High Blood Pressure (Hypertension): Practical Guide
Nearly half of adults in the U.S. meet the current definition of high blood pressure. It often shows no symptoms but raises your risk for heart attack, stroke, and kidney disease. This page gives clear, useful steps you can use today: how to measure, lifestyle moves that work, and what medicines do.
How to measure and track your blood pressure
Use a validated upper-arm cuff at home and sit quietly for 5 minutes before measuring. Take two or three readings one minute apart and record the average. Measure at the same times each day—morning before meds and evening is common. Make sure the cuff size fits your arm; a wrong size gives wrong numbers. Bring your home log to appointments so your clinician can see trends, not just one number.
Know the numbers: many guidelines target below 130/80 mmHg for people at higher risk, but targets vary by age and medical history. Ask your doctor what target is right for you. If you get sudden readings above 180/120 and have chest pain, shortness of breath, or vision changes, seek emergency care.
Lifestyle steps that actually lower blood pressure
Small changes add up. Cut sodium toward 1,500–2,300 mg a day if you can. Try the DASH diet—more vegetables, fruit, whole grains, and lean protein. Aim for 150 minutes of moderate exercise weekly, like brisk walking. Drop 5–10% of body weight if you're overweight; even modest weight loss lowers blood pressure. Limit alcohol to one drink a day for women and two for men. Smoking raises cardiovascular risk—quitting helps overall heart health even if BP changes are modest.
Sleep matters. Poor sleep, sleep apnea, and inconsistent sleep schedules can raise blood pressure. If you snore loudly and feel tired during the day, mention sleep testing to your clinician.
Medication basics: what to expect and common choices
If lifestyle changes aren't enough, medications help and are often combined. Common classes include thiazide diuretics (hydrochlorothiazide, chlorthalidone), ACE inhibitors (lisinopril), ARBs (like azilsartan), calcium channel blockers (amlodipine), and beta-blockers (metoprolol and others). Diuretics help remove excess fluid; loops (like furosemide) are used when fluid retention is a problem—see our article comparing loop vs thiazide diuretics for details.
Every drug has trade-offs. ACE inhibitors can raise potassium and affect kidney tests; diuretics can lower potassium; calcium channel blockers can cause swelling in the ankles. Ask your clinician about single‑pill combination options—these simplify dosing and improve adherence. If you or your doctor are considering switching medicines, check our piece on azilsartan and our guide on alternatives to metoprolol for practical comparisons.
Final practical tip: keep a simple plan—measure regularly, follow a few lifestyle rules you can stick with, and talk with your clinician about a medication strategy that fits your life. Use the linked articles on this site for deeper reading and bring questions to your next visit.
