High Blood Pressure - Patient Guide

What is it?

Blood pressure is the force of blood pushing on the walls of your blood vessels. The top number is the pressure when your heart squeezes. The bottom number is the pressure when your heart rests. High blood pressure means that force stays too high, day after day. It usually causes no symptoms — that is why it is called "the silent killer." Over years, it damages the heart, brain, kidneys, and eyes.

What causes it?

Usually there is no single cause. It runs in families and becomes more common with age, extra weight, a high-salt diet, too little activity, alcohol, poor sleep or sleep apnea, and some medicines (like decongestants and ibuprofen).

What can I do?

• Eat less salt. Most salt comes from packaged and restaurant food, not the shaker. Cook at home when you can.
• Move most days. A 30-minute walk counts. It lowers blood pressure about as much as some medicines.
• Aim for a healthy weight. Losing even 10 pounds lowers blood pressure.
• Limit alcohol — no more than 1 drink a day for women, 2 for men. If you smoke or vape, quitting is the single best thing you can do for your heart.
• Check at home. Sit quietly for 5 minutes, feet flat, arm supported at heart level. Bring your numbers to every visit.

What about medicines?

There are many safe, well-tested blood pressure medicines. Most people need more than one — that is normal, not a failure. Take them at the same time every day. Do not stop on your own, even if you feel fine; feeling fine is the point.

When should I call?

• Your home readings are often above your goal.
• You feel dizzy or lightheaded, or notice swelling or a new cough after starting a medicine.
• Before using cold medicines (decongestants) or ibuprofen/naproxen regularly — they can raise blood pressure.