High Blood Pressure

High blood pressure is known as “The Silent Killer” because it usually does not cause symptoms.  You can expect that we will check your blood pressure at every visit, and we will keep you informed if you need treatment.  Along with diabetes, high blood pressure is one of the leading causes of stroke, heart disease, and kidney failure.  We are well equipped to treat even the most difficult and resistant patients with high blood pressure.  If you have resistant high blood pressure, you may need evaluation for “Secondary High Blood Pressure.”   If you have Secondary High Blood Pressure, you may have another hidden medical condition that is causing you to have elevated blood pressures.  You may have undiagnosed Sleep Apnea, Kidney disease, or elevated Aldosterone levels.  We can test for most causes of secondary high blood pressure in our office.

Blood pressure is measured as systolic (sis-TOL-ik) and diastolic (di-ah-STOL-ik) pressures.  The top number or systolic blood pressure refers to blood pressure when the heart beats while pumping blood. The bottom number or diastolic blood pressure refers to blood pressure when the heart is at rest between beats.

The table below shows normal blood pressure numbers for adults. It also shows which numbers put you at greater risk for health problems.

Categories for Blood Pressure Levels in Adults


(top number)


(bottom number)


Less than 120


Less than 80





High blood pressure
     Stage 1




     Stage 2

160 or higher


100 or higher

Blood pressure is variable, and it changes throughout the day.  It lowers as you sleep and rises when you wake up.  Blood pressure also rises when you’re excited, nervous, or active. If your numbers stay above normal most of the time, you’re at risk for medical problems. As the numbers get higher, the risk for medical problems raises.  “Prehypertension” means that you are at risk for developing high blood pressure.

 If you’re being treated for high blood pressure and have repeat readings in the normal range, your blood pressure is under control. However, you still have the condition. You should see your doctor and follow your treatment plan to keep your blood pressure under control.

Your systolic and diastolic numbers may not be in the same blood pressure category. In this case, the more severe category is the one you’re in. For example, if your systolic number is 160 and your diastolic number is 80, you have Stage 2 high blood pressure. If your systolic number is 120 and your diastolic number is 95, you have Stage 1 high blood pressure.

Austin family practice high blood pressureHow do I get evaluated for high blood pressure?  How do I get tested for high blood pressure?

Being tested for blood pressure is easy and painless.  At each office visit, we check every patient’s blood pressure by wrapping a cuff around the patient’s upper arm (or wrist) and inflating the cuff until enough pressure builds up to squeeze the arteries in your arm.  The pressure required to limit the systolic and diastolic pressures are recording as your blood pressure.  This can be done in our office, at home, or at your local pharmacy.

How do I get treated for high blood pressure?

There are multiple different ways to treat blood pressure, including:

  • Lowering salt intake
  • DASH Diet (healthy foods)
  • Exercising
  • Blood pressure medicine

First, you should begin by limiting your sodium (salt) intake.  The Nation Heart, Lung, and Blood Institute (NHLBI) support the DASH eating plan which includes limiting saturated fat, cholesterol, and sugar.  It focuses on increasing intake of foods rich in nutrients that are expected to lower blood pressure, mainly minerals (like potassium, calcium, and magnesium), protein, and fiber.

Next, you should exercise regularly.  Although exercise can raise blood pressure temporarily, it helps to reduce blood pressure in the long run.  In fact, many marathon runners and cyclists have lower blood pressures at rest.

If these measures fail, and you have had multiple readings that show high blood pressure, then you should begin treatment with medications.  There are many different types of medications, including:

  • ACEi – Angiotensin Converting Enzyme Inhibitors (lisinopril, quinapril, ramipril)
  • ARB – Angiotensin Receptor Blockers (Olmesartan, Valsartan)
  • BB – Beta-Blockers (Metoprolol, Carvedilol)
  • CCB – Calcium Channel Blockers (Amlodipine, Verapamil)
  • Diuretics (HCTZ or Hydrochlorothiazide, Lasix, Spironolactone)

Your doctor will choose the best medication for you.  Sometimes medications cause side effects, and you will need to switch to a different medication.  Also, since each person is different, the same blood pressure medicine may not work for you as others.  It is important to get regular check-ups in order to monitor the status of your blood pressure – Is it well controlled?  Has it gotten worse?  Is it too low?

How can I check my blood pressure?

There are multiple ways to get your blood pressure checked:

  1. Doctor’s office
  2. Grocery Store
  3. Pharmacy
  4. Home Blood Pressure Cuffs

It is important to make sure that the blood pressure meter you use is accurate.  You should be sitting, relaxed, and your legs should be uncrossed when you check your blood pressure.  Also, you should make sure your blood pressure cuff is accurate by comparing it to other cuffs or your doctor’s office.   There are also wireless blood pressure cuffs that can transmit via Bluetooth to your phone.  For example, the iHealth My Vitals Wireless Blood Pressure Cuff can be worn throughout the day, so you can see what your blood pressure is doing at various times of the day.  In general, if you buy a blood pressure cuff, you should buy an arm cuff instead of a wrist cuff, and you should expect to spend more than $40 on the meter.  The cuffs that are cheaper than $40 often give inaccurate results or break easily.