How to Work with Your PCP If You Have High Blood Pressure

A doctor takes a patient's blood pressure.

Nearly half of American adults have hypertension, more commonly known as high blood pressure. If not properly managed, this condition can lead to severe medical complications including heart disease, stroke, and even death.  

Luckily, there are many steps you can take to manage this common condition and lead a full, healthy life. In this guide, we’ll go over the recommended treatments for addressing your high blood pressure.  

Understanding High Blood Pressure

Blood pressure refers to the pressure of blood pushing against the walls of your arteries. When your doctor measures your blood pressure, it is recorded using two numbers, known as systolic and diastolic. Systolic is the pressure in your arteries when your heart beats, while diastolic is the pressure in your arteries when your heart rests between beats. The measurement is written out as 120/80, or spoken aloud as “120 over 80.”

A normal or ideal blood pressure reading is less than 120/80 mm Hg. Your blood pressure rises and falls throughout the day, so each reading is a snapshot. However, if your readings are consistently above 120/80, your doctor will likely diagnose you with high blood pressure.  

Warning Signs of High Blood Pressure

Among doctors and medical professionals, hypertension is sometimes referred to as “the silent killer.” This is because most people experience zero symptoms or warning signs of the condition. For most people, the only way to know if you have high blood pressure is by getting regular readings at your doctor's office, home or a pharmacy or other health clinic.

There are many common misconceptions about high blood pressure, like that it causes sweating, anxiety or trouble sleeping. None of these symptoms are proven to be associated with high blood pressure. You may have also heard that hypertension commonly causes severe headaches and nosebleeds, but there is no evidence to suggest this. 

Symptoms of Advanced or Severe Hypertension

Symptoms may begin to appear with very high blood pressure or readings above 180/120. A reading this high is also known as “stroke-level blood pressure,” meaning it is high enough to significantly increase the chances of having a stroke. Symptoms of stroke-level blood pressure include:

  • Blurred vision
  • Chest pain
  • Nausea and vomiting
  • Seizures
  • Confusion
  • Shortness of breath
  • Anxiety
  • Unresponsiveness

Whether or not you experience the above symptoms, a blood pressure reading above 180/120 is a medical emergency known as a hypertensive crisis. If your blood pressure is above 180/120, it is imperative that you seek medical treatment immediately. 

Risk Factors for Developing Hypertension

Even though most people with hypertension don’t experience any symptoms, there are certain factors known to increase the likelihood that you either have or will one day develop the condition. Common risk factors include:

  • Weight: Being overweight or obese
  • Genetics/ethnicity: Family history of hypertension
  • Activity Level: Not getting enough exercise
  • Diet: Eating a high-salt diet
  • Alcohol: Drinking excessive amounts of alcohol  
  • Age: Being over 65
  • Co-existing conditions: Diabetes, kidney disease
  • Smoking cigarettes

How Lifestyle Factors Influence Hypertension

When it comes to risk factors for hypertension, not all of them are under our control. For example, you can’t do anything about your age, ethnicity or family history of high blood pressure. But you do have options when it comes to risk factors like weight, activity level and diet. These are known as lifestyle factors.

Lifestyle factors are personal choices or behaviors related to how you lead your everyday life. These include your exercise habits, what you eat and how much alcohol you drink. Lifestyle factors are under your control, but that doesn’t mean it’s easy to change these habits.  

woman-doing-yoga-poseFor many of us, our body weight is a sensitive subject and may be a source of shame. It can be hard to talk about if you are overweight or obese, but it is especially important to address it if you have high blood pressure. You may take comfort in knowing that 69% of Americans are overweight or obese. In other words, most people today struggle with their weight. 

To manage your high blood pressure and prevent it from getting worse, you will likely need to make some major lifestyle changes like losing weight, adopting a healthy diet and exercising regularly. These changes are not easy and will not be accomplished overnight; you will need to change your lifestyle for the long term.

How to talk to your doctor about high blood pressure

Because it is associated with so many serious complications, it can be scary to talk about high blood pressure. Even though nearly half of U.S. adults have hypertension, there is still a stigma associated with the condition, as some people erroneously think that it’s the patient’s “fault.”

It can be intimidating to bring up sensitive topics that may be related to high blood pressure, like weight, exercise and smoking with our doctors because they hold a position of authority over us. Taking time to prepare before your appointment can help build your confidence and ensure you cover everything you need to. Here are some tips:

Be completely honest with your doctor.

Sometimes, it’s temping to be less than truthful with our doctors when it comes to fraught topics like diet, exercise and weight. It’s understandable to feel embarrassed or even guilty if you struggle with things like obesity, binge eating or addiction.  

Smoking, obesity and a poor diet are all risk factors for high blood pressure, so it is important to tell your doctor if you struggle with any of them (and you won’t be their first patient to struggle with these!). You can also communicate to your doctor that you are anxious or embarrassed about these topics and that you could use reassurance.  

Make a list of your questions and concerns.

It’s easy to forget important questions at the doctor, especially if your appointment is short or rushed. A simple solution is to write out your questions and concerns ahead of time. You could even keep a list on your phone or a pocket notebook and add to it whenever you think of something else you want to bring up.  

If you are planning to make (or have already made) major lifestyle changes, it’s recommended that you check with your doctor to ensure these changes are safe and appropriate for you. Good general questions to ask include:

  • What steps do you recommend for managing my hypertension?  
  • Should I be testing my blood pressure at home? If so, how often?
  • Do you have patients who successfully reversed their hypertension?
  • Is there a hypertension medication I should try?
  • Are there hypertension books podcasts, or literature I should check out?
  • What lifestyle changes do you recommend? 

Bring a spouse or trusted friend.

Not everyone knows that you are allowed to bring someone with you when you go to the doctor. Having a confidante by your side can make you feel more secure and help you remember what you want to talk about with your doctor. It also shows your doctor that you have a strong support system, and research has shown that strong social and emotional support are associated with better health.

Take notes.

Doctor’s appointments can be overwhelming. In order to remember your doctor’s recommendations, it can be helpful to take notes during your appointment. If you bring someone with you, you can ask them ahead of time to take notes for you. You should also get a visit summary from your doctor after each appointment. If you are not sure how to access this summary, ask your doctor or a member of your doctor’s front desk staff. 

FAQ about High Blood Pressure    

Can dehydration cause high blood pressure?  

Dehydration can affect your blood pressure, but it is more likely to cause low blood pressure (hypotension). However, when your blood pressure drops due to dehydration, your body may release a hormone known as vasopressin, which helps your body retain water. This can cause your blood pressure to rise. Avoid these complications by staying hydrated.

Can stress cause high blood pressure?

Stress is known to temporarily cause your blood pressure to rise. When that stress goes away, your blood pressure will return to normal. Brief events of high blood pressure can still be dangerous, as they can cause heart attacks and strokes, and may cause damage to your blood vessels, heart, and other organs. <H3> Does high blood pressure make you tired? 

Does smoking cause high blood pressure?  

When you smoke, your body experiences a sudden but temporary increase in both blood pressure and heart rate. This goes away about 20 minutes after smoking a cigarette. While researchers are still determining whether smoking causes hypertension by itself, it has been proven to raise your risk of heart attack, stroke and many life-threatening diseases.   

Can Covid cause high blood pressure?  

Because Covid is such a new disease, we are still learning about its symptoms, risk factors and long-term effects. A recent study suggests that certain adults — those with preexisting heart conditions or who are Black, male or elderly — are significantly more likely to develop high blood pressure after a Covid infection. 

Which decongestants are safe for high blood pressure?  

Over-the-counter decongestants like pseudoephedrine can be dangerous for those with hypertension, because they can both raise your blood pressure and lessen the effectiveness of blood pressure medication. If you have hypertension and need a decongestant, ask your doctor or pharmacist which one is safe for you to use.

Does high blood pressure make you tired?  

Feeling fatigued or tired is not one of the common symptoms of high blood pressure or hypertenston — in fact, it can be a symptom of low blood pressure. But fatigue is a sign of other diseases linked to hypertension, like type 2 diabetes, heart failure and heart disease. 

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