In most cases where high blood pressure is diagnosed, the cause remains unclear. One review paper in the International Journal of Hypertension explains that this accounts for around 90% of all hypertension diagnosis and is usually referred to as essential hypertension. Secondary hypertension is diagnosed when a cause can be identified. Potential causes of secondary hypertension may include:
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.
If you have hypertension, ask your doctor if OSA could be behind it. (In addition to loud snoring, common symptoms include excessive daytime tiredness and early morning headaches.) Getting your sleep apnea under control could be helpful for improving your blood pressure, says Robert Greenfield, MD, Medical Director of Non-Invasive Cardiology & Cardiac Rehabilitation at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in Fountain Valley, CA.

As blood pressure tends to vary somewhat from day to day, it’s recommended to only diagnose someone with high blood pressure if they have given a repeatedly high reading. If the average of either of the readings (either the systolic or diastolic) is higher than the norm, it will be considered an elevated blood pressure. That is, an average of 150/85 or 135/100 over readings on several occassions will be considered too high.
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Diabetics often have lower recommendations for blood pressure, the maximum normal value being seen as 130/80-85. However, it’s questionable whether it’s a good idea to medicate your blood pressure levels down to those values. Diabetics can probably stick to approximately the same upper limit as people with heart disease: 140/90 (according to new studies and expert comments, as well as the latest recommendations from the American Diabetes Association, ADA).
Eat dark chocolate. Dark chocolate and cocoa powder are both full of heart-healthy plant compounds called flavonoids. Flavonoids are good for you because they cause your blood vessels to dilate, which can help lower blood pressure. Just make sure your chocolate doesn’t have too much sugar. Choose chocolate that is at least 70 percent dark for best results. You can buy individually wrapped chocolate pieces that are the perfect size. Eat one or two a day and enjoy the delicious heart-protective effects.
Regular visits with your doctor are also key to controlling your blood pressure. If your blood pressure is well-controlled, check with your doctor about how often you need to check it. Your doctor may suggest checking it daily or less often. If you're making any changes in your medications or other treatments, your doctor may recommend you check your blood pressure starting two weeks after treatment changes and a week before your next appointment.
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.)
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