Blood pressure is the force of blood flow against artery walls. It is measured in millimeters of mercury (mmHg) and recorded as two numbers - systolic pressure (as the heart beats) over diastolic pressure (between heart beats). High blood pressure is diagnosed based on the average of several readings taken after an initial screening.

Why is High Blood Pressure a Concern?

With high blood pressure, high blood cholesterol or tobacco use, fatty deposits can accumulate on artery walls and reduce the flow of blood to vital organs like your heart, brain or kidneys. In addition, these deposits can harden the arteries and increase your risk of blood clots. High blood pressure can also damage arteries so they become more likely to leak or rupture.

Classification of Blood Pressure for Adults Aged 18 Years and Older*

* not taking antihypertensive drugs and not acutely ill.
** based on the average of 2 or more readings taken at each of 2 or more visits after an initial screening.

The Link to Coronary Heart Disease

High blood pressure, or hypertension, affects about 50 million adults in the United States. Known as the “silent killer,” high blood pressure often goes undetected. If left untreated, it can lead to stroke, kidney disease, or coronary heart disease (CHD).High blood pressure is one of the modifiable or controllable risk factors for CHD.

Modifiable Risk Factors

• High Blood Pressure (BP >140/90 mmHg or taking blood pressure medication)
• High LDL Cholesterol (130 mg/dL or higher)
• Low HDL Cholesterol (35 mg/dL or lower)
• Tobacco Use
• Obesity
• Whole body obesity (Body Mass Index 27 or higher)
  • Visceral obesity (Waist circumference of 35 inches or more in women, 39 inches or more in men)
  • Physical Inactivity
• Diabetes Mellitus (type I and type II)

Negative Risk Factor (Protective)

• High HDL Cholesterol (60 mg/dL or higher)

Non-Modifiable Risk Factors

• Age
  • Male (45 and older)
  • Female (55 years and older or premature menopause without estrogen replacement therapy)
• Male Gender
• Family History or Premature CHD (heart attack or sudden death before age 55 in father or other male first-degree relative or before age 65 in mother or other female first-degree relative)

The prevention and/or management of high blood pressure should include regular check ups with your health care provider to determine accurate blood pressure readings. Once developed, high blood pressure lasts a lifetime. It can, however, be controlled and/or prevented by following the guidelines below.

• Know your blood pressure. Get your blood pressure checked at least once a year and discuss with your health care provider a schedule for regular monitoring. If medication is prescribed, take as directed.
• Achieve and maintain a healthy body weight. Excess body weight is correlated closely with increased blood pressure. Losing as little as 10 pounds reduces blood pressure in many overweight persons with high blood pressure.
• Limit alcohol intake. Excessive alcohol intake is an important risk factor for high blood pressure. For someone already taking blood pressure medication, alcohol can interfere with its effectiveness. For those who choose to use alcohol, no more than 2 drinks per day for men or 1 drink per day for women is recommended. A drink is defined as: 12 oz. of beer, 5 oz. of wine, or 1 oz. of 100-proof whiskey (1.5 oz. 80-proof distilled spirits).
• Increase aerobic physical activity. Blood pressure can be lowered with moderately intense physical activity such as 30-45 minutes of brisk walking most days of the week. Before beginning an exercise program, check with your health care provider. Some experts believe that the addition of 30 minutes of accumulated physical activity of any intensity will provide health benefits.
• Reduce sodium intake. Numerous national health agencies concur that (most) Americans should limit daily sodium intake to less than 3,000 mg per day. To achieve a diet with less than 3,000 mg sodium per day, eliminate or eat sparingly: high-sodium processed foods and beverages such as fast foods, salad dressings, smoked, salted and koshered meats, regular canned foods, pickled vegetables, luncheon meats, salty snacks such as chips, salted pretzels and snack mixes, and commercially softened water. Also, eliminate or cut down on salt added in cooking and at the table.
• Consume adequate dietary potassium, calcium and magnesium. To varying degrees, most studies indicate that an adequate intake of these minerals, from food, should be maintained. The Food Guide Pyramid shows how easy it is to eat a diet rich in these minerals. Potassium - found in a wide variety of foods including fruits, vegetables, lean meat, low-fat milk, grains, and cooked, dried beans and peas. Calcium - good sources include milk and milk products such as low-fat cheese and yogurt, some dark green leafy vegetables (kale, broccoli, spinach), fish with edible bones (salmon) and tofu made with calcium sulfate. Many foods are fortified with calcium, such as some brands of orange juice, bread, breakfast bars and cereals and soy milk. Magnesium - found in all kinds of foods in varying amounts. Good sources include legumes, nuts, whole grains and green vegetables.
• Stop smoking/avoid tobacco. Tobacco use is a powerful risk factor for cardiovascular disease. The avoidance of tobacco in any form is essential. A significant rise in blood pressure accompanies the smoking of each cigarette. The lower amounts of nicotine contained in smoking cessation aids usually will not raise blood pressure. They may therefore be used with appropriate counseling and behavior interventions.
• Reduce intake of dietary fat, saturated fat and cholesterol for overall heart health.
• Manage stress. Some studies indicate that individuals who do not effectively manage stress have a higher risk for developing high blood pressure.
• See a Registered Dietitian. Whether you need to lose weight, increase your intake of fruits and vegetables, or cut down on your sodium intake, a dietitian can help you plan a diet that is right for you.

Recently, a national study found that a particular eating plan called the DASH Diet (Dietary Approaches to Stop Hypertension) can help lower elevated blood pressure and may help to prevent and control high blood pressure. The DASH Diet is rich in fruits, vegetables, fiber, and low-fat dairy foods, and low in saturated fat, total fat and cholesterol. It resembles the traditional heart healthy diet, but with greater emphasis on fruits, vegetables, nuts, seeds and legumes.

It’s easy to adopt the DASH diet. Here are some ways to get started:

Change gradually.

• If you now eat one or two vegetables a day, add a serving at lunch and another at dinner.
• If you don’t eat fruit now or have only juice at breakfast, add a serving to your meals or have it as a snack.
• Use only half the butter, margarine or salad dressing you do now.
• Try low-fat or fat-free condiments, such as fat-free salad dressings.
• Gradually increase dairy products to three servings per day. For example, drink milk with lunch or dinner, instead of soda, alcohol, or sugar-sweetened tea. Choose low-fat (1%) or fat-free (skim) dairy products to reduce total fat intake.

Treat meat as one part of the whole meal, instead of the focus.

• Buy less meat. If it’s not there, you won’t eat it.
• Limit meat to 4-6 ounces a day (two servings of 2-3 ounces each). Three to four ounces is about the size of a deck of cards.
• If you now eat large portions of meat, cut them back gradually - by a half or a third at each meal.
• Include more vegetarian-style (meatless) meals each week.
• Increase servings of vegetables, rice, pasta, and dry beans in meals. Try casseroles, pasta, and stir-fry dishes which have less meat and more vegetables, grains, and dry beans.

Use fruits or low-fat foods as desserts and snacks.

• Fruits and low-fat foods offer great taste and variety. Use fruits canned in their own juice. Fresh fruits require little or no preparation. Dried fruits are easy to carry with you.
• Try these snack ideas: unsalted pretzels or nuts mixed with raisins; graham crackers; low-fat and fat-free yogurt and frozen yogurt; plain popcorn with no salt or butter added; and raw vegetables.

View the DASH eating plan chart. Print it off and take it shopping!