Prescription for Health

How to keep your blood pressure under control

Issue impacts 70 million Americans


High blood pressure or hypertension is a “silent killer” with few warning signs. About 70 million people -- 1 out of 3 adults -- are living with it, but only 52 percent have it under control. This stealth disease is a common risk factor for heart disease and stroke, two leading causes of death in the United States.

It is difficult to tell on your own if you have hypertension as it has few to no symptoms. The single most important step to take is to have your blood pressure checked regularly by a healthcare professional and always ask what it is so you know how it is doing.

What is blood pressure and why is it important?
Blood pressure is vital to life. It’s the force of blood against the walls of the arteries pushing blood through the major arteries into smaller arteries and finally into tiny capillaries allowing the exchange of fluids between the blood and tissues.

When our blood pressure is taken, two numbers are given such as 110/70. The top number is called the systolic pressure which is blood pressure at its highest when the heart is beating. The bottom number is called the diastolic pressure which is blood pressure when the heart is at rest or between beats and the pressure falls.

Throughout the day, blood pressure rises and falls but when it stays high for prolonged periods of time, this can damage the heart and raise your risk for a heart attack or stroke. When the force of blood flow is high, blood vessels stretch so blood flows more easily. Eventually, this stretching scars and weakens blood vessels throughout the body.

The kidneys, which help regulate blood pressure, can also be affected by hypertension. Uncontrolled high blood pressure can cause arteries around the kidneys to narrow, weaken, or harden making hypertension the second leading cause of kidney failure in the United States after diabetes.

Symptoms and causes
Most people do not have any symptoms of hypertension. Some people may experience headaches or nose bleeds but these usually don’t occur until severe hypertension is reached. That is why each time a person goes to a doctor, their blood pressure is always taken. Ideal resting blood pressure is 120/80 or lower. High blood pressure is defined as 140/90 or higher.

There are two types of hypertension: primary or essential hypertension and secondary hypertension
Primary hypertension is when there is no identifiable cause of high blood pressure. This type tends to develop over several years.

Secondary hypertension is caused by an underlying condition. It tends to appear suddenly and causes a higher reading than primary hypertension. Some conditions that can lead to secondary hypertension are kidney or thyroid problems, sleep apnea, or alcohol abuse.

  • Risk factors
    Age – Hypertension risk increases with age. More than two-thirds of adults over age 65 have it, and individuals who have a normal blood pressure at age 55, will have a 90 percent chance of developing high blood pressure during their lifetime.
  • Family history – High blood pressure tends to run in families.
  • Race – It is particularly common among African Americans and often develops at an earlier age than in Caucasians.
  • Obesity – It is estimated that 70 percent of people with hypertension are overweight or obese. Obesity raises blood pressure by altering kidney function, increasing blood volume, and promoting blood vessel damage through insulin resistance. Excess fat also means miles of extra capillaries through which the blood must be pumped.
  • High salt intake – As salt intake increases, so does blood pressure.
  • Reduced potassium intake – Potassium helps balance the amount of sodium in your cells. By not having enough potassium in your diet, too much salt can accumulate in the blood.
  • Alcohol – More than two drinks a day is strongly associated with hypertension. 
  • Stress – High stress can lead to increased blood pressure.
  • Certain chronic conditions – Having diabetes, kidney disease, or sleep apnea can raise blood pressure.


Uncontrolled hypertension can lead to several medical complications which can include:

  • Heart or stroke
  • Aneurysm
  • Heart failure
  • Weakened and narrowed blood vessels in your kidneys
  • Thickened, narrowed or torn blood vessels in the eyes
  • Metabolic syndrome
  • Trouble with memory or understanding

Lifestyle modifications to treat hypertension

Fortunately, there are many lifestyle modifications a person can make to either prevent or treat high blood pressure. The sooner in life one adopts these changes, the greater the likelihood they can avoid or reduce the risk of it developing to begin with.

Here are ways you can help reduce your high blood pressure:

  • Weight reduction – Maintain a healthy body weight (Body Mass Index or BMI of 18.5-24.9).
  • DASH eating plan – Adopt the DASH (Dietary Approaches to Stop Hypertension) diet rich in fruits, vegetables, and low-fat milk products with reduced saturated fat intake.
  • Sodium restriction – Reduce sodium intake to less than 2,300 milligrams of sodium per day and further reduce intake to 1,500 milligrams among people with prehypertension or hypertension for greater reductions in blood pressure.
  • Physical activity – Perform aerobic physical activity for at least 30 minutes per day, most days of the week.
  • Moderate alcohol consumption – Men: limit to 2 drinks per day; women: limit to 1 drink per day.

There are also several medications to treat hypertension. The category of medication your doctor may prescribe depends on your blood pressure measurements and other medical history.

Dr. Samadi is a board-certified urologic oncologist trained in open and traditional and laparoscopic surgery and is an expert in robotic prostate surgery. He is chairman of urology, chief of robotic surgery at Lenox Hill Hospital and professor of urology at Hofstra North Shore-LIJ School of Medicine. He is a medical correspondent for the Fox News Channel's Medical A-Team and the chief medical correspondent for am970 in New York City. Learn more at Visit Dr. Samadi's blog at Follow Dr. Samadi on Twitter and Facebook.