Understanding Your Hypertension Blood Test Results
If your blood test shows hypertension, it means your blood pressure is persistently elevated at ≥130/80 mmHg, which increases your risk of heart attack, stroke, heart failure, and kidney disease—but this can be effectively controlled with lifestyle changes and medications to prevent these complications. 1, 2
What the Numbers Mean
Your blood pressure reading has two numbers:
- Top number (systolic): Pressure when your heart beats
- Bottom number (diastolic): Pressure when your heart rests between beats
Blood pressure categories: 1
- Normal: Less than 120/80 mmHg
- Elevated: 120-129 systolic AND less than 80 diastolic
- Stage 1 Hypertension: 130-139 systolic OR 80-89 diastolic
- Stage 2 Hypertension: ≥140 systolic OR ≥90 diastolic
Why This Matters
Hypertension damages your blood vessels over time, forcing your heart to work harder and increasing risk of: 2, 3
- Heart attacks and heart failure (20-30% increased risk)
- Strokes
- Kidney disease
- Vision problems
The good news: Lowering your blood pressure by just 10 mmHg reduces your risk of cardiovascular events by 20-30%. 2
Treatment Approach
Step 1: Lifestyle Changes (Everyone Needs This)
These changes are partially additive—meaning each one adds to the blood pressure-lowering effect: 2, 1
- Weight loss: If overweight, losing even 5-10 pounds helps 1, 2
- Reduce salt intake: Aim for less than 2,300 mg sodium daily (about 1 teaspoon of salt) 2
- Increase potassium: Eat more fruits, vegetables, and low-fat dairy 2
- Exercise: At least 150 minutes of moderate activity weekly (brisk walking counts) 2, 3
- Limit alcohol: Maximum 2 drinks/day for men, 1 drink/day for women 2
- Stop smoking: Critical for reducing overall cardiovascular risk 1
Step 2: Medications (If Needed)
Your doctor will start medication if: 1, 2
- Your blood pressure is ≥140/90 mmHg, OR
- Your blood pressure is ≥130/80 mmHg AND you have diabetes, kidney disease, or high cardiovascular risk
First-line medications (your doctor will choose one or combine them): 2, 1
- Thiazide diuretics (water pills like hydrochlorothiazide or chlorthalidone): Help your kidneys remove excess salt and water
- ACE inhibitors (like enalapril) or ARBs (like candesartan): Relax blood vessels by blocking hormones that tighten them
- Calcium channel blockers (like amlodipine): Relax blood vessel walls
Most people need 2-3 medications to reach their blood pressure goal. 1, 2
Step 3: Target Blood Pressure Goals
Your doctor will aim for: 1
- Less than 130/80 mmHg if you're under 65 years old
- Less than 130 mmHg systolic if you're 65 or older
- Less than 130/80 mmHg if you have diabetes or kidney disease
Follow-Up Schedule
After starting treatment: 1
- Monthly visits until blood pressure reaches goal
- Check kidney function and potassium levels 1-2 times yearly
- Once stable at goal, visits every 3-6 months
Warning Signs Requiring Immediate Care
Go to the emergency room if you have blood pressure ≥180/120 mmHg WITH: 1, 4
- Severe headache
- Chest pain
- Shortness of breath
- Vision changes
- Confusion or difficulty speaking
- Seizures
This is a hypertensive emergency requiring immediate IV medications in the hospital. 1, 4
Common Pitfalls to Avoid
- Don't stop medications suddenly: Even if you feel fine, hypertension has no symptoms but still causes damage 3
- Don't use immediate-release nifedipine for emergencies: Can cause dangerous blood pressure drops 4
- Don't expect instant results: Medications take weeks to show full effect 1
- Don't skip home monitoring: Check blood pressure at home to ensure control between visits 1
Why Many People Fail Treatment
Only 44% of Americans with hypertension have their blood pressure controlled, mainly due to: 2
- Not taking medications as prescribed
- Not making lifestyle changes
- Using inadequate medication doses
- Not addressing underlying causes (sleep apnea, kidney disease, medication side effects)
The key to success is consistent medication use, lifestyle changes, and regular follow-up with your doctor. 1, 2