Hypertension — or high blood pressure — is often called the "silent killer" because it causes no symptoms in most people until it has already damaged the heart, kidneys, or brain. Despite affecting nearly half of American adults, blood pressure is controlled to target levels in fewer than one in four people with the diagnosis. If you have been told you have high blood pressure, here is what you should know about comprehensive, evidence-based treatment options.
When Is Blood Pressure Considered High?
Current guidelines from major cardiology societies define normal blood pressure as below 120/80 mmHg. Stage 1 hypertension is defined as 130–139/80–89 mmHg, and Stage 2 is 140/90 mmHg or above. Hypertensive crisis (above 180/120 mmHg) requires urgent medical evaluation. Because blood pressure naturally varies throughout the day, diagnosis is typically confirmed over multiple readings on different occasions.
Lifestyle Modifications That Lower Blood Pressure
- DASH diet (rich in fruits, vegetables, whole grains, low-fat dairy, limited sodium)
- Sodium restriction to under 2,300 mg/day (ideally under 1,500 mg/day)
- Regular aerobic exercise — 150 minutes per week of moderate-intensity activity
- Weight loss of even 5–10 lbs can reduce systolic blood pressure by 5–10 mmHg
- Limiting alcohol to no more than 1 drink/day for women, 2 for men
- Stress reduction through mindfulness, sleep improvement, and social support
Medications for Blood Pressure Control
When lifestyle changes alone are insufficient — which is often the case — antihypertensive medications provide safe, effective, and well-tolerated control. First-line options include ACE inhibitors, angiotensin receptor blockers (ARBs), thiazide diuretics, and calcium channel blockers. Many patients require two or more medications to reach their blood pressure target. The choice depends on co-existing conditions like kidney disease, diabetes, heart failure, or prior heart attack.
Dr. Arpana Pillay at Vish Medical provides comprehensive hypertension management, including regular monitoring, medication optimization, and addressing contributing factors like weight and sleep apnea. Schedule an appointment to discuss your blood pressure goals.