Living With High Blood Pressure

If you have been diagnosed with high blood pressure (hypertension), it is important that you:

• Keep track of your own blood pressure (See NHLBI's "My Blood Pressure Wallet Card" for help tracking your blood pressure ). Learn to take your own blood pressure at home or have it regularly checked by a health care professional. Write it down each time (with a date) to help you monitor trends.
• Talk to your health care provider about the names and dosages of your blood pressure medicines and how to take them.
• If you think you're having other problems (side effects) from taking your medicine, talk to your doctor. Another medicine may be better for you, or the problem may not be related to the medicine. Your doctor should always take you seriously and listen to your concerns and observations.
• Refill your blood pressure medicines before they run out.
• Take your blood pressure medicines exactly as directed — don't skip days or cut pills in half. If you believe you need a lower dose (such as during the summer), check with your doctor first. If you forgot a dose, do not take an extra dose to make up for that.
• Keep your followup appointments with your health care provider.
• Choose healthier habits wherever you have the opportunity to do so — for example, eat a heart healthy diet, get regular physical activity, and don't smoke.
• Ask your doctor or health care provider questions about your treatment and what you need to do to take care of yourself and lower your high blood pressure.

Women and High Blood Pressure

In some women, blood pressure can increase if they use birth control pills, become pregnant, or take hormone therapy (HT) during menopause. While this kind of secondary hypertension has an indentifiable cause, it is still important to talk to your doctor about ways to manage it.

Oral Contraceptives (Birth Control Pills)

Women taking birth control pills usually have a small increase in both systolic and diastolic blood pressure. If you have high blood pressure and are using birth control pills, get your blood pressure checked regularly. Talk to your doctor about a possible rise in blood pressure and what you can do about it.

If you have high blood pressure, are age 35 or older, and also smoke, you should not take birth control pills unless you quit smoking. Women age 35 and older who smoke and use birth control pills are more likely to develop heart disease or have a stroke. High blood pressure also raises your chances of stroke and heart disease.

If you are age 35 or older, are healthy, do not smoke, and your high blood pressure is controlled, it may be safe for you to use birth control pills. Ask your doctor if birth control pills are safe for you.

Pregnancy

Many pregnant women with high blood pressure have healthy babies. However, high blood pressure can be dangerous for both the mother and the baby. High blood pressure can harm the mother's kidneys and other organs, and it can cause low birth weight and early delivery.

If you are thinking about having a baby and you have high blood pressure, talk first to your doctor or nurse. You can take steps to control your blood pressure before and during pregnancy. Regular prenatal care (health care during pregnancy) is very important for your and your baby's health.

Before becoming pregnant:

• Be sure your blood pressure is under control. Making changes—such as limiting the salt and sodium in your diet, exercising regularly, and losing weight if you are overweight—can be helpful.
• Discuss with your doctor how high blood pressure might affect you and your baby during pregnancy, and what you can do to prevent or lessen problems.
• If you take medicines for your blood pressure, ask your doctor what you should do about taking them during pregnancy. Women who take angiotensin converting enzyme inhibitors should talk to their doctor before they become pregnant.

While you are pregnant:

• Be sure to get regular prenatal health care. Don't miss any appointments.
• Don't drink alcohol or smoke.
• Talk to your doctor about any over-the-counter or prescribed medicines you are taking or are thinking about taking.

Some women develop high blood pressure for the first time in the middle of their pregnancy. In the most serious cases, the mother develops a condition called preeclampsia (pre-e-KLAMP-se-a) or "toxemia of pregnancy." This condition causes high blood pressure, rather than the other way around, but it is one of the reasons why it is so important to minitor your blood pressure during pregnancy. This condition can threaten the lives of both the mother and the unborn child. More information about high blood pressure and pregnancy is available at the NHLBI Web site Your Guide to Lowering Your High Blood Pressure.

Even though high blood pressure during pregnancy can be serious, most women with high blood pressure and those who develop preeclampsia have successful pregnancies. Getting early and regular prenatal care is the most important thing you can do for you and your baby.
 

Postmenopausal Hormone Therapy

Large randomized trials indicate that postmenopausal hormone therapy causes a small increase in systolic blood pressure. If you start taking postmenopausal hormone therapy, you should have your blood pressure checked regularly. Your doctor can help answer your questions.

Older Adults and High Blood Pressure

A common form of high blood pressure in older adults is isolated systolic hypertension (ISH).

ISH is high blood pressure, but only the top (systolic) number is high (140 or higher). ISH can be as harmful as high blood pressure in which both numbers are high.

ISH is the most common form of high blood pressure for older adults. About 2 out of 3 people over age 60 with high blood pressure have ISH.

You may have ISH and feel fine. As with other types of high blood pressure, ISH often causes no symptoms. To find out if you have ISH—or any type of high blood pressure—get your blood pressure checked.

If not treated, ISH can cause damage to your arteries and to body organs. ISH is treated the same way as high blood pressure in which both systolic and diastolic pressures are high—by making changes in your health habits and with blood pressure medicines.

Key Points

• Normal blood pressure is less than 120/80 mmHg.
• Uncontrolled high blood pressure is dangerous and can lead to stroke, heart failure, heart attack, kidney failure, and blindness.
• You have prehypertension if your top (systolic) number is usually between 130 and 139, or your bottom (diastolic) number is usually between 80 and 89.
• You have high blood pressure if your top (systolic) blood pressure number is usually 140 or higher, or your bottom (diastolic) number is usually 90 or higher. Both numbers are important.
• If you have diabetes or chronic kidney disease, you have high blood pressure if your top number is usually 130 or higher, or your bottom number is usually 80 or higher.
• Over half of all Americans aged 60 and over have high blood pressure.
• African Americans are more likely to have high blood pressure than Caucasians.
• High blood pressure is called the silent killer because it usually has no signs or symptoms.
• Having your blood pressure checked is quick and easy.
• You can control your high blood pressure through healthy lifestyle habits and taking medicines, if needed.
• It is important to keep track of your blood pressure and keep it under control.
• You can help prevent high blood pressure by choosing a healthy way of life.