Alicia Jacobs, MD is the medical director of Colchester Family Practice, which is a certified medical home, working in collaboration with Milton, South Burlington and Hinesburg Family Practices. Dr. Jacobs is also an associate professor of Family Medicine at the Larner College of Medicine at UVM.

High blood pressure, or hypertension is known as the “silent killer” because most people never have any symptoms.  If left untreated for several years, high blood pressure can lead to heart attacks, strokes, heart failure, and kidney failure – all of which may significantly impact quality of life or even be fatal.

What is my goal blood pressure?

Generally, goal blood pressure is less than 140/90 (130/80 if you are diabetic or have heart disease).  In order to be diagnosed with hypertension, you must have three separate blood pressure readings above that level.  The ideal time to check blood pressure is after 5 minutes of sitting or relaxing.

Are there dietary suggestions?  For example, how much salt can I have?

Once diagnosed with high blood pressure, you should be treated to avoid complications, but treatment does not always mean taking medicine.  You can make dietary changes to decrease salt intake or sodium in your diet.  The goal is less than 2 grams (2000 mg) a day.  This means more than avoiding the salt shaker – you should also avoid several foods that include high amounts of sodium, such as fast food, junk food, prepared foods or pre-made meals, and canned soups and vegetables.  Eating more foods high in potassium can help.  These foods include bananas, potatoes, papaya, kale and orange juice.  The DASH diet (Diet Approaches to Stop Hypertension) following these recommendations can help improve readings.

What else can help lower my blood pressure beside medications?

If you’d like to lower your blood pressure, there are several other changes that can help including avoiding cigarettes, chewing tobacco, caffeine (coffee and soda), alcohol, excess weight, and anti-inflammatory medicines such as ibuprofen (Motrin and Advil) and naprosyn (Aleve).  If you begin an exercise program, you should see your blood pressure decrease even more.  Twenty minutes of brisk walking, three times a week is a good start.  You can also wear a pedometer and try to walk 10,000 steps each day.  Relaxation techniques such as yoga or Tai Chi can be quite beneficial.  If you successfully put all those behavioral changes together, you can significantly improve your blood pressure and may be able to avoid having to take medication.  Now many doctor’s offices are medical homes and have extra help such as health coaches to help guide in these behavioral changes.

Do I really need to take medication?

If all these measures are not working after about six months to a year, it is probably time for you to start thinking about medication.  With moderate to severe high blood pressure, medications may be recommended right away.  Check your blood pressure at home, at the pharmacy, or at the grocery store.  If it’s too high, you may have hypertension, which means you should make an appointment to discuss a treatment plan with your doctor.

Alicia Jacobs, MD, family medicine physician, is Vice Chair of Clinical Operations in Family Medicine at The University of Vermont Medical Center. She is also practices at Family Medicine Colchester.

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