Certain groups of people—the elderly, African Americans, and those with a family history of high blood pressure—are more likely than others to have blood pressure that's particularly salt-sensitive. But because there's no way to tell whether any one individual is at risk, everyone should consume less sodium, says Eva Obarzanek, PhD, a research nutritionist at the National Heart, Lung, and Blood Institute.
What is considered low depends a bit on the person, their medical history, and the particular circumstances. It is also important to compare a person’s blood pressure to his or her “usual blood pressure.” A SBP of 102 is different in a young woman who usually has SBP 100-105, compared to an older person who has historically registered SBPs of 130-150.
Various organizations including the United States Department of Agriculture recommend that Americans consume less than 2,300 milligrams (mg) of sodium per day. But the ideal limit is really no more than 1,500 mg per day for most adults. Unfortunately, the average sodium intake of Americans is more than 3,400 mg per day, according to the Centers for Disease Control and Prevention (CDC). This is partly because sodium is so easy to consume — just 1 teaspoon of salt contains 2,300 mg of sodium.
Many factors can cause your blood pressure to rise, and each factor may or may not require medication. Many people make lifestyle changes that lower their blood pressure without medication; especially for pre-hypertension and stage 1 of hypertension. Also, each time you take your blood pressure, make sure you are still and calm, sitting with both feet on the floor, arm supported on a flat surface, and you are measuring at the same time everyday. You can also take multiple readings in one sitting, but wait one minute between each reading. These steps will ensure you are providing your healthcare provider with the most accurate blood pressure reading!
If you’re eating more fruits and vegetables, you’re already taking a positive step toward reducing salt and enhancing potassium intake. Sodium can be found in abundance in processed foods – anything that comes in a package, can, or especially from a fast food restaurant. If you’re over 50, or at higher risk, aim for no more than 1,500 mg/day. Check your food labels for sodium content. If you see that a food has more than 400-500 mg in a serving, see if there’s a lower-sodium option.
Your mother’s situation does sound worrisome, as you are describing falls and also some concerns with thinking. Her age of 96 is pretty old, so clinical research studies don’t provide much guidance on what is optimal blood pressure. Unless she has compelling medical reasons to aim for a SBP of 120, most geriatricians would probably reduce her BP meds and try to aim for a SBP in the 130s or 140s. So you may want to ask your mother’s doctor to discuss with you what is a suitable BP goal for her, and whether a reduction in BP meds might be reasonable.
Dairy or soy—it’s your choice. Replacing some of the refined carbohydrates in your diet with foods high in soy or milk protein (like tofu or low-fat dairy) can bring down systolic blood pressure if you have hypertension or prehypertension, findings suggest. "Some patients get inflammation from refined carbohydrates, which will increase blood pressure," says Matthew J. Budoff, MD, FACC, Professor of Medicine at the David Geffen School of Medicine and Director of Cardiac CT at the Division of Cardiology at the Harbor-UCLA Medical Center.
Swearing off cigarettes is probably the single best thing you can do for your heart. It’s good for your health in general, too. Not only does smoke hurt you over the long term, but your blood pressure goes up every time you have a cigarette. Lower your blood pressure and prolong your life by quitting. If you need help getting started, talk to your doctor.
Magnesium: Magnesium, which is present in nuts, seeds, avocado, and green leafy vegetables, has also been proposed as a natural way to reduce blood pressure. Supplements are also available in pill form. Studies show that higher levels of magnesium are associated with lower blood pressure, but it is still not completely clear whether there is a cause-and-effect relationship.
Some years ago I was put on medication for elevated blood pressure, as my mother before me. I took my medication and checked my values “religiously”… All of a sudden last October I developed malignant hypertension. I was hospitalized 3 times in 3 days with values over 220, then the hospital sent me to a nephrologist. He started running tests which were all normal. The hospital put me on Clonidine but the nephrologist did not add anything while running tests. In November I had to be hospitalized again. That time the ER doctor said they were not going to release me back to the same situation and added Amlodipine Besylate. My blood pressure has been normal with one brief spike since. Problem now are medication side effects: edema of feet and legs, hearing loss from fluid retention, bloating and constipation and generally not feeling well. I had always worked full time but finally retired this March. I am very disappointed to think that after working so hard for so may years I am going to feel like this in retirement due to side effects. I have talked to my nephrologist, especially a few weeks ago when I developed hearing loss from fluid retention and found that all the side effects are cumulative. He sent me an email saying we will stop the Clonidine and Amlodipine with no adjustments or anything in their place!! My pharmacist has tried to be helpful but can’t change anything. He says Amlodipine is one of the worst meds for side effects and many patients have to stop it for something else. The nephrologist does not seem to have done any research on side effects in order to suggest alternative medications, or to offer adjustments. He seems kind and listens, but offers nothing. In fact all of my medications for this condition were prescribed at the hospital. We have few geriatric doctors in this area, and no geriatric cardiologists. My regular cardiologist who just prescribed my standard meds cancelled my appointment when I developed the spikes. I already knew he was not up to challenges…I see an adult congenital cardiologist every so often even though he tells me I don’t need him as my congenital repair and heart are fine. There are not a lot of nephrologists here, but I think there is a better one in the same group so I doubt he will see me. I am really in a dilemma because I certainly cannot risk spikes, but would hope to feel better and not risk side effects such as fluid retention causing worse problems. It has also elevated my blood glucose which I watch and control through diet and exercise. The medication had my blood pressure running as low as the low 80s over low 50s, obviously too low, which is when the edema developed and I was lethargic. Now values are good. I have found little information on malignant hypertension and had never heard of it. I will greatly appreciate any suggestions. Thank you! PS I do not have a primary care doctor because so many here will not take Medicare and the “good” ones are not taking new patients or retiring. I have been looking for some time. My neurologist even had me send records to his good friend, an internal medicine specialist and they called and said he couldn’t help me….I had endocarditis at age 5 and have some medical PTSD. Sorry to write a novel, but I am thrilled there may be some help for me!
Elevating your feet will not lower blood pressure and will actually increase the blood pressure reading when your feet are higher than your heart. On the other hand, if you are doing activities to relieve stress such as yoga (which often elevates your legs, such as legs-up-the-wall pose), then over the long run, these stress reducing activities may help to decrease your blood pressure (but it is not the act of elevating the legs that is lowering the blood pressure it is the stress relieving activity).
Also focus on eating nitrate and nitrite-rich vegetables (not to be confused with the other types of nitrates and nitrites that are found in processed meats) . Nitrates and nitrates from vegetables help to relax and dilate blood vessels throughout your body and increase blood flow. Although it’s a short-term effect, eating more nitrate-rich vegetables like beets, cabbage, leafy greens, and vegetable juices, can reduce blood pressure for a few hours. Recent studies have also shown that those who drank beetroot juice showed an immediate effect on lowering blood pressure. By eating plant-based foods consistently, you’ll see their regular benefits.
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.
Caffeine can raise blood pressure by tightening blood vessels and magnifying the effects of stress, says James Lane, PhD, a Duke University researcher who studies caffeine and cardiovascular health. "When you're under stress, your heart starts pumping a lot more blood, boosting blood pressure," he says. "And caffeine exaggerates that effect." (Not sure whether you need to cut back? Here are 6 physical symptoms that mean you're drinking too much coffee.)