5 Things Cardiologists Want You to Know About Blood Pressure

High blood pressure can lead to serious health problems, yet it often goes unnoticed. Here’s how to find out if you have it — plus the steps to lower it.

High blood pressure, also known as hypertension, has a pretty scary nickname: the silent killer. That’s because the condition often creeps up without causing any symptoms, so it can progress unchecked.

The National Council on Aging (NCOA) reports that seven out of 10 U.S. adults over age 65 have hypertension, which puts them at risk for a heart attack, stroke, kidney disease, sexual dysfunction, and more.

Hypertension is deadly. It contributed to the deaths of nearly 700,000 Americans in 2021 alone, according to the Centers for Disease Control and Prevention.

Fortunately, there’s so much you can do to bring your blood pressure down to healthy levels. Here are five things you should know about high blood pressure, including treatments and heart-healthy lifestyle changes that can save your life.

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Your Risk for High Blood Pressure Increases With Age

Just like your hair and skin change as time moves on, your blood vessels do too. “Arteries become stiffer with age,” says New York City–based preventive cardiologist Suzanne Steinbaum, D.O. “With stiffer arteries, your heart has to work a bit harder to push blood out, which increases blood pressure.” Weight gain and a more sedentary lifestyle also contribute to elevated blood pressure.

Know Your Numbers

How do you know if you have high blood pressure? There are two components to a blood pressure reading. The first one is systolic blood pressure, which is the pressure in the arteries during each heartbeat. This is the top number in a blood pressure reading. The second component is diastolic blood pressure, which is the pressure on arteries between heartbeats. This is the bottom number of a reading.

Your blood pressure can be low, normal, elevated, or high. According to the National Institute on Aging (NIA), here’s where those categories stand:

• Low: <90/<60
• Normal: <120/<80
• Elevated: 120-129/<80
• High: >130/>80

Understand the Difference Between the Two Numbers

The most common type of hypertension older adults have is called isolated systolic hypertension, says Dr. Steinbaum. This is when your systolic blood pressure is 130 or higher but your diastolic blood pressure is less than 80. This is caused by stiffness in the arteries that happens with age, says the NIA.

It’s important to lower your systolic blood pressure, even when your diastolic reading is normal. Isolated systolic hypertension is associated with a 39% increased risk for cardiovascular disease compared to having normal blood pressure, according to a study in the Journal of Hypertension.

Keep Hypertension on Your Radar

Remember how hypertension doesn’t have symptoms? That’s why it’s so important to check your blood pressure regularly. As many as four in 10 Americans don’t even know what their blood pressure is, according to a survey from the American Medical Association and the American Heart Association.

The survey also found that among people who had been diagnosed with hypertension, about one in three had their blood pressure measured within the last week. If you don’t know your blood pressure numbers, you can have it checked at your doctor’s office, pharmacy, or with a home blood pressure monitor.

How to Lower Your Blood Pressure

If you’re diagnosed with hypertension, your doctor may recommend a blood pressure-lowering medication. Some options include diuretics, ACE-inhibitors, calcium channel blockers, or a combination of those medicines. Your doctor will let you know what the right medication is for you, depending on your health history and presence of other diseases, like diabetes.

Besides prescription drugs, there are also lifestyle changes you can make to keep your blood pressure under control. The first tweak you should make? Start moving more. Routine and regular exercise is one of the best lifestyle choices you can make to bring down your blood pressure, says Dr. Steinbaum. “Exercise keeps the lining of your arteries healthy, allowing them to dilate easier, decreasing blood pressure,” she says.

Even small bites of exercise help. “Doing something is the most important thing,” says Dr. Steinbaum.

Activities that are easy on joints make a lot of sense, such as walking and swimming. And if you feel good when you’re doing them—and when you’re done—you’re more likely to make movement part of your life.

“In my opinion, exercise is the best medicine,” Dr. Steinbaum says.

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Here are other heart-healthy habits experts say you should adopt:

• Maintain a healthy weight. According to the American Heart Association, even losing as few as 10 pounds can make a difference.
• Get enough sleep. For adults over 65, that’s seven to eight hours a night).
• Eat a healthy diet. The DASH diet —short for Dietary Approaches to Stop Hypertension—is packed with veggies, fruits, whole grains, fat-free or low-fat dairy, fish, poultry, beans, and nuts. This eating plan has been shown to lower blood pressure and “bad” LDL cholesterol.
• Reduce your sodium Limit salt to 2,300 milligrams (mg) per day. Some people may be advised to consume just 1,500 mg of sodium per day.
• Manage your diabetes. High blood pressure is twice as likely to develop in a person with diabetes than someone who doesn’t have it, according to Johns Hopkins Medicine.
• Cut back on alcohol. Drinking just one alcoholic beverage a day is associated with higher blood pressure, according to a study in the journal Hypertension.
• Quit smoking. Smoking promotes plaque buildup in the arteries, which interferes with healthy blood flow.

Recommended reading: The 4 Best Drinks to Lower Blood Pressure (and 1 to Avoid)
8 Ways to Lower Blood Pressure Without Meds
6 Surprising Reasons Your Blood Pressure Spikes

See our sources:
High blood pressure statistics: National Council on Aging and Centers for Disease Control and Prevention
Health threats from high blood pressure: American Heart Association
Blood pressure reading basics: Centers for Disease Control and Prevention and National Institute on Aging
Isolated systolic hypertension study: Journal of Hypertension
Survey: American Medical Association and American Heart Association
Blood pressure medications: F1000 Research and National Institute on Aging
Weight and high blood pressure: American Heart Association
Diabetes and high blood pressure: Johns Hopkins Medicine
Alcohol and high blood pressure study: Hypertension

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