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Other Names for High Blood Pressure

High blood pressure (HBP) also is called hypertension.

When HBP has no known cause, it may be called essential hypertension, primary hypertension, or idiopathic hypertension.

When another condition causes HBP, it's sometimes called secondary high blood pressure or secondary hypertension.

In some cases of HBP, only the systolic blood pressure number is high. This condition is called isolated systolic hypertension (ISH). Many older adults have this condition. ISH can cause as much harm as HBP in which both numbers are too high.


Those with high blood pressure who are seeking to modify their diet habits are at an advantage, since most of the advised eating guidelines are so similar to the healthy dietary advice with which most people are already familiar. Namely

•low fat
•lots of natural fruits and vegetables
•moderate consumption of red meat
•moderate consumption ofsweets

1. Whole Grains
Whole grain foods such as

•hearty breads
•natural oat products
are very good for you. They are a powerful source of complex carbohydrates (a great long term energy source) and can help to control cholesterol and balance secretion of hormones like insulin.

These hormone balancing effects can help decrease appetite and lower body weight, which is another important facet of high blood pressure control.

2. Fruits & Vegetables
Probably the most familiar piece of dietary advice: eat lots of fruits and vegetables. They are a good source of stable energy, low in calories, help curb appetite, and work to regulate blood sugar and cholesterol. They are also a great source of vitamins and minerals.

The easiest rule of thumb to remember is to eat at least three different colors of vegetables with each meal. So, a few pieces of carrot, two cherry tomatoes, and a serving of green, leafy vegetables would do the trick. Remember too that when in comes to cooking fruits and vegetables steamed is better than boiled, and raw is the best.

.3. Lean Meats
Traditionally, lean meats have been identified as

•poultry (white meat)
•lean pork
With the continued expansion of food choices, though, some interesting new options are available. For those who relish the taste of a steak, or love spicy tacos, the increasing availability of both buffalo and ostrich are worth looking into. Buffalo tastes nearly identical to beef but a serving contains less than half the fat and only one third of the calories as a serving of white meat chicken! Ostrich is positioned similarly on the health ladder. Both can be used in any recipe that calls for beef.

Eating Fruits and Vegetables

"I know I should eat more fruits and vegetables. But how?"
"How can I get my kids to eat more vegetables?"

"Are oranges the only foods with vitamin C?"

Any of these questions sound familiar? Fruits and vegetables are key parts of your daily diet. Everyone needs 5 to 9 daily servings of fruits and vegetables for the nutrients they contain and for general health.

Nutrition and health may be reasons you eat certain fruits and vegetables, but there are many other reasons why you choose the ones you do. Perhaps it is because of taste, or physical characteristics such as crunchiness, juiciness, or bright colors.

You may eat some fruits and vegetables because of fond memories - like watermelon or corn at cookouts, your mom's green bean casserole, or tomatoes your dad brought in from the backyard garden. Or you may simply like them because most are quick to prepare and easy to eat.

Whatever the reasons you select certain fruits and vegetables, the important thing is that you eat them and encourage children to do the same. With such a large selection of fruits and vegetables to choose from-with colors across the rainbow-you can find a variety to eat. Look at page 4 and check off some of your favorites.

Nutrition Tidbit

Fruits and vegetables give you many of the nutrients that you need: vitamins, minerals, dietary fiber, water, and healthful phytochemicals. Some are sources of let vitamin A, while others are rich in vitamin C, folate, or potassium. Almost all fruits and vegetables are naturally low in fat and calories and none have cholesterol. All of these healthful characteristics may protect you from getting chronic diseases, such as heart disease, stroke, and some types of cancer.

Fruits taste great and they're bright and colorful, easy to find, and easy to prepare and eat. There are so many to choose from. Fruits are available in many different forms - fresh, frozen, canned, dried, and as juice. All are good ways to get the recommended 2 to 4 servings of fruits a day. (Check page 4 to see how many you need.) Here are some ways you can eat more fruits throughout the day.
•At breakfast, top your cereal with bananas or peaches; add blueberries to pancakes; drink 100% orange or grapefruit juice.
•At lunch, pack a tangerine, banana, or grapes to eat, or choose fruits from a salad bar. Don't forget inidividual containers of fruits - they are easy and convenient. Kids think they're fun!
•At dinner, add crushed pineapple to coleslaw; include mandarin oranges in a tossed salad; have a fruit salad for dessert.
•For snacks, spread peanut butter on apple slices, have a frozen juice bar (100% juice), top frozen yogurt with berries or slices of kiwi fruit, or snack on some dried fruit.
Nutrition Tidbit
What vitamin do you associate with oranges and other citrus fruits? Vitamin C is correct! Citrus fruits are rich in this vitamin, but did you know that strawberries, mangoes, red peppers, and tomatoes are also sources of vitamin C? Vitamin C helps heal cuts and wounds and also keeps your gums healthy.

For some of us, summertime just wouldn't be the same without fresh produce. Maybe you garden or take trips to a local farmers market. Even your grocery store may have more fruits and vegetables in the summer. With vegetables, you and your family are getting delicious food and, nutritionally, you are getting many of the nutrients needed for good health vitamins, minerals, and dietary fiber.
Like fruits, vegetables are available not only fresh, but frozen, canned, dried, and as juice. You can eat them raw, steamed, boiled, stir-fried, grilled, microwaved, or baked. Aim for 3 to 5 servings of vegetables a day. (Check page 4 to see how many you need.) Here are some ways you can jazz up vegetables to make them even more flavorful... to help you eat the servings you need.

Spice it!
Top corn or black beans with salsa or a dash of hot sauce.
Add garlic to mashed potatoes.
Add a dash of nutmeg to spinach dishes.
Slice it!
Add cooked, chopped onions to cooked peas.
Add sliced or diced vegetables to meatloaf, stews, or scrambled eggs.
Make a grated carrot salad.
Mix it!
Cook zucchini and stewed tomatoes together.
Mix green beans, Italian dressing, and almonds together.
Stirfry broccoli with chicken or beef.
Zap it!
Microwave broccoli and sprinkle on Parmesan cheese.
Microwave a sweet potato with ground cloves or cinnamon on top.
Heat frozen mixed vegetables for a last-minute side dish.

Check off the fruits and vegetables that you enjoy eating.
Do you eat a variety, including some from each category?

Bok choi
Collard greens
Mustard greens
Turnip greens
Citrus and berries
Kiwi fruit
Acorn squash
Butternut squash
Sweet potatoes
Dry beans and peas
Adzuki beans
Baked beans
Black beans (turtle beans)
Black-eyed peas
Chickpeas (garbanzo beans)
Cranberry beans
Dark- and light-red kidney beans (Mexican beans)
Great Northern beans (white beans)
Green and red lentils
Soybeans (edamame)
Kidney beans
Lima beans
Navy beans (pea beans)
Pink beans
Pinto beans
Small red beans (Mexican red beans)
Split peas
Tofu (soybean curd)
Yellow-eyed beans
More Choices
Bean sprouts
Green beans
Green peas
What others do you eat?

Fruits and vegetables differ in the nutrients they contain. To promote health, include some from each category regularly.

Are you getting 5 to 9 servings a day?
Children ages 2 to 6, women, some older adults who need about 1,600 calories each day should have 2 servings of fruit and 3 servings of vegetables each day.

Older children, teen girls, active women, most men who need about 2,200 calories each day should have 3 servings of fruit and 4 servings of vegetables each day.

Teen boys and active men who need about 2,800 calories each day should have 4 servings of fruit and 5 servings of vegetables each day.

What counts as a serving?
1/2 cup fruit
1 medium piece of fruit
1/2 grapefruit
1/4 small cantaloupe
1/4 cup dried fruit
1/2 cup berries
a dozen grapes
3/4 cup fruit juice (100% juice)
1/2 cup chopped vegetables
1 cup raw leafy vegetables (a small salad)
6-8 carrot sticks (3" long)
1 medium potato
1/2 cup cooked or canned dry beans or peas
3/4 cup vegetable juice

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The topic of dietary recommendations in the setting of high blood pressure is an interesting one. On one hand, it is exceedingly complex and has been the continued focus of research for the better part of three decades. On the other hand, the vast majority of dietary recommendations for high blood pressure are exceedingly similar to healthy diet recommendations in general.

1. Alcohol
People with high blood pressure should not drink alcohol. While studies have demonstrated that low levels of alcohol intake can have protective effects for the heart, and can possibly reduce the risk of developing high blood pressure 1, research has also clearly demonstrated that consuming alcohol in the setting of exisiting high blood pressure is unhealthy 2.

Alcohol directly raises blood pressure, and further acts to damage the walls of blood vessels, which can elevate the blood pressure further and make it more difficult to treat, while simultaneously increasing the risk of complications.

2. Salt
In some people, eating too much salt can make high blood pressure much worse. In others, the same salt consumption may have no effect. The problem is that no doctor or scientist can tell which is the case for an individual patient until it is too late.

This, combined with the fact that too much salt is bad for the heart regardless of blood pressure status, means that reduced sodium is a strongly recommended part of a healthy diet. These recommendations are especially important in the setting of secondary high blood pressure due to kidney problems.

.3. Fats
Saturated fats, especially trans-fats, are bad for both the heart and blood vessels. Because the circulatory system is already under a lot of stress in the setting of high blood pressure, extra strain can be devastating.

The balanced high blood pressure diet should include sparse amounts of saturated and trans-fats (red meat, fast food), and moderate amounts of other fats (olives, canola oil).

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What is Low Blood Pressure?

First off, "low blood pressure" is not strictly defined. While high blood pressure has clear numerical definitions, low blood pressure is not defined by a universally accepted value. In the past, some attempts were made to standardize the meaning of "low blood pressure," but no official set of guidelines is currently supported by any medical authority.
Generally speaking, doctors sometimes refer to a blood pressure of 90/60 as a rough rule of thumb when evaluating patients because experience seems to show that this is the point at which symptoms tend to develop.

In general, if you have no history of medical problems and are not experiencing any symptoms, a low blood pressure reading is not cause for concern. If you discover on your own that your blood pressure is below 120/80, you should mention it to your doctor during your next visit but probably don’t need to schedule a special appointment unless you know that the low reading represents a significant change from your average blood pressure.

Is Low Blood Pressure Dangerous?

With very few exceptions, chronic blood pressure below 120/80 is not dangerous. Low blood pressure is usually considered dangerous only when it causes symptoms or results from sudden blood pressure decreases. In cases where the blood pressure drops suddenly, it isn’t actually the low blood pressure itself that causes the danger, but rather the sudden change from a higher value to a lower value. Sudden changes in blood pressure can cause interruptions in the blood supply to the heart, kidneys and brain, and will almost always be accompanied by distinctive symptoms. An example of this situation is orthostatic hypotension, where changes in body position (usually a change from sitting to standing) are accompanied by a rapid drop in blood pressure. Usually, sudden episodes of low blood pressure are a sign that something else might be wrong, and are typically an indication for a full medical workup.

There is some recent research that suggests chronic low blood pressure may be of unique importance in people who have underlying kidney disease. For these people, chronic low blood pressure appears to trigger a complicated cascade of events that can lead to blood vessel damage and may lead to a stroke. Because this data is relatively new, no clear blood pressure guidelines for these patients have yet been developed.

What are the Symptoms of Low Blood Pressure?

Unlike high blood pressure symptoms, which are poorly defined and often totally absent, low blood pressure has several classic, easily recognized symptoms. The development of symptoms is considered an indicator that a patient should be evaluated to discover the cause of the low blood pressure and to rule out any underlying problems. Generally, blood pressure must fall to a fairly low value before symptoms develop.

Clincally, the value most often associated with the development of symptoms is 90/60, though this varies from person to person. Situations where the blood pressure drops rapidly, rather than exists chronically at a low level, do not require the blood pressure to drop to 90/60 before symptoms develop. Instead, changes of about 20mmHg from baseline blood pressure have been shown to cause classic low blood pressure symptoms.

Classic symptoms of low blood pressure include:

•Dizziness, or feeling like you’re standing on a rocking boat
•Changes in mental status (difficulty concentrating, confusion) or a sense of "impending doom" or anxiety
•Changes in breathing patterns (fast, shallow breathing is common during an episode of low blood pressure)
•Suddenly feeling cold or clammy, or a rapid onset of pale skin
While all of these symptoms indicate that a visit to the doctor is needed, fainting or ongoing dizziness are especially alarming and warrant an immediate visit to either your own doctor or to the emergency room. If you experience fainting along with nausea, chest pain, or any type of weakness/numbness in your body, you should consult a doctor immediately. These symptoms may be indicators of stroke, heart attack, or dangerous problems with the nervous system.

What Causes Low Blood Pressure?

Many things can make your blood pressure too low. These range in severity from normal changes caused by pregnancy to dangerous underlying conditions, like heart problems or hormone disturbances. Some low blood pressure causes are simple cases of dehydration brought on by vomiting, intense exercise, or the overuse of diuretics. Some studies have shown that a dehydration-induced weight loss of 1 percent is enough to trigger dizziness, confusion, or other symptoms of low blood pressure.

One especially important cause of low blood pressure is orthostatic hypotension, which is sometimes referred to as postural hypotension. This happens when blood pressure drops rapidly during changes to body position--usually when changing from sitting to standing--inducing classic signs that the blood pressure is too low, like dizziness, blurry vision, and fainting.

Other important causes of low blood pressure include:

•Heart problems that cause low heart rate, diminished heart strength, or a decrease in the amount of blood supplied to the body
•Normal changes associated with the first and second trimesters of pregnancy
•Side effects from certain medications, especially diuretics or other high blood pressure medications, like beta blockers. Medicines used to treat erectile dysfunction and certain psychiatric disorders can also cause low blood pressure.
•Hormone problems such as adrenal insufficiency or thyroid disease (overactive or underactive thyroid)
•Problems with the nervous system--especially disorders of the autonomic nervous system, including POTS and vasovagal syncope--can cause low blood pressure after extended periods of standing.
•Deficiencies of essential nutrients, such as folic acid, can cause the number of red blood cells to decrease (anemia)
•Alterations in blood sugar, like those caused by diabetes
•Age: Some older patients, especially those with existing high blood pressure, can experience postprandial hypotension, where the blood pressure drops suddenly after eating a large meal
While most cases of low blood pressure are not considered medical problems, cases where the low blood pressure is accompanied by symptoms should always be evaluated by a physician. A complete medical workup will often be needed in order to rule out the possibility of an underlying disorder.

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Blood pressure is the force in the arteries when the heart beats (systolic pressure) and when the heart is at rest (diastolic pressure). It's measured in millimeters of mercury (mm Hg). High blood pressure (or hypertension) is defined in an adult as a blood pressure greater than or equal to 140 mm Hg systolic pressure or greater than or equal to 90 mm Hg diastolic pressure.
High blood pressure directly increases the risk of coronary heart disease (which leads to heart attack) and stroke, especially when it's present with other risk factors.

High blood pressure can occur in children or adults, but it's more common among people over age 35. It's particularly prevalent in African Americans, middle-aged and elderly people, obese people, heavy drinkers and women taking birth control pills. It may run in families, but many people with a strong family history of high blood pressure never have it. People with diabetes mellitus, gout or kidney disease are more likely to have high blood pressure, too.

American Heart Association recommended blood pressure levels

Blood Pressure Category Systolic Diastolic
(mm Hg) (mm Hg)

Normal less than 120 and less than 80
Prehypertension 120–139 or 80–89


Stage 1 140–159 or 90–99
Stage 2 160 or higher or 100 or higher

*Your doctor should evaluate unusually low readings.

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Blood pressure is the force of blood against the walls of arteries. Blood pressure is recorded as two numbers—the systolic pressure (as the heart beats) over the diastolic pressure (as the heart relaxes between beats). The measurement is written one above or before the other, with the systolic number on top and the diastolic number on the bottom. For example, a blood pressure measurement of 120/80 mmHg (millimeters of mercury) is expressed verbally as "120 over 80."

Normal blood pressure is less than 120 mmHg systolic and less than 80 mmHg diastolic.

Blood is carried from the heart to all parts of your body in vessels called arteries. Blood pressure is the force of the blood pushing against the walls of the arteries. Each time the heart beats (about 60-70 times a minute at rest), it pumps out blood into the arteries. Your blood pressure is at its highest when the heart beats, pumping the blood. This is called systolic pressure. When the heart is at rest, between beats, your blood pressure falls. This is the diastolic pressure.

Blood pressure is always given as these two numbers, the systolic and diastolic pressures. Both are important. Usually they are written one above or before the other, such as 120/80 mmHg. The top number is the systolic and the bottom the diastolic. When the two measurements are written down, the systolic pressure is the first or top number, and the diastolic pressure is the second or bottom number (for example, 120/80). If your blood pressure is 120/80, you say that it is "120 over 80."

Blood pressure changes during the day. It is lowest as you sleep and rises when you get up. It also can rise when you are excited, nervous, or active.

Still, for most of your waking hours, your blood pressure stays pretty much the same when you are sitting or standing still. That level should be lower than 120/80. When the level stays high, 140/90 or higher, you have high blood pressure. With high blood pressure, the heart works harder, your arteries take a beating, and your chances of a stroke, heart attack, and kidney problems are greater.

What causes it?

In many people with high blood pressure, a single specific cause is not known. This is called essential or primary high blood pressure. Research is continuing to find causes.

In some people, high blood pressure is the result of another medical problem or medication. When the cause is known, this is called secondary high blood pressure.

This section � National Heart, Lung, and Blood Institute

What is high blood pressure?
A blood pressure of 140/90 or higher is considered high blood pressure. Both numbers are important. If one or both numbers are usually high, you have high blood pressure. If you are being treated for high blood pressure, you still have high blood pressure even if you have repeated readings in the normal range.

There are two levels of high blood pressure: Stage 1 and Stage 2 (see the chart below).

Categories for Blood Pressure Levels in Adults*
(In mmHg, millimeters of mercury) Category Systolic
(Top number) Diastolic
(Bottom number)
Normal Less than 120 Less than 80
Prehypertension 120-139 80-89

High Blood Pressure Systolic Diastolic
Stage 1 140-159 90-99
Stage 2 160 or higher 100 or higher

* For adults 18 and older who:

Are not on medicine for high blood pressure
Are not having a short-term serious illness
Do not have other conditions such as diabetes and kidney disease

Note: When systolic and diastolic blood pressures fall into different categories, the higher category should be used to classify blood pressure level. For example, 160/80 would be stage 2 high blood pressure.
There is an exception to the above definition of high blood pressure. A blood pressure of 130/80 or higher is considered high blood pressure in persons with diabetes and chronic kidney disease.

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A home blood pressure test allows you to keep track of your blood pressure at home. Blood pressure is a measure of the force of blood inside an artery. A blood pressure measurement is taken by temporarily stopping the flow of blood in an artery (usually by inflating a cuff around the upper arm) and then listening for the sound of the blood beginning to flow through the artery again as air is released from the cuff.

As blood flows through the artery, it can be heard through a stethoscope placed on the skin over the artery. Blood pressure is recorded as two measurements.

The reading on the gauge when blood flow is first heard is called the systolic pressure. Systolic pressure represents the peak blood pressure that occurs when the heart contracts.
The reading on the gauge when blood flow can no longer be heard is the diastolic pressure. Diastolic pressure represents the lowest blood pressure that occurs when the heart relaxes between beats.
These two pressures are expressed in millimeters of mercury (mm Hg) because the original devices that measured blood pressure used a column of mercury. Blood pressure measurements are recorded as systolic/diastolic (say "systolic over diastolic"). For example, if your systolic pressure is 120 mm Hg and your diastolic pressure is 80 mm Hg, your blood pressure is recorded as 120/80 (say "120 over 80").

Types of blood pressure monitors
The two general types of blood pressure monitors commonly available are manual and automatic.

Manual blood pressure monitors
Manual models are similar to those that your doctor might use to take your blood pressure. Called a sphygmomanometer, these devices usually include an arm cuff, a squeeze bulb to inflate the cuff, a stethoscope or microphone, and a gauge to measure the blood pressure.

Blood pressure is displayed on a circular dial with a needle. As the pressure in the cuff rises, the needle moves clockwise on the dial. As the cuff pressure falls, the needle moves counterclockwise.

Automatic (also called electronic or digital) blood pressure monitors
Electronic battery-operated monitors use a microphone to detect blood pulsing in the artery. You do not need to listen with a stethoscope. The cuff, which is attached to your wrist or upper arm, is connected to an electronic monitor that automatically inflates and deflates the cuff when you press the start button.

The type of blood pressure monitor typically found in supermarkets, pharmacies, and shopping malls is an electronic device.

Ambulatory blood pressure monitoring (ABPM)
Ambulatory blood pressure monitoring (ABPM) is another method that may be ordered by your doctor if other methods do not give consistent results. It is often used if there is a big difference between the blood pressure readings you get at home and your readings in your doctor's office. You will wear a cuff on one arm and a monitor around your waist. Your doctor's office will fit you with the device and tell you how to use it.

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