Get Your Blood Pressure Under Control With These Expert Tips

illustration of two people, one taking the other's blood pressure


This “silent killer” impacts nearly half of Americans.

There’s a “silent killer” out there that plagues nearly half of all Americans — it’s high blood pressure, aka hypertension, and it can lead to a number of deadly disorders, from heart disease to dementia. And we can’t hide from it: As we age, we become more and more likely to develop hypertension. Women need to be on particularly high alert because it becomes more common after menopause, says Nisha Jhalani, M.D., who specializes in internal medicine and cardiovascular disease. 

“The scary thing about high blood pressure is that unless it’s monitored, it’s very easy to miss,” Dr. Jhalani says. People can live with it for years and not feel anything while the condition takes its toll, earning it its grim nickname. 

But researchers are finding more evidence that how we eat and how active we are can have a profound impact on our blood pressure, Dr. Jhalani says. We’re taking a closer look at what’s known about the causes of hypertension, why women over 65 should be paying close attention to their blood pressure, and the steps we can take to bring it back down into a healthy range.

What causes high blood pressure and what’s considered “normal” blood pressure?

For years, high blood pressure was defined as a reading of 140 over 90 millimeters of mercury or higher. (The first number is a measure of systolic blood pressure, which shows how much pressure is being exerted against the walls of arteries as your heart beats. The second number is diastolic blood pressure, which indicates how much pressure is within your arteries when your heart is resting between beats.) But in 2017, the country’s leading heart experts, the American Heart Association and the American College of Cardiology made a major change, shifting the standard for hypertension down to 130/80 — meaning millions more Americans now meet the criteria. 

High blood pressure often develops over time, through years of unhealthy eating habits or not getting enough physical activity, according to the CDC. Other conditions like diabetes or obesity can also increase your risk for hypertension. There’s also secondary hypertension, where high blood pressure can be directly linked to a medical condition or as a side effect of a medication. Kidney or thyroid disease, or preeclampsia — a complication during pregnancy — are common causes of secondary hypertension. The routine use of anti-inflammatory medicines, like ibuprofen, to treat chronic pain or oral contraceptives have also been linked to high blood pressure, she says.

Why are we more likely to develop hypertension as we get older?

One big factor is the shift in our hormones as we age. For women, estrogen has a protective effect against high blood pressure. But as levels of the hormone wane, “typically around 10 years after menopause,” the risk of hypertension in women dramatically increases, Dr. Jhalani says.

There are a number of other reasons, but another major factor is that as we get older many people tend to become less active. “Exercise can bring down blood pressure because your arteries are allowed to vasodilate, or relax, more often,” Dr. Jhalani says.

How can we lower blood pressure?

First things first: If you’re smoking, quit. Smoking causes vasoconstriction, or the narrowing of blood vessels, which elevates blood pressure. Second, limit your alcohol consumption, Dr. Jhalani says. Drinking is also known to raise blood pressure, as is a high-sodium diet. 

Eating lots of salty foods can cause water retention, which can lead to hypertension. 

To keep your blood pressure in check, Dr. Jhalani recommends consuming less than 2 grams of sodium a day. One way to accomplish that is by cutting back on processed or packaged foods, which are often very high in sodium. You can also consider following the Dietary Approaches to Stop Hypertension (DASH) diet, which recommends limiting foods high in salt, saturated fat, and added sugars. Our bodies need a certain amount of fat to function, but too much can raise the amount of cholesterol in your blood, which can build up in the arteries, raising blood pressure. 

Being physically active is another great way to lower your blood pressure. Getting just 30 minutes a day of brisk exercise will go a long way, Dr. Jhalani says. Exercise keeps your heart and blood vessels healthy and can help reduce stress — another contributor to high blood pressure. That’s why calming activities like yoga have proven to be especially beneficial, Dr. Jhalani says. And hot yoga, which is practiced in a humid studio at up to 105 degrees, maybe even better for you. One study found that 12 weeks of hot yoga lowered the average systolic blood pressure from an average of 126 to 121, and dropped their diastolic pressure from 82 to 79. 

“There’s so much that a patient can do if they’re just empowered with the information on how to do it,” says Dr. Jhalani.