February 22, 2021
5 min. read

What to Do When You’re Struggling to Bring Down Blood Pressure


High blood pressure, also known as hypertension, is one of the most prevalent health conditions in American. In fact, 68 million Americans – 1 in every 3 U.S. adults – have high blood pressure, and nearly 20 percent do not know they have it.

This is because hypertension is generally a silent condition, meaning many people with high blood pressure won’t experience any symptoms. It may take years or even decades for the condition to reach levels severe enough that symptoms become obvious. Even then, these symptoms may be attributed to other issues.

The only way to know if you have high blood pressure is to get your blood pressure checked. Read below to get a better understanding of what your blood pressure numbers mean, and how to bring them down.

high bp

What is high blood pressure?

High blood pressure occurs when your blood pressure increases to unhealthy levels. When your provider measures your blood pressure, they are measuring how much blood is passing through your blood vessels as well as the amount of resistance the blood meets while the heart is pumping. Narrow arteries will increase this resistance, and the narrower your arteries are, the higher your blood pressure will be. Over the long term, high blood pressure can cause health issues, including heart disease.

An important part of treating high blood pressure is early detection, which you can achieve with regular blood pressure readings. If your blood pressure is elevated, your doctor may have you check your blood pressure over a few weeks to see if the number stays elevated or falls back to normal levels.

What do my blood pressure numbers mean?

When your provider takes your blood pressure, they’ll come up with two different numbers:

  • Systolic pressure: This will be the first, or top number, and it indicates the pressure in your arteries when your heart beats and pumps out blood.
  • Diastolic pressure: This will be the second, or bottom, number. It reads the pressure in your arteries between beats of your heart.

Your blood pressure numbers will also give your provider the info necessary to categorize your blood pressure.

  • Healthy: A healthy blood pressure reading is less than 120/80 millimeters of mercury (mm Hg).
  • Elevated: In those with elevated blood pressure, the systolic number is between 120 and 129 mm Hg, and the diastolic number is less than 80 mm Hg. Doctors usually don’t treat elevated blood pressure with medication but may encourage lifestyle changes to help lower your numbers.
  • Stage 1 hypertension: The systolic number is between 130 and 139 mm Hg, or the diastolic number is between 80 and 89 mm Hg.
  • Stage 2 hypertension: The systolic number is 140 mm Hg or higher, or the diastolic number is 90 mm Hg or higher.
  • Hypertensive crisis: The systolic number is over 180 mm Hg, or the diastolic number is over 120 mm Hg. Blood pressure in this range requires urgent medical attention. If any symptoms such as chest pain, headache, shortness of breath, or visual changes occur when blood pressure is this high, medical care in the emergency room is needed.

patient provider

How is high blood pressure treated?

High blood pressure is treated in a variety of different ways, depending on factors such as which type of hypertension you have and what is causing your hypertension. You’ll want to work with your provider to determine which treatment method or methods are best for you.

If you have primary hypertension, your provider may simply suggest lifestyle changes and later, medication. However, if you have secondary hypertension, your doctor will usually attempt to decipher the underlying cause and will focus on treating that condition. However, if your hypertension is persistent despite treatment for the underlying cause, your doctor may work with you to develop lifestyle changes and prescribe medications to help reduce your blood pressure.

Treatment plans for hypertension often change over time because treatments that worked at first may become less useful over time. Your doctor will continue to work with you to refine your treatment.

blood pressure treatment

What are some lifestyle changes that can bring down high blood pressure?

Healthy lifestyle changes can help you control the factors that cause hypertension. Here are some of the most common home remedies:

  • Adopt a healthy diet. Ask your provider if a heart-healthy diet is right for you, as it can be vital in helping to reduce high blood pressure and risk of complications, including heart disease, stroke, and heart attack. A heart-healthy diet emphasizes foods that include fruits, vegetables, whole grains, and lean protein like fish.
  • Increase physical activity. Exercise can help you to lose weight, reduce stress, and strengthen your cardiovascular system, in addition to helping to lower blood pressure naturally. For those with high blood pressure, it’s appropriate to have a goal of 150 minutes of moderate physical activity each week, or 30 minutes of exercise five times per week.
  • Maintain a healthy weight. If you are overweight or obese, losing weight through a heart-healthy diet and increased physical activity can help lower your blood pressure.
  • Manage stress. In addition to physical activity, you can lower your blood pressure by engaging in meditation, deep breathing, yoga, massages, muscle relaxation, and tai chi.
  • Adopt a healthy lifestyle. This means quitting smoking and reducing your alcohol intake as well, as both habits are known to raise blood pressure.

blood pressure chart

What medications are available to treat high blood pressure?

You may go through a trial-and-error phase with your provider when trying different blood pressure medications. You may need to try different medicines until you find one or a combination of medications that work for you.

Your provider may suggest one of a few of these common medications:

Diuretics: Diuretics, also known as water pills, are medications that act on your kidneys in order to help increase the amount of water and salt, or sodium, and potassium expelled from the body as urine. By reducing the body’s blood volume, a diuretic can help lower your blood pressure. These medications are often the first, but not the only, choice in high blood pressure medications. Chlorthalidone, Hydrochlorothiazide (Microzide), and Indapamide are some examples of diuretic medications.

Beta blockers: Beta blockers work by opening your blood vessels and reducing the workload on your heart, causing your heart to beat slower and with less force.. Beta Blockers are usually prescribed in conjunction with other blood pressure medications. Common beta blockers include Atenolol (Tenormin), Nebivolol (Bystolic), Metoprolol (Lopressor, Toprol XL) and others.

Angiotensin-converting enzyme (ACE) inhibitors: Ace inhibitors help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels. Examples include Lisinopril (Zestril, Prinivil), Benazepril (Lotensin), Enalapril (Vasotec), and Ramipril (Altace).

Angiotensin II receptor blockers (ARBs): Similar to ACE inhibitors, these medications block a natural chemical that narrows blood vessels. Unlike ACE inhibitors, however, ARBs block the action, not the formation, of that natural chemical, thereby helping to relax the body’s blood vessels. ARBs include Candesartan (Atacand), Losartan (Cozaar), Valsartan (Diovan) , and Azilsartan (Edarbi).

Calcium channel blockers: Calcium channel blockers work by relaxing the muscles of your blood vessels, and some can even slow your heart rate. Note that grapefruit juice can interact with some calcium channel blockers, which can increase blood levels of the medication and put you at higher risk of side effects. Talk to your doctor or pharmacist if you’re concerned about interactions. Examples of calcium channel blockers include Amlodipine (Norvasc), Verapamil (Calan, Calan SR) and Diltiazem (Cardizem, Cardizem CD, Cardizem XT).

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