By: Shanrae’l Vinel, MPH, Pharm D Candidate Class of 2016
Supervised By: By Pamela Wiltfang, Pharm.D., M.P.H., B.A., CHES, NuCara Pharmacist
About 1 in 3 Americans have hypertension (high blood pressure). Only about half of all people with high blood pressure have their condition under control. If left untreated, high blood pressure can lead to other health problems such as stroke, heart failure and kidney disease. A normal blood pressure is less than 120/80mmHg. People have high blood pressure when either their systolic blood pressure (the top number) or their diastolic blood pressure (bottom number) is above normal. Prehypertension is a stage when you are at risk for having high blood pressure. People who have high blood pressure may not be able to feel that their blood pressure is high. It is important to remember that high blood pressures can cause damage to your heart, blood vessels and kidneys even if you feel well. If a person can lower their blood pressure to normal just by making lifestyle changes, then they may not need medications.
|Systolic Blood Pressure
|Diastolic Blood Pressure
|Normal||Less than 120 mmHg||Less than 80 mmHg|
|Prehypertension||120 to 139 mmHg||80 to 89 mmHg|
|Hypertension||Greater than 140 mmHg||Greater than 90 mmHg|
Risk Factors for High Blood Pressure
There are some things that can put you at risk for having high blood pressure.
- Family History of High Blood Pressure
- Other Chronic Conditions (Examples include diabetes and kidney disease)
- Unhealthy Diet
- Physical Inactivity
- Tobacco Use
- Too Much Caffeine
- Too Much Alcohol
How to Lower Blood Pressure
People who have been diagnosed with prehypertension or hypertension can lower their blood pressure with a combination of medications and lifestyle changes. Lifestyle changes include: exercise, weight loss, improving your diet, and reducing your caffeine and alcohol consumption. The table shows how much each of these changes can lower your blood pressure.
|Activity||Blood Pressure Lowering|
|Weight Loss||5 – 20 mmHg|
|Exercise||4 – 9 mmHg|
|Sodium Reduction||2 – 8 mmHg|
|Improving Diet||8 – 14 mmHg|
|Reducing Caffeine Intake||5 – 10 mmHg|
|Reducing Alcohol Intake||2 – 4 mmHg|
|Smoking Cessation||5 – 20 mmHg|
Adding 150 minutes of cardio exercise per week can help reduce blood pressure. The exercise can be divided into 30 minute intervals throughout the week. Cardio exercise includes activities such as walking, running, swimming, biking and dancing.
Your diet can be improved by gradually adding fruits and vegetables, eating more lean meats and eating lower fat dairy products. An example of a healthy diet is the DASH (Dietary Approaches to Stop Hypertension) diet:
|Food Type||Recommended Number of Servings||Examples|
|Vegetable||4 to 5||Carrots, squash, cucumber, and lettuce|
|Fruit||4 to 5||Bananas, tomatoes, avocados, dates, tomatoes, raisins, cantaloupe, and oranges|
|Dairy||2 to 3||Low fat or fat free milk, yogurt, and cheese|
|Grains||7 to 8||Whole grain bread|
|Meat||2 or fewer||Lean beef, poultry or seafood|
|Other proteins||4 to 5||Nuts, seeds, or beans|
|Fats||2 to 3||Fats and oils|
|Sugars||5 or fewer||Pastries, candies, other sweets|
Sodium can raise blood pressure by forcing your body to retain water. This makes your heart and kidneys work harder and can make blood pressure medications less effective. Limit sodium intake to 2,300 milligrams or less. You can do this by reading food labels to figure out the sodium content of what you are eating, eating fewer processed foods and not adding salt to your food. It may be easier to ease into a reduced sodium diet gradually so that you can get used to your food tasting different.
Improving diet and exercise can lead to weight loss. A healthy rate of weight loss is 1 to 2 pounds per week, which can be achieved by burning or cutting out 3500 calories per week. Large waist circumference has also been associated with heart disease. To reduce their risk, men should limit their waist circumference to less than 40 inches and women should limit their waist circumference to less than 35 inches.
Drinking caffeine containing beverages can cause spikes in blood pressure of 5 to 10 mmHg. Try to limit your caffeine consumption to 200 milligrams per day, which is about two 12oz brewed cups of coffee. To determine how much caffeine is in your beverages please read food labels on caffeine containing beverages such as soda or coffee. Some other sources of caffeine include flavored water, chocolate, tea, and ice cream.
Drinking too much alcohol can raise blood pressure and make medications less effective. Excess alcohol can also cause weigh gain, which can raise blood pressure. Men should limit themselves to 1 to 2 drinks per day. Women should limit themselves to one drink per day. One drink equals 12 ounces of beer, five ounces of wine or 1.5 ounces of 80-proof liquor.
Each time you smoke you cause dramatic spikes in your blood pressure (up to 20mmHg), which can stress your heart and other organs. Quitting smoking can reduce your risk of heart disease, lung disease, and cancer.
Please contact your doctor or pharmacist if you are interested in discussing these lifestyle changes.
- American Heart Association. (2014). “Tobacco and Blood Pressure”. Retrieved from: http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Tobacco-and-Blood-Pressure_UCM_301886_Article.jsp#.VqvFuFJpKKI
- Centers for Disease Control and Prevention. (2014). “Behaviors That Increase Risk for High Blood Pressure”. Retrieved from: http://www.cdc.gov/bloodpressure/behavior.htm
- Mayo Clinic. (2015). “10 Ways To Control High Blood Pressure”. Retrieved from: http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20046974?pg=1
- Mayo Clinic. (2015). “Does Drinking Alcohol Affect Your Blood Pressure?”. Retrieved from: http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-answers/blood-pressure/faq-20058254
- Collins, S. (2014). “A List of Foods That Contain Caffeine”. Retrieved from: http://www.livestrong.com/article/281076-a-list-of-foods-that-contain-caffeine/
- Mayo Clinic. (2014). “How does caffeine affect your blood pressure?”. Retrieved from: http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-answers/blood-pressure/faq-20058543