Feeding the monsters of heart disease, vascular disease, diabetes and chronic kidney disease, high blood pressure affects half the adult population in the United States. This means there are 129,000,000 people who have this diagnosis whether they know it or not walking around America. Often blood pressure is the first domino to fall in many syndromes that affect all of our most essential organs. The cause of blood pressure elevation is tricky to figure out in terms of the physics and chemistry, but what we know is that there are tons of risk factors that contribute to it. Many of these, are related to lifestyle habits. In practice, hypertension is mostly silent. Many folks are diagnosed the first few times they come into a clinic and have their blood pressure checked. I have seen this many times… and pandora’s box is opened. Blood work, return visits and starting medication are usually sure things to avoid the horrible consequences of letting blood pressure damage the essential organs in the body.

Hate is a strong word. The vast majority of horrible things that I have seen in healthcare are likely related one way or another to high blood pressure. It’s ok to hate horrible things… and fight them with everything in your power. My least favorite example of the horrible consequences of uncontrolled hypertension is kidney failure which most likely results in lifelong dialysis.

So if you have elevated blood pressure, what are things to do to decrease risk?

Actually, the list is pretty standard: stop smoking, decrease alcohol consumption, exercise regularly, eat a healthy, balanced diet, and work on a lifestyle with more activity, and less sitting.

If you have hypertension, then, please get treated by your primary care provider. I think waiting is typically a bad decision as the problematic effects can accumulate. Then, if you’re able to lower your blood pressure with lifestyle change, come off medication in a titrated way. Make sure to go buy yourself a home blood pressure monitor and check regularly and keep a record. This will help your provider with managing your medication dosing. Depending on age and other factors, your goal blood pressure may be a different number than other patients. Make sure to ask for a goal, and how to contact your healthcare team if blood pressure numbers are not in the right ball park.

Has anyone ever taken your blood pressure correctly? One piece of information will likely turn your answer into a no. Sitting for 5 minutes and relaxing prior to taking a blood pressure reading is the correct way to do it. Your arm needs to be relaxed and extended at the level of your heart. Legs should not be crossed. I always have patients take a few deep breaths and exhale slowly, and then I start taking the blood pressure reading. Take your blood pressure like this at home.

Luckily, we have tons of lifestyle and medication interventions for blood pressure that can bring it under good control. This is a good thing. Number one, get your blood pressure checked. Number two: work on lifestyle interventions that will keep you from having this problem in the future.