High Blood Pressure Treatment and Prevention

Lifestyle, medication and natural alternatives may lower your hypertension

Kimberly Hayes,

AARP

Reviewed by:

Stan Sack, M.D.

Comments

En español

Published August 09, 2024

woman exercising with small weights with a blood pressure line across the image

AARP (Source: Getty Images)

High Blood Pressure Treatments

Many older Americans see blood pressure levels start to creep up, especially after age 60 when nearly three-quarters of people reach the level of hypertension, putting them at high risk for stroke, heart disease, kidney disease, cognitive impairment and even eye problems. So, if your doctor starts talking to you about getting your numbers under control, it’s important to take it seriously.

Blood pressure numbers are measured in millimeters of mercury (mm Hg). Your blood pressure is considered elevated when it rises above 120 mm Hg systolic (the top number) and above 80 diastolic mm Hg (the bottom number). You then move into higher stages of high blood pressure as the numbers rise. The numerous hypertension stages and types are complex, yet understanding what risks lie behind the numbers is vitally important, especially as we age.

It’s important to talk with your doctor about the ideal blood pressure target for you, as it can vary by age and other health conditions that you face. Your doctor will also consider what may be causing your hypertension, including genetics and lifestyle factors, and your risk of having a serious cardiovascular event when determining a treatment plan, which could include lifestyle changes, medication or a combination of both.

Risk calculators can guide blood pressure treatment

Doctors sometimes use a risk calculator to determine a patient’s chances of having a stroke or heart attack. For example, there’s the American Heart Association’s Predicting Risk of Cardiovascular Disease Events (Prevent) risk calculator, which considers cholesterol levels, age, sex, body mass index (BMI), where you live, if you are a smoker and your blood pressure to determine your risk for cardiovascular disease and complications.

While your blood pressure target goal and treatment plan will be determined by your doctor, there are some industry standard recommendations. For example, the Mayo Clinic recommends a blood pressure treatment goal of less than 130/80 mm Hg if:

You’re a healthy adult age 65 or older
You’re a healthy adult younger than age 65 and your doctor determines that you have a 10 percent or higher risk of developing cardiovascular disease in the next 10 years
You have chronic kidney disease, diabetes or coronary artery disease

“Blood pressures over 140/90 definitely need treatment,” said Beverly Green, M.D., senior investigator for Kaiser Permanente Washington Health Research Institute. However, sometimes when people are getting close to their blood pressure targets, they back off on their treatment. This can be dangerous because blood pressure is quite variable, so it’s best to aim for an average blood pressure that is a little lower than your target BP. “You want the majority of your blood pressures to be in the right range,” Green added.

If you are having difficulty staying on your treatment regimen, your doctor may want to discuss any barriers to taking your medication regularly, including cost, side effects or not remembering to take your dose. Reducing or suddenly stopping certain medications can cause sudden sharp increases in blood pressure.

VIDEO: How to Read Your Own Blood Pressure

The importance of home blood pressure monitoring

Taking your blood pressure routinely at home is especially important for people who have been diagnosed with high blood pressure, and for individuals whose doctors are trying to figure out if they have the condition. Getting a range of blood pressures using a validated blood pressure home monitor can provide a more accurate picture of your blood pressure and a course for treatment than occasional measurements in a doctor’s office.

Lifestyle changes to help lower blood pressure and manage hypertension

Medication is often recommended for older people with high blood pressure, but consistent lifestyle changes can help bring your numbers down on their own or in combination with prescription drugs.

“We’ve engineered our society for an unhealthy lifestyle. I call it access to excess. Access to excess calories, sugar and salt, labor-saving devices and passive entertainment. Wherever those things exist, we get an avalanche of chronic disease,” said Brent Egan, M.D., vice president of the American Medical Association’s Cardiovascular Disease Prevention. “We need to engineer our houses and environment so that we don’t have access to those things. Those things are killing us.”

Here are 10 changes you can make in your everyday life to help reduce your blood pressure naturally.

1. Maintain a healthy weight

People with a BMI of 30 or higher tend to have higher blood pressure, and even modest weight loss of just 5 to 15 percent is associated with improvement in systolic and diastolic blood pressure.

BMI estimates body fat based on your height and weight. For hypertension risk, where you carry the body fat is important too, with the waistline being an especially critical area:

Men should aim to keep their waist measurement less than 40 inches.
Women should aim for a waist measurement of under 35 inches.

Read more on how to lose weight naturally and how to maintain a healthy weight long-term.

2. Lower sodium intake

Sodium causes your body to hold on to water, which makes your blood vessels expand and creates more pressure. Additionally, too much sodium makes your heart pump harder, leading your blood pressure to rise. Research finds that most older adults who cut about a teaspoon of salt from their daily diet over the course of one week lowered their systolic blood pressure by about 6 mm Hg. Impressively, the effect was even found on people already taking blood-pressure-lowering drugs.

3. Embrace healthier snacking

While it’s best to concentrate on an overall healthy diet to get control of your blood pressure, foods such as fruits, vegetables and low-fat dairy that are rich in micronutrients can work together to help regulate blood pressure. Even potatoes have been shown to reduce blood pressure if prepared in a healthy way.

You can reduce your blood pressure down by about one point for each additional fruit and vegetable you eat a day, Egan said. “So, you could expect a 5 to 6 mm HG reduction if you [ate] five or so fruits and vegetables a day. When combined with exercise you could see up to a 15 mm HG reduction.” Healthy treats can also help take the place of salty snacks and other harmful foods for blood pressure.

4. Explore the DASH diet for lower blood pressure

Research has shown the DASH diet to be effective in lowering blood pressure, as well as for weight loss and reduced cognitive decline. It involves eating specific foods such as fruits and vegetables, low-fat and no-fat dairy, whole grains, fish, poultry, beans and nuts. A key component is also reducing sodium.

man shopping for healthy food at the grocery store

Getty Images

5. Increasing physical activity to lower blood pressure

A recent study showed that static isometric exercises like wall sits, also known as wall squats, and planks are the best exercises for lowering blood pressure. These exercises engage muscles without movement and involve holding your body in one position until your muscles tire.

If this type of exercise is too strenuous due to arthritis or other pain issues, even just six minutes of lower-intensity physical activity can significantly lower blood pressure, Egan said.

VIDEO: Wall Sits Can Lower Blood Pressure

Discover more exercise ideas.

6. Breathing exercises to reduce stress and lower blood pressure

Deep breathing exercises can help to lower stress and make changes in our physiology that reduce blood pressure. Experts say that by learning to control our own breath we can harness a natural remedy to improve hypertension. However, not all breathing exercises are right for everyone. It’s important to find the best breathing technique for you.

Use AARP’s visual guide to learn how to perform top breathing techniques to lower blood pressure.

Other natural blood pressure remedies, from increasing your daily steps to taking up tai chi, stretching routines and mindfulness, are also helpful stress and blood pressure reducers. Learn more about controlling blood pressure with natural remedies.

7. Try tart cherry juice for high blood pressure

Tart cherry juice is growing in popularity for older adults who are concerned about their blood pressure, or who experience side effects from blood pressure medications. While the tasty treat may not be right for everyone and shouldn’t be considered a replacement for blood pressure medication, it could be a tool in your arsenal against high blood pressure.

“We’ve engineered our society for an unhealthy lifestyle. I call it access to excess. Access to excess calories, sugar and salt, labor-saving devices and passive entertainment."

Brent Egan, M.D., American Medical Association

Take a closer look at the science behind tart cherry juice.

8. Reduce alcohol intake

Studies show that heavy drinking raises your risk for high blood pressure, and more recent research has found that even light to moderate drinking can carry risks.

Read more about how alcohol can harm your blood pressure.

9. Quit smoking

Smoking isn’t a primary risk factor for high blood pressure, but the habit can damage blood vessels. Additionally, the addictive chemical compound nicotine can increase blood pressure.

Read more about smoking and high blood pressure.

10. Get enough sleep

Many Americans suffer from chronic sleep problems, contributing to numerous adverse health conditions, including high blood pressure. Sleep apnea is particularly hard on our vascular system and blood pressure. Here are 43 steps to fine-tune your sleep routine and reduce your risk of hypertension.

Medications for high blood pressure

While lifestyle changes can be beneficial for hypertension control and your overall health, they may not be enough to get your blood pressure down to the ideal target level, especially if you are over 65 or already have Stage 2 hypertension or above, which is defined as a confirmed systolic pressure of 140 mm Hg or higher or a diastolic pressure of 90 mm Hg.

“There are good lifestyle interventions to lower blood pressure; it is hard to change lifestyle though, and it's been known for a long time that medications trump lifestyle,” Green said. “When you have people on a very, very good program, medications will reduce deaths by more than a very good lifestyle program.”

Beverly Green, M.D., Kaiser Permanente Washington Health Research Institute

Courtesy of Beverly Green

Generally, medications are indicated as the first line of defense against hypertension if your blood pressure is 130/80 and your risk for cardiovascular disease is medium to high, Green said. It's only for those people at low risk for cardiovascular disease that lifestyle changes alone are recommended as the first line of treatment.

Sometimes lifestyle isn’t even the main cause of high blood pressure. Genetics can play a big role. Green herself discovered she had high blood pressure after doing 24-hour ambulatory blood pressure monitoring, which involves measuring blood pressure on a continuous basis as you live your daily life, even during sleep.

“I don’t eat any meat and I’m a normal weight. I run, and I love fruits and vegetables, so I consider myself to not have an unhealthy lifestyle. I still had hypertension,” Green said. Knowing that high blood pressure is one of the top causes of death and heart failure, she chose to go on blood pressure medication, which has helped to get her numbers under control.

Primary medications that your doctor may prescribe for hypertension include:

Angiotensin-converting enzyme inhibitors (ACEI) — These medications inhibit your body from making the hormone angiotensin II so that your blood vessels can relax and dilate, therefore reducing blood pressure.
Angiotensin II receptor blockers (ARBs) — These also keep the angiotensin II hormone from narrowing blood vessels.
Calcium channel blockers (CCBs) — These prevent calcium from entering muscle cells in the walls of your arteries, which helps them to relax and dilate.
Diuretics — Often called water pills, they help your kidneys flush out water and salt from your body.

These drugs can be used in combination with one another, and your doctor may adjust the type and dosage you take, particularly if you experience side effects. Side effects can sometimes cause patients to stop taking their medication, putting their hypertension at risk of becoming much worse.

Common complaints include feeling lightheaded or fatigued when taking blood pressure medications. In addition, each type of medication has its own set of side effects; thus, it’s important to discuss any potential ones with your doctor. Sometimes two low doses of different medications are much more powerful than a single medication, and the lower dosages can diminish side effects, Green said.

Discover the different options for hypertension treatment, including secondary agents such as beta blockers, and how you can deal with the side effects of blood pressure medications.

The best time to take blood pressure medication

Knowing when your blood pressure is at its highest can help you and your doctor pinpoint the best time to take your medication. This is important, as you will see the strongest effect from the medicine soon after you take it. Peak effect is usually achieved within a few hours of swallowing your pill, according to the Cleveland Clinic.

Treating resistant hypertension

Resistant hypertension occurs when blood pressure stays over 140/90 even when the patient is taking three or more prescription hypertension medications. You could receive this diagnosis if your high blood pressure is still present after six months of treatment.

Your medical provider may want to explore a more effective treatment plan in this scenario, including changing the combinations of your medications and asking you to do regular home blood pressure monitoring to determine if your hypertension is consistent outside of the doctor’s office.

According to the Mayo Clinic, researchers are exploring renal denervation to treat resistant hypertension. This involves using heat to destroy specific nerves in the kidney that could play a role in the condition, and studies have shown mixed results so far. Further research is underway.

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Kimberly Hayes is an editor-writer for AARP and has written on health and social justice issues for numerous organizations, including the National Organization for Women, the Robert Wood Johnson Foundation and the Lawyers’ Committee for Civil Rights. She previously served as editor of Native American Report.

Dr. Stan Sack practiced pediatrics for 33 years in Massachusetts and Florida. He now works as a freelance health writer and editor. His articles have appeared in several outlets, including Keys Weekly, Rural Health Quarterly and AARP.