flat surface (like a table) with the upper part of the arm at heart level. Place the middle of the cuff directly above the bend of the elbow. Check the monitor's instruction manual for an illustration.
• If you take multiple blood pressure measurements, they should be taken at least 1 minute apart.
• Take your blood pressure at the same time every day, or as your doctor recommends.
• Record the date, time, and blood pressure reading.
• Take the record with you to your next medical appointment. If your blood pressure monitor has a built-in memory, take the monitor with you to your next appointment.
• Contact your doctor if you have several high readings. Don't be frightened by a single high blood pressure reading. But if you get several high readings, check in with your doctor.
• Note: If your blood pressure reaches a systolic (top number) of 180 or higher OR diastolic (bottom number) of 120 or higher and you have any symptoms, or as directed by your doctor, get emergency medical treatment.
• Note: If your blood pressure reaches a systolic (top number) of 180 or higher OR diastolic (bottom number) of 120 or higher and you do not have any symptoms, wait at least 1 to 2 minutes and recheck your blood pressure. If your blood pressure is still a systolic (top number) of 180 or higher OR diastolic (bottom number) of 120 or higher and you still do not have any symptoms, or as directed by your doctor, contact your doctor right away.

Because a new blood pressure medicine was started today, it's important that you have your blood pressure rechecked. This is to make sure that the medicine is working and that you have no serious side effects. Keep all your follow-up appointments. Write down medicine and blood pressure questions and bring them to your next appointment. If you have pressing concerns about your new medicine or your blood pressure, contact your doctor. Unless told otherwise, follow up with your doctor within the next 3 days.

Call 911 if you have:

• Blood pressure that has a systolic (top number) of 180 or higher, OR diastolic (bottom number) of 120 or higher and you have any symptoms, or as directed by your doctor.
• Chest pain or shortness of breath.
• Extreme drowsiness, confusion, or fainting.
• Numbness, tingling, or weakness of your arm, leg, or one side of your face.
• Problems speaking or seeing.
• Sudden severe pain in your belly (abdomen) or back.

Contact your doctor right away if you have:

• A severe headache.
• Throbbing or a rushing sound in the ears.
• A nosebleed.