High Blood Pressure

National Institute on Aging

You can have high blood pressure, or hypertension, and still feel just fine. That's because high blood pressure does not cause symptoms that you can see or feel. But, high blood pressure, sometimes called "the silent killer," is a major health problem. If not treated, it can lead to stroke, heart disease, eye problems, or kidney failure. The good news is that there are ways you can prevent high blood pressure. And, if you already have high blood pressure, there are ways to control it and prevent its complications.

What Is Blood Pressure?

When your doctor checks your blood pressure and tells you the result, she or he will say two numbers. The numbers are written one above, or before, the other. The first, or top, number is your systolic pressure. This tells you how much the blood flowing through your blood vessels pushes against the vessel walls as your heart beats. The second, or bottom, number measures the pressure while the heart relaxes between beats. This is the diastolic pressure. If your blood pressure is normal, your systolic pressure is less than 120 and your diastolic pressure is less than 80-for example, 119/79.

Do You Have High Blood Pressure?

One reason to have regular check-ups by your doctor is to check your blood pressure. If you have only a slightly higher reading-such as a top number between 120 and 139 or the bottom number between 80 and 89, you have prehypertension. You may be at risk for developing high blood pressure. Your health care provider will probably want you to make changes in your daily habits to try and lower those numbers.

Your doctor will say your blood pressure is high when it measures 140/90 or higher at two or more checkups. He or she may also ask you to check your blood pressure at home at different times of the day. If the numbers are still high after several checks, your health care provider will probably suggest medicine, changes in your diet, and exercise.

What If Just the First Number Is High?

For older people, the first number (systolic) often is high (greater than 140), but the second number (diastolic) is normal (less than 90). This problem is called isolated systolic hypertension. Isolated systolic hypertension is the most common form of high blood pressure in older people.

Isolated systolic hypertension can lead to serious health problems. It should be treated in the same way as regular high blood pressure. If your systolic pressure is over 140, ask you doctor how you can lower it.

Can You Prevent or Control High Blood Pressure?

More than half of Americans over age 60 have high blood pressure. But, that does not mean it is part of normal aging. Try these healthy habits to help you control or prevent high blood pressure.

Keep a healthy weight. Being overweight adds to your risk of high blood pressure. Ask your doctor if you need to lose weight.

Exercise every day. Moderate exercise can lower your risk of heart disease. Try to exercise at least 30 minutes a day, 5 days a week or more. Check with your doctor before starting a new exercise plan if you have a long-term health problem or if you are a man over 40 or a woman over 50.

Eat more fruits, vegetables, whole grains, and low-fat dairy foods. A healthy diet is important. To control high blood pressure, eat a diet rich in these foods. Make sure you are getting enough potassium. Fresh fruits and vegetables are high in potassium. If using packaged foods, read the nutrition labels to choose those that have more potassium.

Cut down on salt and sodium. Most Americans eat more salt and sodium than they need. A low-salt diet might help lower your blood pressure. Talk with your doctor about your salt intake.

Drink less alcohol. Drinking alcohol can affect your blood pressure. The effect is different depending on body size. As a general rule, men shouldn't have more than two drinks a day; women not more than one drink a day.

Follow your doctor's orders. If lifestyle changes alone do not control your high blood pressure, your doctor may tell you to take blood pressure pills. You may need to take your medicine for the rest of your life. If you have questions about it, talk to your doctor.

High Blood Pressure Facts

If you have high blood pressure, remember that:

  • High blood pressure may not make you feel sick, but it is serious. See a doctor to treat it.
  • You can lower your blood pressure by changing your daily habits and, if needed, by taking medicine. If you need to take high blood pressure medicine, lifestyle changes may help lower the dose you need and reduce side effects.
  • Are you already taking blood pressure medicine and your blood pressure is less than 120/80? That's good. It means the lifestyle changes and medicine are working. But if another doctor asks if you have high blood pressure, the answer is still "yes, but it is being treated."
  • Tell your doctor about all the drugs you take. Don't forget to mention over-the-counter drugs, vitamins, and dietary supplements. They may affect your blood pressure. They also can change how well your blood pressure medicine works.
  • Blood pressure pills should be taken at the same time each day. For example, take your medicine in the morning with breakfast or in the evening after brushing your teeth. If you miss a dose, do not double the dose the next day. Call your doctor to find out what to do.
  • If you have high blood pressure, test it at home between checkups. Ask your doctor, the nurse, or your pharmacist to show you how. Make sure you are seated with your feet on the floor and your back has something to lean against. Relax quietly for 5 minutes before checking your blood pressure. Your arm should be resting on a support at the level of your heart. Keep a list of the results to share with the doctor, physician's assistant, or nurse.

Visit NIHSeniorHealth.gov (www.nihseniorhealth.gov), a senior-friendly website from the National Institute on Aging and the National Library of Medicine. This simple-to-use website features popular health topics for older adults. It has large type, and a 'talking' function that reads text aloud.

National Institute on Aging U.S. Department of Health and Human Services National Institutes of Health July 2004

Web page last updated: December 21, 2005

©2004 National Institute of Aging


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