First of all, what is high blood pressure? Blood pressure refers to the force of blood pushing against artery walls as it courses through the body. Like air in a tire or water in a hose, blood fills arteries to a certain capacity. Just as too much air pressure can damage a tire or too much water pushing through a garden hose can damage the hose, high blood pressure can threaten healthy arteries and lead to life-threatening conditions such as heart disease and stroke, according to WebMD.
When lifestyle changes fail to fix the problem, doctors tend to reach for the prescription pad and add medication, says Dr. William Kormos, editor-in-chief of Harvard Men’s Health Watch and a primary care physician at Massachusetts General Hospital. Many people would rather not take a pill, or add another. For them, there are other ways to step up a blood pressure control campaign. The school has a special report: Hypertension: Controlling the Silent Killer.
Reduce sodium intake. The medically proven DASH diet keeps sodium to 2,300 milligrams per day (about one teaspoon of salt). Cutting it to 1,500—not easy, but doable—works even better. The DASH diet can lower your systolic pressure (upper number) by 10 points or more.
Monitor your pressure at home. Checking blood pressure at home with an appropriate device can give you instant feedback on the benefits of diet and exercise and give you and your doctor a more accurate picture of your blood pressure. This is valuable, because some people experience “white coat hypertension,” in which blood pressure spikes higher than normal when measured at the doctor’s office.
Limit your alcohol intake. Drinking too much alcohol can raise blood pressure. For men, the suggested limit is one to two alcoholic drinks per day, defined as 1.5 ounces (1 shot glass) of 80-proof spirits, a 5-ounce serving of wine, or a 12-ounce serving of beer. (For women it’s no more than one drink a day.)
Take more meds if you need to—but take the right ones. Many people who are already taking one or two hypertension medications ultimately come into “control” (blood pressure below 140/90) only when taking three or even four medications. But they need to be the right drugs.
Your doctor should combine medications that work to lower blood pressure in different ways. “Your doctor should pick medications in different classes that complement each other and won’t just be redundant,” Dr. Kormos says.