High Blood Pressure Treatment and Prevention

BMI estimates body fat based on your height and weight. For hypertension risk, where you carry the body fat is important too, with the waistline being an especially critical area:

• Men should aim to keep their waist measurement under 40 inches.
• Women should aim for a waist measurement of under 35 inches. 

There are slightly lower recommendations for Asian men (35.5) inches and Asian women (31.5 inches) because of a higher risk of cardiovascular disease and other health concerns at lower levels of abdominal fat. 

Read more on how much you should weigh, how to lose weight naturally, what waist circumference says about your health and how to maintain a healthy weight long term.

2. Lower sodium intake

Sodium causes your body to hold on to water, which makes your blood vessels expand and creates more pressure. Additionally, too much sodium makes your heart pump harder, causing your blood pressure to rise.

Research finds that most older adults who cut about a teaspoon of salt from their daily diet over the course of one week lowered their systolic blood pressure by about 6 mm Hg. Impressively, the effect was found even for people already taking blood pressure lowering drugs.

Read more about how lowering your salt can improve blood pressure.

3. Embrace healthier snacking

While it’s best to concentrate on an overall healthy diet to get control of your blood pressure, foods such as fruits, vegetables and low-fat dairy that are rich in micronutrients can work together to help regulate blood pressure. Even potatoes have been shown to reduce blood pressure if prepared in a healthy way. 

You can get your blood pressure down by about 1 point for each additional fruit and vegetable you eat a day, Egan says. “So you could expect a 5 to 6 mm Hg reduction if you [ate] five or so fruits and vegetables a day. When combined with exercise, you could see up to a 15 mm Hg reduction.” Healthy treats can also help replace salty snacks and other unhealthy foods for blood pressure.

Read more on the best and worst foods for high blood pressure.

4. Explore the DASH diet for lower blood pressure 

Research has shown the DASH diet is effective in lowering blood pressure, as well as for weight loss and lowering the risk of cognitive decline. It involves eating specific foods such as fruits and vegetables, low-fat and no-fat dairy, whole grains, fish, poultry, beans and nuts. A key component is reducing sodium.

Read more about the DASH diet.

5. Increasing physical activity to lower blood pressure

A recent study showed that static isometric exercises like wall sits, also known as wall squats, and planks are the best exercises for lowering blood pressure. These exercises engage muscles without movement and involve holding your body in one position until your muscles tire.

Read more about the top exercise for lowering blood pressure.

If this type of exercise is too strenuous because of arthritis or other pain issues, even just six minutes of lower-intensity physical activity can significantly lower blood pressure, Egan says. 

Discover more exercise ideas.

6. Breathing exercises to reduce stress and lower blood pressure

Deep breathing exercises can help lower stress and alter our physiology, reducing blood pressure. Experts say that by learning to control our own breath, we can harness a natural remedy to improve hypertension. However, not all breathing exercises are right for everyone. It’s important to find the best breathing technique for you.

Use AARP’s visual guide to learn how to perform top breathing techniques to lower blood pressure.

Other natural blood pressure remedies, from increasing your daily steps to taking up tai chi, stretching routines and mindfulness, are also helpful in reducing stress and blood pressure. Learn more about controlling blood pressure with natural remedies.

7. Try tart cherry juice for high blood pressure

Tart cherry juice is growing in popularity for older adults who are concerned about their blood pressure. While the evidence for consistent blood pressure reduction remains mixed, it could be a healthy addition to your diet that helps lower inflammation in your body.

Take a closer look at the science behind tart cherry juice.

8. Reduce alcohol intake

Studies show that heavy drinking is associated with high blood pressure, and more recent research has found that for some people even light to moderate drinking can contribute to high blood pressure. 

Read more about how alcohol can harm your blood pressure.

9. Quit smoking

Smoking isn’t a primary risk factor for high blood pressure, but the habit can damage blood vessels. Additionally, the addictive chemical compound nicotine can increase blood pressure.

Read more about smoking and high blood pressure.

10. Get enough sleep

Many Americans suffer from chronic sleep problems, which contribute to numerous adverse health conditions, including high blood pressure. Sleep apnea is particularly hard on our vascular system and blood pressure.

Here are 58 steps to fine-tune your sleep routine and reduce your risk of hypertension.

Medications for high blood pressure

While lifestyle changes can be beneficial for hypertension control and your overall health, they may not be enough to get your blood pressure down to the ideal target level, especially if you are over 65 or already have stage 2 hypertension or above. That is defined as a confirmed systolic pressure of 140 mm Hg or higher or a diastolic pressure of 90 mm Hg or higher. 

“There are good lifestyle interventions to lower blood pressure. It is hard to change lifestyle, though, and it's been known for a long time that medications trump lifestyle,” Green says. “When you have people on a very, very good program, medications will reduce deaths by more than a very good lifestyle program.” 

The AHA recommends eight steps for a heart-healthy lifestyle: be more active, eat healthy, manage weight, quit nicotine, get healthy sleep, control cholesterol, keep blood sugar in check and manage blood pressure. Following these steps can help prevent hypertension and keep it under control, Green says. 

However, sometimes lifestyle isn’t the primary cause of high blood pressure. Genetics can play a big role. Green herself discovered she had high blood pressure after doing 24-hour ambulatory blood pressure monitoring. This involves a device that is prescribed and given to a patient. It measures blood pressure at regular intervals for a 24-hour (or longer) period at home.

“I don’t eat any meat, and I’m a normal weight. I run, and I love fruits and vegetables, so I consider myself not to have an unhealthy lifestyle. I still had hypertension,” Green says. Knowing that high blood pressure is one of the top causes of death and heart failure, she chose to go on blood pressure medication, which has helped to get her numbers under control.

Primary medications that your doctor may prescribe for hypertension include:

• Angiotensin-converting enzyme inhibitors (ACEI) — These medications inhibit your body from making the hormone angiotensin II so that your blood vessels can relax and dilate, thereby reducing blood pressure.
• Angiotensin II receptor blockers (ARBs) — These also keep the angiotensin II hormone from narrowing blood vessels.
• Calcium channel blockers (CCBs) — These prevent calcium from entering muscle cells in the walls of your arteries, which helps them to relax and dilate.
• Diuretics — Often called water pills, they help your kidneys flush out water and salt from your body.

These drugs can be used in combination with one another, and your doctor may adjust the type and dosage you take, particularly if you experience side effects.

Common side effects of high blood pressure medications

Side effects can sometimes cause patients to stop taking their medication, putting their hypertension at risk of becoming much worse.

Common complaints include feeling lightheaded or fatigued when taking blood pressure medications. In addition, each type of medication has its own set of side effects, which is why it’s important to discuss any potential ones with your doctor.

Sometimes two low doses of different medications are much more powerful than a single medication, and the lower dosages can diminish side effects, Green says.

Discover the different options for hypertension treatment, including secondary agents such as beta blockers, and how you can deal with the side effects of blood pressure medications.

The best time to take blood pressure medication

When you take your medication can be important both for your blood pressure and for dealing with potential side effects of the medication. Understanding more about medication timing can help you have an informed discussion with your doctor on what time of day works best for your treatment plan.

Read more on blood pressure medication timing.

Treating resistant hypertension

Resistant hypertension occurs when blood pressure stays over 140/90 mm Hg, even when the patient is taking three or more prescription hypertension medications or if blood pressure is at goal but requires four or more medications to control it.

Your medical provider may want to explore a more effective treatment plan in this scenario, including changing the combinations of your medications and asking you to do regular home blood pressure monitoring to determine if your hypertension is consistent outside of the doctor’s office.

In 2023, the Food and Drug Administration approved catheter-based renal denervation to treat resistant hypertension. This involves using radio frequency or ultrasound energy to destroy specific nerves in the kidney that could play a role in the condition.

Guidelines from leading medical groups now include this procedure as an option after medication treatments have been thoroughly explored, although the procedure is not advised for all patients. While many studies have provided evidence supporting renal denervation, further research is needed and is underway to determine safety and efficacy.