What to Do If You Have High Blood Pressure
Understand your numbers and how to lower your risk
Understand your numbers and how to lower your risk
Key Takeaways
- High blood pressure often has no symptoms
- Regular screenings help detect it early
- Healthy habits and medication can help manage it
- Knowing your numbers lowers your risk of complications
High blood pressure, also called hypertension, affects nearly half of adults in the United States. It is one of the most common conditions screened for during routine primary visits and a leading risk factor for heart disease, stroke and other serious health problems.
In many cases, hypertension is first found during a routine checkup or screening.
“High blood pressure often has no symptoms, which is why regular screenings during primary care visits are so important,” says Max MacMillan, MD, an internal medicine physician at Scripps Clinic Rancho San Diego. "Checking blood pressure regularly allows us to detect problems early and help patients take steps to protect their long-term health.”
When hypertension goes undetected or untreated, it can gradually damage blood vessels throughout the body. Over time, this damage can cause arteries to stiffen and narrow, increasing the risk of serious health problems. It can also contribute to peripheral artery disease, where narrowed arteries reduce blood flow to the arms and legs.
"For this reason, routine blood pressure screenings are a key part of preventive care,” Dr. MacMillan says.
What to do if you have high blood pressure
If your blood pressure readings are consistently high, your doctor can help you create a plan to lower them and reduce your risk of heart disease and stroke.
You can manage high blood pressure by:
- Making lifestyle changes, such as eating healthy and exercising often
- Taking medicine if your doctor prescribes it
- Checking your blood pressure on a regular schedule
- Attending follow-up visits
- Following your care plan
What is blood pressure?
Blood pressure is the force of blood pushing against artery walls as the heart pumps. It rises and falls during the day. It can change with activity, stress, sleep and other factors. But if blood pressure stays high, it can strain the heart and blood vessels.
Uncontrolled hypertension can contribute to:
- Heart attack
- Stroke
- Heart failure
- Kidney disease
- Vision problems
- Cognitive decline or dementia
- Circulatory problems
What do blood pressure numbers mean?
Blood pressure is measured in millimeters of mercury (mmHg) and written as two numbers: systolic over diastolic. For example: 120/80 mmHg.
Systolic pressure (top number): the pressure in your arteries when your heart beats and pumps blood.
Diastolic pressure (bottom number): the pressure in your arteries when your heart rests between beats.
According to guidelines from the American Heart Association and American College of Cardiology, readings fall into the following categories:
- Normal: Less than 120 / 80 mmHg
- Elevated: 120–129 systolic and less than 80 diastolic
- High blood pressure (Stage 1): 130–139 systolic or 80–89 diastolic
- High blood pressure (Stage 2): 140 systolic or higher or 90 diastolic or higher
- Hypertensive crisis: 180/120 mmHg or higher (seek immediate medical care)
If your readings often fall in the stage 1 or stage 2 range, your doctor may recommend lifestyle changes, medication or both.
Symptoms of high blood pressure
Most people with hypertension do not notice any symptoms. Blood pressure often rises slowly over time and the body may adjust without clear warning signs.
Even when numbers are high, a person may still feel normal. This is why regular screenings are important.
In rare cases, a hypertensive crisis may cause symptoms such as:
- Severe headaches
- Shortness of breath
- Chest pain
- Nosebleeds
- Vision changes
If these symptoms occur along with very high readings, seek medical care immediately.
What causes high blood pressure?
Many factors can contribute to hypertension. Some are related to lifestyle and can be improved. Others are linked to genetics or certain health conditions.
Modifiable risk factors
These lifestyle factors can increase your levels but can often be changed or improved:
- Smoking or tobacco use
- Overweight or obesity
- High-sodium diet
- Lack of physical activity
- Excess alcohol consumption
- Chronic stress
- Poor sleep
Non-modifiable risk factors
These factors cannot be changed or are difficult to change:
- Family history of hypertension
- Increasing age
- Certain racial or ethnic backgrounds
- Chronic kidney disease
- Obstructive sleep apnea
Having one or more risk factors does not mean you will develop hypertension, but it does raise your risk. Regular checkups can help find changes early.
How high blood pressure is treated
Treatment depends on how high your readings are and your overall risk of heart disease. Management typically includes lifestyle changes and, in some cases, medication.
Healthy eating
- Eat more whole foods, such as fruits, vegetables, whole grains and lean proteins
- Reduce sodium intake, since too much salt can cause the body to retain fluid and raise blood pressure
- Choose fresh foods more often and limit processed or packaged meals
Regular physical activity
- Exercise regularly through activities like walking, swimming or cycling
- Physical activity helps strengthen the heart and may lower blood pressure over time
Medications
If lifestyle changes are not enough to control your levels, your primary care doctor can prescribe medications to help lower your blood pressure and reduce the risk of heart disease and stroke. Patients may be referred to a cardiologist if hypertension is difficult to control or if other heart conditions are present.
These medications work in different ways, such as relaxing blood vessels, removing excess fluid from the body or blocking hormones that raise blood pressure.
Common types include:
- Diuretics (sometimes called water pills)
- ACE inhibitors
- Angiotensin II receptor blockers (ARBs)
- Calcium channel blockers
Some people may need more than one medication.
It’s important to take medications exactly as prescribed and discuss any new medications or supplements with your doctor.
Certain over-the-counter medicines used to treat pain, colds or allergies may raise blood pressure or interact with heart medicines. For example, cold medicines containing decongestants may increase heart rate and blood pressure.
Anti-inflammatory drugs, such as ibuprofen or naproxen, may not be recommended for people with heart disease or those taking blood thinners.
Your doctor can help ensure that all medications you take are safe for your condition.
Why monitoring matters
Checking your blood pressure regularly can help detect high blood pressure early and confirm that treatment is working.
Many doctors recommend home monitoring, especially for people with hypertension. Measuring at home can help you and your doctor track your condition and adjust treatment if needed.
Your doctor can recommend a validated home blood pressure monitor and help you understand your numbers.
When to see your doctor
Talk with your doctor if your readings are often 130/80 mmHg or higher.
Schedule a checkup if you have risk factors, such as obesity, smoking, diabetes or a family history of hypertension.
Regular visits with a primary care doctor can help detect the condition early and reduce the risk of serious complications.
Seek medical care right away if you have symptoms of very high blood pressure, including:
- Chest pain
- Severe headache
- Shortness of breath
- Vision changes
“High blood pressure often develops without noticeable symptoms until it becomes severe,” Dr. MacMillan says. “But with routine screenings and healthy habits, many people can prevent it or keep it under control.”