High Blood Pressure: Talking to Your Medical Provider

What should I know about talking to my doctor about high blood pressure (hypertension)?

In the office

Please bring your blood pressure log and ALL of your pill bottles to your appointment, including over-the-counter medications.

Questions to ask

• What is my current blood pressure measurement?
• What should my blood pressure be?
• What conditions or situations will increase my blood pressure?
• How much should I weigh? Can you recommend a diet or eating plan to help me reach that weight?
• Would I benefit from a visit to a Registered Dietitian to achieve my dietary goals?
• What kind of diet should I follow to help manage my blood pressure?
• How much exercise should I be doing? What types of activities are recommended?
• What is the name of my blood pressure medication?
• What are the side effects of this medication?
• Should I be taking potassium supplements or increasing the amount of potassium in my diet?

How can I get help to quit smoking?

Here are some tips to help you stop smoking and stay stopped:

• Pick a quit date—usually 1 to 3 weeks in the future—and write it down. Prepare for the date by cutting down on tobacco use, staying away from your favorite places to use tobacco, and making a plan for how you will deal with stressful events without smoking. Don't try to become tobacco-free during a very stressful time in your life. This will lower your chance of success.
• List your reasons for becoming tobacco-free. Read over the list before and after you stop. Carry the list with you and look at it several times a day. (Successful people usually have strong personal reasons to become tobacco-free.)
• Tell yourself you are a great person for becoming tobacco-free. Remind yourself of this when you want to use tobacco.
• When you get the urge to use tobacco, take a deep breath. Hold it for 10 seconds, then release it slowly. Take it one moment, one hour, and one day at a time. Cravings are usually short-lived and will go away whether or not you use tobacco.
• Keep your hands busy. Doodle, play a sport, knit or work on a computer.
• Write down and understand what triggers your urge to use tobacco. Then change the activities that were connected to tobacco. Find new activities to replace tobacco use. Be ready to do something else when you want to use tobacco.
• Eat low-calorie, healthful foods when the urge for tobacco strikes. Carrot and celery sticks, fresh fruits, and fat-free snacks are good choices.
• Remove all reminders of tobacco use from your home, office and vehicle.
• Drink a lot of fluids. Cut down on alcohol and caffeine. They can trigger urges to use tobacco. Select water, herbal teas, caffeine-free soft drinks, and juices.
• Exercise. Exercising will help you relax. Other ways to relax might include meditation or prayer.
• Hang out with other people who do not use tobacco.
• Get support when you need it. Ask friends and family for their support. Tell them about your milestones with pride. In addition to family and friends, seek support from a comprehensive tobacco cessation program, an individual counselor, and support groups as needed.
• Treatment options include medication, nicotine replacement therapy, and/or behavioral therapy.

Lifestyle modifications to improve blood pressure

Calling your medical provider

Call your medical provider if you are not responding to the treatment your medical provider prescribed and your blood pressure is still high. For instance, call if you have two to three high readings in a row. You may need to be evaluated to find out if you have other problems causing your high blood pressure, such as kidney disease, over-production of certain hormones, blocked blood vessels, or an overactive thyroid.

Call your provider if you have certain symptoms, including:

• Fatigue.
• Nausea.
• Shortness of breath.
• Lightheadedness.
• Headache.
• Excessive sweating.
• Problems with your vision.
• Confusion.

These issues might also be side effects from your medication. Your medical provider might need to adjust the dosage or switch you to another medication.

Weight management - Blood pressure can fall by 5-20 mmHg for every 10 kg (about 22 pounds) of weight loss.

• Recommendation: If you have overweight/obesity, losing weight will help your blood pressure. Talk to your provider about a weight that's healthy for you.

Alcohol consumption - Drinking only in moderation can result in a reduction of 2-4 mmHg in blood pressure.

• Recommendation: Keep alcohol intake to no more than two drinks per day for most men and one drink per day for most women. (One drink equals 12 oz. beer, 5 oz. wine, or 1.5 oz. spirits.)

Physical activity - Getting enough exercise can improve blood pressure by 4-9 mmHg.

• Recommendation: Get at least 2.5 hours (150 minutes) of moderate activity (like a brisk walk) per week.

Dietary Approaches to Stop Hypertension (DASH) Sodium Diet - Following this sodium-limited food plan can improve blood pressure by 2-8 mmHg.

• Recommendation: Limit sodium to no more than 2,000 mg per day. Some groups of people (people who are Black, over the age of 60, or those who have hypertension or diabetes mellitus) often are sensitive to changes in sodium (salt) intake.

Potassium consumption - Getting enough potassium can improve blood pressure by 2-4 mmHg).

• Recommendation: Maintain adequate potassium levels. Potassium-rich foods include cooked beans, baked potato, squash, sweet potato, spinach, banana, tomato, orange juice and melon.

Tobacco use and second-hand smoke - Not smoking and not being around smoke can result in blood pressure decreases of 2-4 mmHg after one week of stopping.

• Recommendation: Quit smoking, and avoid second-hand smoke. Tobacco and its by-products increase cardiovascular risk.

Stress management - Reducing your stress can reduce your blood pressure by 5 mm/Hg.

• Recommendation: Practice stress reduction techniques such as meditation, yoga, sleeping well and breathing deeply.