Thank you so much for your highly informative article on hypertension for seniors–the best one that I have read. Presently, my wife, age 78, weight 98 lbs., height 4′ 11″, has been on a 4 m Atacand (brand name) per day for close to ten years now. Healthwise, I was concerned about its side effects on her. Pricewise, it is a very, very costly drug and our plan now requires her to pay a newly required deductible of $350 before reaching a new copay that has also become more expensive as well. She does not smoke or drink. Her family doctor has suggested that she switches to a generic brand Atacand but she prefers not to risk with its poorer bioavailability. Is such a preference valid? Are there any benefits in a generic that would outweigh its bioavailability constraint? Is there any alternative brand name drug that would offer her a good transition? Thank you kindly again for sharing the above highly informative, useful, and rare article regarding hypertension for seniors. I’d look forward to your reply with great appreciation–if I may.
I would not recommend changing BP medications every 3-4 months just to prevent the onset of potential side-effects, but it certainly makes sense to reassess how you are doing on a BP med after a certain interval (usually after a few weeks, and then every few months or more often if the dose still needs to be refined or if there is concern about potential side-effects).
As the body increases production of an enzyme called angiotensin I-converting enzyme, or “ACE”, blood pressure increases. Pharmaceutical drugs called ACE inhibitors work by blocking the formation of this enzyme, but they have multiple side effects. Garlic contains gamma-glutamylcysteine, a natural ACE inhibitor.  This chemical, in combination with the high allicin content, gives garlic its ability to dilate arteries, thereby lowering blood pressure. I usually take one clove of garlic and remove the skin, chew well and swallow. Yes nobody wants to be around me after. You can also buy in pill form.
Glad to be helpful. If the nephrologist says all the tests were negative, that sounds reassuring and might mean your doctors could try different types of BP medication with you. Generally, three types of medication are considered equally acceptable for first-line treatment of high blood pressure: thiazide-type diuretics, ACE inhibitors or angiotensin receptor blockers (these two are related), or calcium channel blockers such as amlodipine.
The DASH (Dietary Approaches to Stop Hypertension) diet has been proven best for controlling blood pressure, according to the American Heart Association.  People who follow the diet eat 2,000 calories a day of fruits, vegetables, low-fat dairy foods and whole grains. The diet is rich in potassium, magnesium and calcium, as well as protein and fiber, and low in sodium. Foods on the diet are low in saturated fat, total fat, and cholesterol.
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It’s a common question among our guests at the Pritikin Longevity Center, who are taught how devastating the high-salt U.S. diet is to our blood pressure and overall health. Searching for alternatives, people often ask: What about salt substitutes with potassium? And what about MSG? Isn’t it a bad choice? Here are answers, some of which may surprise you.

All of these steps and techniques are things you should ask your doctor about as part of your personalized health plan. Preventative care from an experienced physician is the best way to fend off many health problems, and hypertension is no exception. Find a skilled St. Joseph Health primary care physician or heart specialist using our online provider directory. Download our health numbers report card to help you track your blood pressure and other common markers that measure heart health.


I am a 55 year old woman who was diagnosed with hbp about 5 years ago. I also have degenerative arthritis in my hips, in particular,and have had to keep up with strength training exercises over the past 20 years to ward off the pain. When first diagnosed with hpb, my doctor put me on Benicar. It helped immediately but I also began to experience some severe muscle and joint pain in my hips and legs. She switched me to Valsartan and the pain abided for about 2 months. Then came back again. Fast forward to last fall when I had a left hip replacement. Recovery was slow, especially for my age. I kept stumping the PT as to why my muscle tension was so tight. Finally, after I started working out at the gym, my pain resided. Counter intuitive, I know. Now I am scheduled to have a right hip replacement in November 2018 and am experiencing intermittent excruciating pain in my quads and tibia. I’ve been reading about an uncommon side effect of bp meds being muscle and joint pain. I’m wondering how much the bp meds are contributing to my pain. Would it be unreasonable to try switching bp meds every 3/4 months? Thank you for any advice you can provide. 

Those who received a placebo drink improved their reading by only 1 point. The phytochemicals in hibiscus are probably responsible for the large reduction in high blood pressure, say the study authors. Many herbal teas contain hibiscus; look for blends that list it near the top of the chart of ingredients for low blood pressure—this often indicates a higher concentration per serving.
Reduce your fat and sugar intake: Maintaining a healthy weight for your body type helps keep blood pressure under control. It has been proven that losing excess weight can drastically lower blood pressure values. When obesity and hypertension are coupled together, it can lead to some dangerous long-term health effects that could eventually be fatal in the long run. It is estimated that about 36.5 Americans are obese, with the consumption of excessive amounts of sugar being the main culprit. It is important to make weight loss a priority when treating your high blood pressure.
When added to a healthy diet, almonds can help influence lower blood pressure levels. In fact, almonds are included in the Dietary Approaches to Stop Hypertension — DASH — Diet. In the diet, almonds are included in the “nuts, seeds and legumes” group. The diet recommends eating four to five servings of this food group per week. With regard to almonds, one serving of almonds is just one-third cup. The healthy monounsaturated fat in almonds contributes to lower blood cholesterol levels and reduced arterial inflammation, which ultimately helps lower the pressure inside the arteries.
Glad you’ve found the information here helpful. Sounds like you are being very thoughtful and proactive about maintaining your health. Wonderful that your Medicare plan is covering an exercise program with a trainer! It’s true that as one gets older, being more deliberate and purposeful about exercise and strength work becomes more important. good luck and take care!

Could it ever be appropriate for a physician to prescribe slightly higher-than-routine dosing of a well-tolerated blood pressure medication, when other types of BP meds are not tolerated or would be problematical because of interactions with all the other drugs one might be on? I would assume fall risk should be evaluated in conjunction with such a consideration, and that it also might depend on how the particular tolerated BP med actually works in the body.
Those who received a placebo drink improved their reading by only 1 point. The phytochemicals in hibiscus are probably responsible for the large reduction in high blood pressure, say the study authors. Many herbal teas contain hibiscus; look for blends that list it near the top of the chart of ingredients for low blood pressure—this often indicates a higher concentration per serving.
Visit the zoo: Viewing and being around animals can be very therapeutic, having a positive effect on blood pressure levels. A study in Japan found that when people visited a zoo, their systolic blood pressure dropped by six percent and their diastolic blood pressure dropped by eight percent. It is thought that observing animals simulated the parasympathetic nervous system, which reduces blood pressure to help counteract stress-induced adrenaline spikes.
Sorry to hear of all your challenges related to blood pressure. Your situation sounds particularly complicated and so it’s probably appropriate for you to be seeing a specialist. High blood pressure can be treated by either cardiology or nephrology; nephrology might be better if you are also experiencing edema, but it also depends on what they think caused your hypertensive emergency in the first place and whether you seem to have anything going on with your kidneys.
Raw almonds: Consuming a handful of raw almonds can make a significant difference in your blood pressure. Almonds are considered a key component of the DASH diet—dietary approaches to stop hypertension diet—as they are rich in monounsaturated fats scientifically proven to lower cholesterol, reduce arterial inflammation, and lower blood pressure. It is important to note that almonds are high in fat and calories, but when eaten as part of a healthy lifestyle, they may actually promote weight loss and muscle growth.

Much of the salt we ingest comes from fast food, ready-made meals, bread and soft drinks – things to avoid when on a low-carbohydrate diet. This will lower your salt intake automatically. Furthermore, the hormonal effects of LCHF make it easier for the body to dispose of excess salt through urine; this can explain the slight lowering of blood pressure.


Sipping on not one but four cups of tea daily can help control blood pressure. A study presented at the European Society of Hyper tension in Milan found those who avoided coffee and tea consumption all together had the highest rates of blood pressure, pulse pressure, and heart rate. Those who drank tea the most often, between one to four cups a day, had the lowest systolic and diastolic blood pressure readings, as well as the lowest pulse pressure and heart rate. Pinkies up, for your blood pressure’s sake.

Next day I went to a doctor, my reading was 145/94, he ordered a blood test, renal functions and other things and cholesterol level; he put me on a mild ACE inhibitor-10mg. He told me I have essential hypertension and didn’t advise any dietary/lifestyle changes except for lower sodium intake. I’m fit, workout every other day and I’m vegetarian for more than 20 years.

Dear Dr. Kernisan, you don’t know how thrilled I am to hear back from you!! There seems to be so little kindness these days that I so appreciate your caring response. I have had little success finding information about malignant hypertension. You mentioned following up was a lot of work, but it has been so consuming for me due to my fear, but also trying for a decent quality of life with as few side effects as possible, that my daughter says I need to find something else to do. (I have no other family left)…Besides a very stressful job, and caregiving for my mother who lived to be 97, I have always done volunteer work, so am really ready to get back to being productive…As far as my malignant spikes, I have asked every doctor and no one has an answer as to why it suddenly developed. That is one reason it is so scary. The nephrologist says he guesses it was from years of chronic stress. All the tests (kidney and carotid artery) were negative. I do a ton of research and am so glad to have found your site!! I found you through a link in a Washington Post article by Janice Neumann on August 17 “New Blood Pressure Guidelines Can Cause Problems for the Elderly”… I did not find a way to contact her. I have had no luck finding similar patients but need to learn social media skills. Thank you again so much!!!! I will be a faithful follower from now on!!! Best Regards, Kathy


My BP since in my 30’s has been 135/75. I am 72 and last June it was averaging 160/70. I joined WW and lost 35 lbs but my home readings (BP monitor checked with doctor’s) 150-160/65-70. However, at doctors office it went from 170-145/75. I am planning to home monitor twice per day this next week. Another concern, my doctor is not concerned enough to put me on a hypertension pill. Isn’t 140 and above alarming? Health wise, my other health readings are all normal or below…..cholesterol, diabetes, plaque in arteries, etc.
We've got a bit of a different podcast today for you Guys & Gals, but it's still a goodie, and jam packed with exciting information. The Chief Scientist at the Institute of Noetic Sciences, Dr. Dean Radin, joins us to discuss his expertise on real magic and how can it optimize performance for everyone. Dr. Radin is the author of many books, but his newest, titled Real Magic, delves into the worlds of telepathy and psychokinesis; which he explains may not solely be powers of the imagination. Enjoy! 

In addition to these methods being effective, other lifestyle changes and diet adjustments may also be useful in lower blood pressure. One study explains that losing weight can have a significant positive impact on patients that have been diagnosed with hypertension. Even small reductions in bodyweight amongst those individuals who are both obese and hypertensive can yield life-saving benefits. Dietary changes can also help. In particular, the patient should aim to lower their daily intake of sodium, which causes an elevation in blood pressure. The patient should also focus on obtaining more calcium, potassium and other minerals that are useful in balancing blood pressure levels. Fiber, fruits and a lot of vegetables should also be an essential part of the patient’s daily diet.


One of the top causes for heart disease is high blood pressure. High blood pressure is one condition which might not show any symptoms for a really long time. Read here to know some effective ways to control your blood pressure.  By: DoctorNDTV  Updated: Oct 24, 2018 09:26 IST 4-Min Read  SHARES High blood pressure can be controlled by maintaining a healthy lifestyle
Another study by UCLA researchers of 1,117 men and women with high blood pressure reported that within three weeks of arriving at Pritikin, systolic blood pressure fell on average 9%. Diastolic pressure also fell 9%. Of those taking blood pressure drugs, 55% returned home medication-free. Many of the remaining 45% left Pritikin with their dosages substantially reduced.2
All of these steps and techniques are things you should ask your doctor about as part of your personalized health plan. Preventative care from an experienced physician is the best way to fend off many health problems, and hypertension is no exception. Find a skilled St. Joseph Health primary care physician or heart specialist using our online provider directory. Download our health numbers report card to help you track your blood pressure and other common markers that measure heart health.
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