Maintaining a healthy blood pressure is vital for good health. Keeping yours below 120/80 is the ideal goal for dodging a host of afflictions, including heart disease, kidney failure, and erectile dysfunction.
But about half of all Americans with high blood pressure (hypertension) have not reached their goals, reports the July 2012 issue of the Harvard Men’s Health Watch. Many people are still “out of control” after taking basic lifestyle steps like eating a heart-healthy diet.
When lifestyle changes fail to fix the problem, doctors tend to reach for the prescription pad and add medication, says Dr. William Kormos, editor-in-chief of Harvard Men’s Health Watch and a primary care physician at Massachusetts General Hospital.
“There are many men who are always resistant to adding on another pill,” Dr. Kormos says, “but if people aren’t doing the other things, then it’s best to use medications.”
Many people would rather not take a pill, or add another. For them, there are other ways to step up a blood pressure control campaign.
Reduce sodium intake. The medically proven DASH diet keeps sodium to 2,300 milligrams per day (about one teaspoon of salt). Cutting it to 1,500—not easy, but doable—works even better. The DASH diet can lower your systolic pressure (upper number) by 10 points or more.
Monitor your pressure at home. Checking blood pressure at home with an appropriate device can give you instant feedback on the benefits of diet and exercise and give you and your doctor a more accurate picture of your blood pressure. This is valuable, because some people experience “white coat hypertension,” in which blood pressure spikes higher than normal when measured at the doctor’s office.
Limit your alcohol intake. Drinking too much alcohol can raise blood pressure. For men, the suggested limit is one to two alcoholic drinks per day, defined as 1.5 ounces (1 shot glass) of 80-proof spirits, a 5-ounce serving of wine, or a 12-ounce serving of beer. (For women it’s no more than one drink a day.)
Take more meds if you need to—but take the right ones. Many people who are already taking one or two hypertension medications ultimately come into “control” (blood pressure below 140/90) only when taking three or even four medications. But they need to be the right drugs. Your doctor should combine medications that work to lower blood pressure in different ways. “Your doctor should pick medications in different classes that complement each other and won’t just be redundant,” Dr. Kormos says.

Hypertension: Controlling the "silent killer"
An alarming one in three American adults has high blood pressure. Known medically as hypertension, many people don't even know they have it, because high blood pressure has no symptoms or warning signs. But when elevated blood pressure is accompanied by abnormal cholesterol and blood sugar levels, the damage to your arteries, kidneys, and heart accelerates exponentially. Fortunately, high blood pressure is easy to detect and treat. Sometimes people can keep blood pressure in a healthy range... Learn more »



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