Managing high blood pressure: seven tips to lower your blood pressure

Around a quarter of adults in the UK have high blood pressure, which is also known as hypertension.

Your blood pressure refers to the pressure created by your blood as it passes through your arteries, that is, the blood vessels that carry oxygen-rich blood throughout your body. Your heart has to pump against this pressure.

This means that if your blood pressure is persistently too high, then your heart has to work harder to pump oxygen-rich blood throughout your body. Over time, this increases your risk of heart attack and heart failure, as well as other health conditions. 

Here, we will explore how blood pressure is measured, why high blood pressure is dangerous and how you can lower your blood pressure. 

How to measure blood pressure

Your blood pressure is measured using a blood pressure cuff that is placed around your upper arm and is attached to a small machine. It is inflated until blood stops flowing through the main artery running through your arm (brachial artery). Then, the cuff is deflated until your blood starts flowing again through this artery. This produces two blood pressure readings measured in mmHg: your systolic blood pressure and your diastolic blood pressure. 

Your systolic blood pressure is the higher number and refers to your blood pressure when your heart is beating ie pumping blood. Your diastolic blood pressure is the lower number and refers to your blood pressure when your heart is resting in between heartbeats. 

What is a healthy blood pressure?

Your blood pressure is measured as your systolic blood pressure over your diastolic blood pressure. A healthy blood pressure is broadly that which is below 130/80 mmHg ie a systolic blood pressure of 130 mmHg or less and a diastolic blood pressure of 80 mmHg or less. However, it is possible to have blood pressure that is too low (hypotension), that is, below 90/60 mmHg.

If your systolic blood pressure is between 130–139 mmHg, then you have prehypertension ie your blood pressure is higher than normal and should be closely monitored. If your systolic blood pressure is 140 mmHg or higher, you have high blood pressure. 

Getting a diagnosis of high blood pressure

Individuals often first realise that they have high blood pressure when they have their blood pressure measured by their GP. This is because high blood pressure does not usually produce any symptoms. 

If your blood pressure is high when measured at your GP surgery, your GP may refer you for 24-hour blood pressure monitoring. This involves wearing an ambulatory blood pressure monitor for 24 hours. Alternatively, you may be given a blood pressure machine to take home so that you can take regular measurements of your blood pressure through the day. 

In either case, these at-home readings can provide a more reliable measure of whether you have high blood pressure as blood pressure often goes up when an individual goes into a hospital or clinic to have it measured — this is likely due to the stress and/or anxiety of being in a healthcare setting. 

Causes of high blood pressure

Blood pressure naturally rises as you get older; however, lifestyle factors, such as your diet, weight and exercise levels, have a major impact on whether or not you will develop high blood pressure. 

In a small minority of cases, high blood pressure may be a sign of an underlying health condition, such as renal artery stenosis where the arteries supplying your kidneys narrow, or a hormone disorder, such as pheochromocytoma. 

However, in the vast majority of cases, high blood pressure is due to lifestyle factors.

Why is high blood pressure dangerous?

High blood pressure is a silent condition as it doesn’t usually produce any symptoms. But it nonetheless gradually increases your risk of life-threatening conditions. 

Persistent high blood pressure can cause thickening of the wall of muscle that makes up your heart, specifically the wall of your left ventricle, which is the lower left chamber of your heart’s four chambers. This increases your risk of heart attack and heart failure. 

Persistent high blood pressure also affects your blood vessels by damaging the cells that line them. This makes it easier for fatty deposits to build up along the insides of your arteries, causing them to narrow and stiffen, which reduces blood flow. Consequently, as the blood supply to parts of your body becomes impaired, different organs can be affected.

Reduced blood supply to your heart increases your risk of an irregular heartbeat (arrhythmia) called atrial fibrillation and heart attack, while reduced blood supply to your kidneys increases your risk of kidney disease.

Persistent high blood pressure also increases your risk of stroke by increasing the chances of blood clots forming, which can then travel to your brain, and by putting the blood vessels in your brain under such high pressure that they can burst.

Seven tips to lower your high blood pressure

Exercise is extremely important to help lower high blood pressure. Aim to take part in moderate to vigorous cardiovascular exercise for at least 30 minutes, five days a week. This refers to any exercise that raises your heart rate such that you can talk but not sing while exercising eg brisk walking, cycling, running or swimming. 

You should also try to incorporate resistance training two to three times a week. This refers to exercise that strengthens your muscles. It does not have to involve lifting weights; you could, for example, use resistance bands instead.  

If you’re overweight or obese, losing excess weight can help reduce your high blood pressure. You can calculate your body mass index (BMI) using an online calculator if you know your height and weight. You can then aim to reduce your BMI to between 20 and 25 and/or lose 5–10% of your current body weight. 

Losing weight can be challenging and often requires support from friends, family and healthcare professionals. To ensure your weight loss is sustainable, avoid extreme diets and instead make long-term changes to your lifestyle and give yourself time to make progress. Sustainable weight loss can often take six to 12 months. 

Remember, every kilogram of weight you lose makes a difference. On average, systolic blood pressure reduces by 1 mmHg for every one kilogram of weight lost. 

The DASH diet, that is, Dietary Approaches to Stop Hypertension, is proven to help lower high blood pressure. 

This involves following a diet rich in fresh fruit and vegetables, whole grains and lean protein, with limited amounts of sugar, saturated fats, trans fats and red meat. 

You should also reduce how much salt is in your diet, with a goal of having no more than one teaspoon (5 grams) of salt per day. Avoiding caffeine will also help reduce your blood pressure. 

Stress can raise your blood pressure and, consequently, finding ways to manage your stress can help reduce high blood pressure. This may include trying mindfulness apps, yoga and deep breathing exercises. 

Poor sleep is associated with high blood pressure. Aim to get seven to nine hours of good quality sleep each night, whether it is a weekday or weekend.

To ensure you get a good night’s sleep, try to stick to a healthy bedtime routine. This includes going to bed at the same time every night, avoiding digital screens for at least one hour before bedtime and avoiding eating heavy meals during the two to three hours leading up to bedtime. Also, make sure your room is as quiet and dark as possible. 

Smoking increases your risk of a wide range of health conditions, including heart disease and high blood pressure, and nicotine in cigarettes and vapes is directly linked to raising blood pressure.

It is, therefore, important to quit smoking. Your GP can direct you to your local stop smoking service (LSSS).

Drinking too much alcohol is known to increase blood pressure. Try to drink fewer than 14 units of alcohol and spread this out across the week. Alcoholic drinks are often also high in calories and lead to excess weight gain, which can raise your blood pressure too. 

When is medication needed for high blood pressure?

If lifestyle changes are not enough to reduce your high blood pressure and your blood pressure is persistently above 140/90 mmHg, your doctor will recommend that you consider taking medication. 

There are multiple types of medication available for treating high blood pressure, including beta blockers, ACE inhibitors, diuretics and angiotensin II receptor blockers. 

You may need to try several different medications to find the one or combination that works best for you.

In severe cases of high blood pressure where lifestyle changes and medication aren’t effective, renal denervation therapy is available privately. This is a minimally invasive procedure to destroy some of the nerves that supply the kidneys, which subsequently, reduces blood pressure.  

High blood pressure in women

After menopause, women have an increased risk of high blood pressure compared to men of the same age. This is due to hormonal changes, specifically lower oestrogen levels, which can cause arteries to become stiffer. This effect can be made worse due to weight gain after menopause, which is a common consequence of post-menopausal hormone changes. 

In women of reproductive age, pregnancy can trigger high blood pressure known as pre-eclampsia. While pre-eclampsia usually subsides after birth, it doubles the lifetime risk of developing high blood pressure and cardiovascular disease. 

Polycystic ovary syndrome (PCOS) is also linked to high blood pressure in women.

In a small number of women, taking the oral contraceptive pill can cause a slight increase in blood pressure, particularly if there is already a family history of high blood pressure.