November 17, 2017

Stricter numbers mean taking steps to control blood pressure before it gets too high.


The American Heart Association announced this week that it’s revising its guidelines for what is considered high blood pressure — which means even more Americans will be considered “hypertensive.”

Before this report, the association estimated that some 30 percent of Americans have hypertension, or high blood pressure. Under the new guidelines, closer to half of Americans’ blood pressure readings will be considered too high.

What is too high for blood pressure? The new guidelines consider blood pressure readings above 130/80 to be too high — and blood pressure above 120/80 to be “elevated.” Previously, the association considered readings above 140/90 to be high, and 120/80 or below as normal.

High blood pressure is a major risk factor for heart disease and stroke – the two leading causes of death in the world, according to the American Heart Association. The new guidelines note that, in the United States, high blood pressure causes more deaths from heart disease and stroke than all other preventable causes, except cigarette smoking. Yet high blood pressure doesn’t usually make someone feel bad; it can be “silent” until a stroke or heart attack happens.

The good news is that most people can lower their blood pressure even without medication. At Vanderbilt’s Heart and Vascular program, cardiovascular specialist Joshua Beckman, M.D., says that keeping weight within healthy limits helps keep blood pressure normal. Also, Beckman said, people should also be aware of their alcohol consumption, and drink only in moderation. “Moderation” means no more than two drinks per day for men and one for women.

Beyond healthy weight and limited drinking, here are four big weapons against hypertension:

1. Cut way back on salt in your diet.

Southerners love salty food, but it doesn’t love us back. Fried food, processed food, bacon, all those vegetables cooked with bacon — they’re all high in sodium (salt). If you have high blood pressure — even if you’ve only just landed in this category, under the new American Heart Association guidelines — read food labels and keep track of how much sodium you’re taking in. Aim for less than 2,300 milligrams of sodium per day.

Be aware that many foods that don’t taste particularly salty may be hiding a lot of sodium (for example, store-bought salad dressings, white bread and canned goods). Check the actual amount of sodium in a food; don’t assume that because the can is labeled “low sodium” that you can eat that food and stay within your daily salt limit.

Get familiar with the DASH diet. 

Watch out for the “salty 6,” popular foods that are loaded with sodium.

Flavor food with garlic, lemon or lime juice, hot peppers or fresh herbs — all pack a lot of flavor without salt.

2. Get plenty of exercise.

If you get very little (or no) physical activity, learning to work some into your daily routine will give a boost to your health. There are ways to gently ease into an exercise routine to avoid injury and burnout.

You don’t need an hour or more of intense sweating to get the benefits of physical activity. Squeezing it in in short bursts counts, too. Once you are in the habit of a daily workout — even if it’s just a stroll — you’ll discover the nice side benefits of regular walking, things that help manage stress.

3. Yes, manage stress.

Exercise is good for this, too. Brisk walking, lifting weights, a kickboxing class — they all help blow off steam. Yoga does wonders for calming the body and mind.

It’s increasingly clear from recent scientific studies that sleep plays an important role in many aspects of our health, including our ability to shake off stress. Prevent these things from eroding your sleep, to get more rest and lower your stress level.

Don’t let the upcoming holiday season add to your stress load. Tips for managing the holidays are here.

4. Quit smoking.

Smoking cigarettes raises blood pressure, which in turn increases the chances of a stroke and heart disease.

Breaking a nicotine addiction is difficult, but even people who have smoked for decades have been able to do it. Quitting smoking improves health, in many ways, some as quickly as 20 minutes after your last cigarette.  One of the first things to improve is blood pressure — it starts to come down 20 minutes after your last puff. For inspiration and strategies, My Southern Health offers these posts about quitting smoking.


There are many ways to reach a healthy blood pressure, Beckman said. The more strategies the use, the better you will feel and the less likely that your doctor will tell you to start taking hypertension medication.

The Vanderbilt Heart team treats patients with all kinds of cardiovascular disease, including very complex cases, offering a wide range of services in many locations. Learn more here.

Joshua Beckman, M.D., is professor of medicine and director of vascular medicine at Vanderbilt University Medical Center. His research focuses on how and why people develop peripheral artery disease, and strategies for prediction and prevention.