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Chronic Hypertension

AMBULATORY CARE:

Hypertension

is high blood pressure. Your blood pressure is the force of your blood moving against the walls of your arteries. Hypertension causes your blood pressure to get so high that your heart has to work much harder than normal. This can damage your heart. Even if you have hypertension for years, lifestyle changes, medicines, or both can help bring your blood pressure to normal.

Call 911 for any of the following:

  • You have chest pain.
  • You have any of the following signs of a heart attack:
    • Squeezing, pressure, or pain in your chest
    • and any of the following:
      • Discomfort or pain in your back, neck, jaw, stomach, or arm
      • Shortness of breath
      • Nausea or vomiting
      • Lightheadedness or a sudden cold sweat
  • You become confused or have difficulty speaking.
  • You suddenly feel lightheaded or have trouble breathing.

Seek care immediately if:

  • You have a severe headache or vision loss.
  • You have weakness in an arm or leg.

Contact your healthcare provider if:

  • You feel faint, dizzy, confused, or drowsy.
  • You have been taking your blood pressure medicine but your pressure is higher than your provider says it should be.
  • You have questions or concerns about your condition or care.

Treatment for chronic hypertension

may include medicine to lower your blood pressure and cholesterol levels. A low cholesterol level helps prevent heart disease and makes it easier to control your blood pressure. Heart disease can make your blood pressure harder to control. You may also need to make lifestyle changes.

Manage chronic hypertension:

  • Check your blood pressure at home. Avoid smoking, caffeine, and exercise at least 30 minutes before checking your blood pressure. Sit and rest for 5 minutes before you take your blood pressure. Extend your arm and support it on a flat surface. Your arm should be at the same level as your heart. Follow the directions that came with your blood pressure monitor. Check your blood pressure 2 times, 1 minute apart, before you take your medicine in the morning. Also check your blood pressure before your evening meal. Keep a record of your readings and bring it to your follow-up visits. Ask your healthcare provider what your blood pressure should be.
    How to take a Blood Pressure
  • Manage any other health conditions you have. Health conditions such as diabetes can increase your risk for hypertension. Follow your healthcare provider's instructions and take all your medicines as directed. Talk to your healthcare provider about any new health conditions you have recently developed.
  • Ask about all medicines. Certain medicines can increase your blood pressure. Examples include oral birth control pills, decongestants, herbal supplements, and NSAIDs, such as ibuprofen. Your healthcare provider can tell you which medicines are safe for you to take. This includes prescription and over-the-counter medicines.

Lifestyle changes you can make to lower your blood pressure:

Your provider may want you to make more lifestyle changes if you are having trouble controlling your blood pressure. This may feel difficult over time, especially if you think you are making good changes but your pressure is still high. It might help to focus on one new change at a time. For example, try to add 1 more day of exercise, or exercise for an extra 10 minutes on 2 days. Small changes can make a big difference. Your healthcare provider can also refer you to specialists such as a dietitian who can help you make small changes.

  • Limit sodium (salt) as directed. Too much sodium can affect your fluid balance. Check labels to find low-sodium or no-salt-added foods. Some low-sodium foods use potassium salts for flavor. Too much potassium can also cause health problems. Your healthcare provider will tell you how much sodium and potassium are safe for you to have in a day. He or she may recommend that you limit sodium to 2,300 mg a day.

  • Follow the meal plan recommended by your healthcare provider. A dietitian or your provider can give you more information on low-sodium plans or the DASH (Dietary Approaches to Stop Hypertension) eating plan. The DASH plan is low in sodium, unhealthy fats, and total fat. It is high in potassium, calcium, and fiber.

  • Exercise to maintain a healthy weight. Exercise at least 30 minutes per day, on most days of the week. This will help decrease your blood pressure. Ask your healthcare provider about the best exercise plan for you.
    Walking for Exercise
  • Decrease stress. This may help lower your blood pressure. Learn ways to relax, such as deep breathing or listening to music.
  • Limit alcohol as directed. Alcohol can increase your blood pressure. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.
  • Do not smoke. Nicotine and other chemicals in cigarettes and cigars can increase your blood pressure and also cause lung damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.

Follow up with your healthcare provider as directed:

You will need to return to have your blood pressure checked and to have other lab tests done. Write down your questions so you remember to ask them during your visits.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Learn more about Chronic Hypertension (Ambulatory Care)

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