What are 10 top tips for high blood pressure?

Do you have high blood pressure? It is very common. Here is some good advice on what to do if you have it

Before we can say how to control it, we need to know what is normal and what is not. Here goes.

1. First of all, what is normal blood pressure?

There is no such thing as ‘normal blood pressure’. But for most adults there is a normal range of between 110/70 and 135/85 mmHg.

“130/80 is a good average target for most patients, and 120/70 if you have diabetes.”

For most people, high blood pressure (BP) is ‘silent’, i.e. you cannot ‘feel’ whether it is high or low.

And for most people, high BP is called ‘essential (or primary) hypertension’, i.e. there is no underlying cause.

So, what level is ideal and high blood pressure?

130/80 mmHg = ideal blood pressure (for most people, though for some elderly people this target should not be used, and a higher level accepted)
140/90 = moderately high blood pressure
160/100 = very high blood pressure
180/110 = severe high blood pressure.

And why treat high blood pressure?
Treatment for high blood pressure reduces the chance of a heart attack, stroke and chronic kidney disease (CKD).

2. What are the main risk factors for high blood pressure?

Age
Male gender
Smoking
Obesity or being overweight
Lack of exercise
High alcohol consumption
Diabetes.

Some of these risk factors you can alter, e.g. your weight, smoking and alcohol consumption.

3. If your blood pressure is slightly high

If your blood pressure is slightly higher than the ideal level (130/80 mmHg), and your GP feels that the risks of cardiovascular disease are low, you may be able to lower your blood pressure by making simple lifestyle changes (see below).

4. If your blood pressure is moderately high

If your blood pressure is moderately high (140/90 mmHg or above), or your GP feels that your risk of developing cardiovascular disease in the next 10 years, you will be advised about changing your lifestyle and may also be prescribed medication.

5. If your blood pressure is very high

If your blood pressure is very high (160/100 mmHg or above), it needs to be treated with the medication below.

6. If your blood pressure is severely high

If your blood pressure is very high (180/110 mmHg or above) you should also be referred to a specialist blood pressure doctor at your local hospital. This may be someone that also specialises in diabetes, heart or kidney disease.

This is partly as there may be an underlying treatable (called ‘secondary’) cause of the BP. If that is found and treated, the BP may return to normal.

7. Lifestyle changes

The following lifestyle changes are known to reduce high blood pressure:

Regular exercise of at least 30 minutes, a minimum of three times a week (e.g. walking, cycling or swimming)
Cutting your alcohol intake to recommended levels (less than 14 units a week)
Eating a healthy, low-fat, balanced diet, and restricting your salt intake
Losing weight if you are overweight or obese
Relaxation therapies, such as yoga and meditation.

Even if you achieve a relatively small decrease in your blood pressure, it can still have significant health benefits.

8. Monitor your own blood pressure – and write it down

You should buy a BP machine and monitor your own BP. You can do this from any chemist or large supermarket or Amazon – prices vary, approximately £20-£40. ‘A&D’ is a good make.

This is how:

Frequency – measure it once a week until it reaches the target given to you, then once a month, then once every three months. Unless asked by your doctor, do not take it too frequently
Relax – go someone where you are relaxed, with no one talking to you
Arm – same arm
Time – same time of day – first thing in the morning is good
Three times – measure it three times, and take the lowest (usually the last one). Write it down, with previous ones. Show them to your doctor when you see them next.

This is how to take your own blood pressure.

9. Medication

A number of medications can be used to treat high blood pressure. You may need to take more than one type of medication to lower your blood pressure, because a combination of tablets is sometimes needed to successfully treat the condition.

If you have high blood pressure, you may need to take blood pressure-lowering medication for the rest of your life. However, if your blood pressure levels stay under control for several years, you should ask your GP if you could come off your treatment and have your blood pressure monitored.

10. What are tablets for treating high blood pressure?

Angiotensin-converting enzyme inhibitors (ACEs), e.g, Ramipril
Aldosterone receptor blockers (ARBs), e.g. Losartan
Calcium channel blockers, e.g. Amlodipine
Thiazide diuretics, e.g. Bendroflumethazide
Alpha-blockers, e.g. Doxazosin
Beta-blockers, e.g. Bisoprolol
Vasodilators, e.g. Hydralazine. Minoxidil can be used by specialists for severe BP
Centrally acting drugs, e.g. Methyldopa.

BP and ethnicity

Research has shown that different blood pressure lowering medications work better for different ethnic groups. For example, ACE inhibitors are more effective as a first-choice medication for treating high blood pressure in white people; whereas calcium channel blockers, or thiazide diuretics, tend to work better for black people.

Why? It is thought that this is because black people tend to have a lower level of a hormone (made by the kidneys) called renin in their blood. Renin is an chemical that helps to regulate blood pressure. ACE inhibitors are most effective when there is a high amount of renin in the blood; so they are not as effective in treating black people with high blood pressure.

Therefore, your GP will consider your ethnic background when making a treatment plan.

Summary

We have described what are 10 top tips for high blood pressure. We hope it has been helpful.

Other resources

High blood pressure, diabetes and chronic kidney disease (CKD) are connected. And they can all be ‘silent’ (i.e. you cannot feel them) initially.
10 top tips for kidneys
10 top tips for diabetes

Last Reviewed on 1 May 2024