Written by Kerry Puglia, MSN, AGNP-BC

Whether you have been diagnosed with hypertension or want to do what you can to prevent it, following these tips will help keep your blood pressure in check.

• Know Your Numbers

It is important for you to know your blood pressure. If you have not had your blood pressure checked in over a year, please make this a priority. You can get your blood pressure measured by a medical professional, at the pharmacy, or you can do it yourself at home. If elevated (two instances of elevated blood pressure are required to make a diagnosis), your doctor will recommend treatment, which will include lifestyle modifications such as the ones listed below, with or without medication. If in the normal range, continuing to monitor your blood pressure at home can bring awareness to your body, making you an active participant in maintaining your health. If you start to notice the numbers creeping up, you can discuss this with your doctor and instill some of the changes below. 

Performing an accurate blood pressure measurement is something that is often overlooked. If your doctor suggests monitoring your blood pressure at home, or if you decide to do so on your own, use a validated device and follow the technique recommended by a reputable source. This infographic by the AMA and Johns Hopkins Medicine outlines some simple tips for performing an accurate blood pressure measurement.  

• Exercise

Keeping active is extremely important when it comes to heart health. Consistent physical activity makes your heart stronger. When your heart is strong, it pumps the blood out with less force, lowering blood pressure.

The American Heart Association and the CDC recommend you get at least 150 minutes of moderate-intensity exercise a week. Examples of activity involving a moderate intensity are brisk walking, leisurely bicycle riding, or water aerobics. If you prefer a vigorous workout, such as running or bicycle riding with a lot of hills, the time recommendation decreases to 75 minutes per week. It is preferable to spread the activity throughout the week. Shorter workouts most days of the week are better than one or two long sessions. 

In addition to cardio, include movements that aim to strengthen muscles. You can do this with weights, exercise bands, or your body weight. For example, if you want to strengthen your shoulders, you can do shoulder presses with dumbbells, front raises with resistance bands or push-ups with your body weight. Try to add muscle-strengthening exercises twice a week.

When it comes to incorporating an exercise routine, start slow and gradually increase to the recommendations above. If you have any injuries, be sure to ask your doctor what kind of exercises are recommended.

• Eat Healthy to Lower Cholesterol

As mentioned above, cholesterol can attach to tears in damaged arteries, further increasing blood pressure and your risk for a heart attack or stroke. Cholesterol is a type of fat, and while there are many healthy fats we should aim to include in our diets, saturated and trans fats should be limited. Avoid fried foods, red meat, full-fat dairy, and processed foods (such as snacks in packages, frozen entrees and desserts, and fast foods). Include healthy, unsaturated fats in moderation. These include avocado, fish, walnuts, and olives. 

• Eat Healthy to Lower Sodium

Sodium, or salt, attracts water. When we ingest more sodium than we need, the amount of blood that travels through our heart and blood vessels is increased. With increased blood volume, there is increased pressure pushing against the vessel walls, raising blood pressure. Again, we can compare this to the garden hose; more water flowing through the hose increases that force against the hose lining. Aim to maintain an appropriate balance of sodium and water in the body by watching your sodium intake.

Here are some tips recommended by the AHA:

• Poultry is often injected with a salt solution to make it tastier. Read poultry packaging and refrain from purchasing poultry with terms such as “broth,” “saline,” or “sodium solution” on the label. 
• Try to eat more whole foods such as fresh fruits and vegetables. Prepare beans on your own rather than purchasing canned beans. If you must purchase canned or frozen veggies or beans, try to pick a “reduced sodium” or “no salt added” product.
• Limit using salt when cooking. Wait until the meal is finished cooking and taste the food before adding salt. If you use other favorable ingredients, such as onions, garlic, and spices, you may realize that you do not need to add much salt, if any.
  
• Eat Healthy to Increase Potassium 

We now know that too much sodium is not good for our blood pressure. We can reduce sodium by following the recommendations above. But there is another way we can lower sodium levels and that is by increasing dietary intake of potassium. Potassium leads to sodium excretion. This recent study from The New England Journal of Medicine found that participants with the highest urinary potassium levels had a 31% lower risk of a cardiovascular disease event such as heart attack or stroke.

Fruits, vegetables, potatoes, and legumes are some of the most potassium-rich foods. A comprehensive list of potassium-rich food sources can be found here.

• Quit Smoking

Nicotine, an ingredient in cigarettes and tobacco, stimulates the release of hormones that cause a rise in blood pressure. Talk to your doctor about quitting or visit smokefree.gov for tips and tools on making the transition to a smoke-free lifestyle. 

• Limit Alcohol

Alcohol contributes to increased blood pressure in multiple ways. One mechanism involves increasing levels of a hormone that constricts blood vessels and increases blood volume. Drinking excess alcohol is a surefire way to increase your blood pressure. 

If you drink, the AHA recommends consuming no more than two drinks per day for men or one drink per day for women. A drink is considered 1 oz of spirits, 4 oz of wine, or 12 oz of beer. 

If you find cutting back on alcohol difficult, talk to your healthcare provider. 

• Take Your Medication, if Prescribed

The lifestyle modifications above are always recommended to prevent or treat high blood pressure. Depending on your risk factors and blood pressure level, your healthcare provider may also recommend medication. These medications are called antihypertensive medications. There are many different categories of antihypertensives. Your provider will seek to prescribe a medication that will keep your blood pressure controlled while causing as few side effects as possible. 

Changes to your lifestyle can be hard to make on your own. Seek guidance and support while making these healthy lifestyle changes. With the help of a CDC-recognized evidence-based Lifestyle Change Program, you will have the tools needed to exercise, eat healthily, and live a lifestyle without preventable chronic disease.

References

1. American Heart Association. American Heart Association Recommendations for Physical Activity in Adults and Kids.
2. American Heart Association. The Skinny on Fats. 
3. American Heart Association. Get the Scoop on Sodium and Salt.
4. American Heart Association. How to Reduce Sodium.
5. Ma, Y., He, F. J., Sun, Q., Yuan, C., Kieneker, L. M., Curhan, G. C., MacGregor, G. A., Bakker, S. J. L., Campbell, N. R. C., Wang, M., Rimm, E. B., Manson, J. A. E., Willett, W. C., Hofman, A., Gansevoort, R. T., Cook, N. R., & Hu, F. B. (2022). 24-hour urinary sodium and potassium excretion and cardiovascular risk. New England Journal of Medicine, 386(3), 252–263. https://doi.org/10.1056/nejmoa2109794.
6. Dietary Guidelines for Americans. Food Sources of Potassium.
7. Husain K, Ansari RA, Ferder L. Alcohol-induced hypertension: Mechanism and prevention. World J Cardiol. 2014;6(5):245-252. doi:10.4330/wjc.v6.i5.245. 
8. American Heart Association. Limiting Alcohol to Manage High Blood Pressure.