Hypertension: Your Proactive Guide to Understanding and Managing High Blood Pressure
By Dr. Liza Klassen, ND | April 26, 2022 | Reviewed by Dr. Kelly Clinning ND
Definition | Guidelines | Causes | Treatment
Hypertension or high blood pressure is the leading cause of preventable early death globally. It’s preventable because hypertension, once diagnosed, can be treated. Effective and early treatment reduces the risk of having a cardiovascular event such as a heart attack or stroke.
In Canada, over half of adults are hypertensive or pre-hypertensive, primarily due to aging, genetics and lifestyle factors like diet and a sedentary lifestyle.
The most important step you can take is to measure and monitor your blood pressure regularly and create a plan with your doctor to treat your blood pressure if it gets too high. Knowledge is power. Understanding how your body works (or when it needs a tune-up) can help you make proactive, empowered and personalized decisions about your health and well-being.
Hypertension Fast Facts
- Hypertension (high blood pressure) is diagnosed when blood pressure is >140/90 mmHg*
- Blood pressure >180/120 mmHG is an emergency – seek medical care immediately
- Most hypertension is highly treatable
- If left untreated hypertension increases your risk of having a heart attack or stroke
- Hypertension can be managed through lifestyle, medication, specific natural health products or a combination of all three
- Measuring blood pressure regularly is key when proactively managing hypertension
- Always consult with your health care provider before making changes to your blood pressure management plan
* Blood pressure targets may vary based on your age, personal medical history, use of medications and other factors. Talk to your healthcare provider to discuss what your blood pressure target is.
What is blood pressure?
Blood pressure is the force blood exerts against blood vessels after the heart pumps it. This force created by the heart is important to circulate blood throughout the body. When blood pressure is taken two values are recorded; systolic (SBP) and diastolic blood pressure (DBP). When you receive a blood pressure reading it will be recorded with two numbers, like so, 120/80 mmHg, and verbalized as “120 over 80”. The first number is your SBP and the second number is your DBP.
What do systolic blood pressure and diastolic blood pressure mean?
- SBP or systolic blood pressure is the maximum force your blood exerts against blood vessels. This number tells you the pressure in your vessels when your heart is contracting (or beating).
- DBP or diastolic blood pressure is the lowest force your blood exerts against blood vessels. This number tells you the pressure in the arteries when the heart is relaxing (between heart beats).
What is hypertension?
Hypertension occurs when there is too much pressure in the blood vessels. This can happen for several reasons; the most common cause is the stiffening of blood vessels due to aging and/or build-up of atherosclerotic plaques. With increased stiffness or blockages, the heart must work harder to push blood through the arteries. When there is too much force, the blood vessels can become damaged, increasing the risk for various health issues including heart attacks and stroke.
How high is too high?
According to the Canadian Heart and Stroke Foundation and Hypertension Canada blood pressure can be categorized as:
- Low Risk = <120/80 mmHg
- Moderate Risk = 120-139/80-89 mmHg
- Elevated Risk = ≥140/90 mmHg
The first line treatment for patients with moderate risk is lifestyle modification. Hypertension Canada names physical activity, weight reduction, smoking cessation, reduced sodium intake and other dietary changes as key lifestyle modifications. These healthy behaviours are critical at all stages of hypertension care but can be the sole intervention for those at moderate risk.
A medical doctor will typically begin pharmaceutical treatment for hypertension when blood pressure levels reach 140/90 mmHg or greater. Treatment may be started at lower numbers if an individual has other health conditions such as diabetes or a history of stroke. Blood pressure targets may vary based on your age, personal medical history, use of medications and other factors. Talk to your healthcare provider to discuss what your blood pressure target is.
In some cases, a medical doctor will give a patient a window of time to decrease their blood pressure with lifestyle modifications before pharmaceutical treatment is initiated. This depends on personal medical history and risk factors.
What causes hypertension?
Hypertension Canada breaks down the risk factors or causes of hypertension into two categories:
- Those you can control OR modifiable risk factors which include:
- Lack of physical activity
- Less than 75 minutes of vigorous or 150 minutes of moderate aerobic activity weekly (10 – 20 minutes each day)
- BMI ≥30 kg/m2 for men and women
- Waist circumference:
- Women: >88cm (>34.5”)
- Men: >102cm (>40”)
- Diets high in salt
- >5g salt/day, this includes hidden salt in packaged foods!
- Any amount of smoking increases your risk!
- Smoking cessation is the single most effective lifestyle measure for the prevention of a large number of cardiovascular diseases. Check out this article by the CDC for smoking cessation resources.
- Excessive alcohol intake
- Women: >10 drinks/week or >2/day
- Men: >15 drinks/week or >3/day
- Routine or chronic stress, especially work-related stressors
- Other health conditions
- Including sleep apnea, diabetes or insulin resistance, kidney disease or decreased kidney function
Managing these factors, can help decrease your blood pressure. The table below illustrates the impact modifying these factors has on blood pressure. If you are feeling overwhelmed by making many changes all at once, start with one or two interventions and add more when you are ready.
To put these values in perspective a 5mmHg reduction in blood pressure leads to a:
- 14% reduction in heart failure10
- 13% reduction in stroke10
- 7% reduction in ischaemic heart disease10
- 5% reduction in mortality due to cardiovascular disease10
This shows how many opportunities we have to positively impact our heart health and overall wellbeing!
- Those you can’t control OR non-modifiable risk factors which include:
While we can’t change these factors, we can delay and positively influence their impact. Knowing you have a family history of hypertension may inspire you and your doctor to start monitoring your blood pressure at an earlier age and incentivize you to make changes to any of the modifiable risk factors discussed above! Even making one change can significantly decrease your risk of developing hypertension.
Why does blood pressure change throughout the day?
Blood pressure naturally fluctuates throughout the day. It is typically lowest when you are sleeping or relaxing and highest in the morning or when you are under physical stress, including exercising. If you’re monitoring your blood pressure at home make sure to take it at the same time each day, preferably in the morning when it’s highest. Check out this blog for more information on understanding your numbers.
Should I take my blood pressure at home?
Monitoring your blood pressure is an important healthy habit to get into whether you have hypertension or not. It becomes especially important as you age and if you have other risk factors for developing hypertension like those listed above. If you take your blood pressure consistently you can identify unusual changes like higher than normal values or significant swings. If either of these trends are identified it’s important to consult your doctor. Stroke and heart attack can be avoided by properly managing hypertension. Follow this guidelines for correct blood pressure monitoring at home and record your results with our simple blood pressure tracking app.
What do I do if I get a high blood pressure reading?
If your reading is slightly or moderately higher than usual, take it a few more times and record the results. Contact your doctor with this information to verify if it’s a concern or not. If your blood pressure exceeds 180/120 mmHg, wait 5 minutes and then take the reading again. If your reading remains high you may be experiencing a hypertensive crisis and should contact your doctor immediately.
White Coat Syndrome
There’s a common phenomenon termed “white coat syndrome” where acute or situational anxiety increases your blood pressure, typically in the doctor’s office11. This causes higher than normal blood pressure readings and is why we now use a 3 reading average rather than a single reading to diagnose hypertension. It also highlights the importance of at home blood pressure measurements to collect data you can share with your health care team. Check out this blog to ensure your at-home readings are accurate and reliable.
White coat syndrome helps us to understand how acute stress (which is a normal response) causes an increase in blood pressure11. However, this rise in blood pressure is temporary and isolated events of anxiety or stress like this do not cause hypertension11.
Measure, plan and monitor.
Whether you currently have high blood pressure or are looking to reduce your risk of developing it, there are simple steps you can take. Working to improve your modifiable risk factors through diet, exercise and well-managed chronic conditions can be tremendously beneficial for your overall health.
Taking daily blood pressure readings will give insight into your body and help identify any deviations from your normal before major problems arise. Understanding what hypertension is and what your blood pressure readings mean will help you make empowered decisions about your health.
For more expert advice on blood pressure health, and overall health and wellbeing, visit our growing library of articles at precardix.com/blog.
Always consult with your health care provider before making changes to your blood pressure management plan. PreCardix® does not treat, cure or prevent medical conditions. Measure and monitor blood pressure regularly. Know the signs of heart attack and stroke. Do not take PreCardix® if you are pregnant, breastfeeding, have renal artery stenosis, history of angioneurotic edema or shellfish allergy.
- Leung, A., Williams, J., McAlister, F., Campbell, N., Padwal, R., & Tran, K. et al. (2020). Worsening Hypertension Awareness, Treatment, and Control Rates in Canadian Women Between 2007 and 2017. Canadian Journal Of Cardiology, 36(5), 732-739. doi: 10.1016/j.cjca.2020.02.092
- Keyhani, S., Scobie, J., Hebert, P., & McLaughlin, M. (2008). Gender Disparities in Blood Pressure Control and Cardiovascular Care in a National Sample of Ambulatory Care Visits. Hypertension, 51(4), 1149-1155. doi: 10.1161/hypertensionaha.107.107342
- Mosca, L., Ferris, A., Fabunmi, R., & Robertson, R. (2004). Tracking Women’s Awareness of Heart Disease. Circulation, 109(5), 573-579. doi: 10.1161/01.cir.0000115222.69428.c9
- Maas, A., & Franke, H. (2009). Women’s health in menopause with a focus on hypertension. Neth Heart J, 17(2), 68-72. doi: 10.1007/BF03086220
- Parry, M. (2019). Caregiver Burden and Cardiovascular Disease: Can We Afford to Keep the Health of Caregivers in Canada Invisible?. Canadian Journal Of Cardiology, 35(10), 1267-1269. doi: 10.1016/j.cjca.2019.06.025
- Thoenes, M., Neuberger, H., Volpe, M., Khan, B., Kirch, W., & Böhm, M. (2009). Antihypertensive drug therapy and blood pressure control in men and women: an international perspective. Journal Of Human Hypertension, 24(5), 336-344. doi: 10.1038/jhh.2009.76
- Frisoli TM, Schmieder RE, Grodzicki T, Messerli FH. Beyond salt: lifestyle modifications and blood pressure. European Heart Journal. 2011;32(24):3081-3087. doi:10.1093/eurheartj/ehr379
- Musa-Veloso K, Paulionis L, Pelipyagina T, Evans M. A Randomized, Double-Blind, Placebo-Controlled, Multicentre Trial of the Effects of a Shrimp Protein Hydrolysate on Blood Pressure. International Journal of Hypertension. 2019;2019:1-13. doi:10.1155/2019/2345042
- Watson KE, Al Hamarneh YN, Rabi D, Daskalopoulou SS, Tsuyuki RT. Hypertension Canada’s 2020 hypertension guidelines for pharmacists: An update. Can Pharm J. 2021;154(1):19-25. doi:10.1177/1715163520975809
- European Society of Cardiology. “Blood pressure-lowering is even more beneficial than previously thought.” ScienceDaily. ScienceDaily, 1 September 2020.
- Spruill TM, Pickering TG, Schwartz JE, Mostofsky E, Ogedegbe G, Clemow L, Gerin W. The impact of perceived hypertension status on anxiety and the white coat effect. Ann Behav Med. 2007 Aug;34(1):1-9. doi: 10.1007/BF02879915. PMID: 17688391.