8 Things Your Doctor Wants You to Know About High Blood Pressure

Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Lorna Collier on September 7, 2020
  • Group of mature friends outdoors
    Want to live longer? Control your blood pressure.
    High blood pressure, also known as hypertension, is very common and potentially very serious. About a third of Americans—70 million people—have been diagnosed with high blood pressure, while another third have "prehypertension," meaning they are at risk for it. Hypertension can lead to heart attack, stroke, kidney failure and other serious complications; it’s linked to about 360,000 deaths annually. However, it is treatable and often preventable. Here's what doctors have to say about high blood pressure.
  • woman laying on couch
    "It has no symptoms, but it can be doing deadly damage."
    High blood pressure has been called a silent killer because "for years, you can have no symptoms, but the disease just keeps marching along, doing its damage," says Mary Ann Bauman, MD, an internist at Integris Health in Oklahoma City. "Most people won't have symptoms until it has damaged vital organs," says Elizabeth Goldberg, MD, an assistant professor of emergency medicine at Brown University. Yet if caught early, she notes, the damage can be prevented: "It's the leading cause of preventable death worldwide." 
  • Woman in computer room sleeping
    “Patients don’t understand it or take it seriously.”
    "About one-fifth of people with high blood pressure don't know they have the condition," says Dr. Goldberg. And roughly half of people who have been diagnosed aren't keeping their pressure under control. "Many people we see in the emergency department only use their medication when they have a headache or aren't feeling well," she says, but "blood pressure medication needs to be taken on a daily basis to work."
  • senior patient talking to doctor
    “People don’t get that hypertension is a chronic disease.”
    "Just today I had a patient ask me, 'Now that my blood pressure is controlled, can I come off my medications?'" says Ali Rahimi, MD, a cardiologist at Kaiser Permanente in Atlanta. But unless a patient is able to make significant lifestyle changes—such as a big weight loss or drop in sodium use—medication will be needed to maintain a healthy pressure. "You must continue on hypertension medications and only stop on advice of your physician," says Dr. Rahimi.
  • Young-doctor-giving-pills-to-a-male-patient
    “If one medication doesn’t work, there are others to try.”
    Your doctor may prescribe a medication for your hypertension that causes side effects you don't like. This doesn't mean you have no other options. Dr. Bauman says there are a wide variety of medications available. "If one doesn't work for you, rather than just saying, 'I'm not taking it,' let your doctor know, because there are other choices." The typical patient with hypertension takes three medications to control the disease, she says.
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    “Home blood pressure monitoring is useful, especially for older people.”
    Dr. Bauman says if you have prehypertension or hypertension, you should get a home blood pressure monitor and make sure it's the right size for your arm. Older adults may especially benefit from having a home monitor, says Dr. Goldberg, "because they are more likely to be on multiple medications that can affect their blood pressure. Knowing what your readings have been can be really useful to your doctor to help adjust your medication or advise you on lifestyle changes."
  • Mature woman sitting on bed reading information on pill bottle
    “Take your medicine at night.”
    Patients who take blood pressure medication at night, rather than in the morning, "may achieve better control and may reduce their risk of cardiovascular disease," says Dr. Goldberg, citing recent research. To remember to take your meds, set a timer on your phone, she suggests, or download a mobile application that can not only remind you to take your pills but also log your pressure readings. 
  • Close-up-of-nutrition-facts
    “Cutting your salt can make a huge difference.”
    People need about 1,500 milligrams of sodium a day—but most Americans get about 4,000 milligrams, says Dr. Bauman. Sodium is linked to a rise in blood pressure and is often hidden in food, such as bread and pastries. "Our meals have gotten bigger and saltier over the years," says Dr. Rahimi, who recommends avoiding processed, ready-made foods and sodas, while using fresh herbs and spices to replace salt.
  • Woman in Warrior Yoga Pose
    “Lifestyle changes really do work.”
    "Making changes to your diet, increasing your exercise, losing weight, and quitting smoking can have a big impact on your blood pressure," says Dr. Goldberg. Dr. Bauman points out that cutting your top (systolic) pressure 10 points leads to a 35 to 50% reduction in your risk for heart attack or stroke. Just the step of losing weight can drop your pressure 5 to 20 points, she says—a difference that literally could be life-saving..
8 Things Your Doctor Wants You to Know About High Blood Pressure

About The Author

Lorna Collier has been reporting on health topics—especially mental health and women’s health—as well as technology and education for more than 25 years. Her work has appeared in the AARP Bulletin, Chicago Tribune, U.S. News, CNN.com, the APA’s Monitor on Psychology, and many others. She’s a member of the American Society of Journalists and Authors and the Association of Health Care Journalists.
High Blood Pressure Fact Sheet. Centers for Disease Control.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Sep 7
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