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.

And I am 67 and am on HCTZ25mg (I retain a lot of water) and Losartan 75mg which causes leg cramps but I think I am experiencing angina – not always; it goes away after the initial pain – now I’m worried – yes I could lose weight but do not smoke(17yrs ago) or drink(used to then stopped now for a number of years). What’s are next move. Iam adopted so I can’t look to my Mom for any genetics…Thank you, Laurie
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.
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.
About 80 million Americans over age 20, 1 in 3 adults, have high blood pressure, and many don’t even know they have it. Not treating high blood pressure is dangerous. High blood pressure increases the risk of heart attack and stroke. You can live a healthier life if you treat and manage it! There are many ways to do so, taking natural remedies is just one of them.
About 80 million Americans over age 20, 1 in 3 adults, have high blood pressure, and many don’t even know they have it. Not treating high blood pressure is dangerous. High blood pressure increases the risk of heart attack and stroke. You can live a healthier life if you treat and manage it! There are many ways to do so, taking natural remedies is just one of them.
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.

When was the last time you thought about your blood pressure? If you're like most people, it probably hasn't been since your doctor mentioned it during your last checkup. But high blood pressure (hypertension) is a serious condition that can lead to life-threatening problems, like heart attack and stroke. The good news is that you can lower your risk of hypertension with lifestyle changes.


About 80 million Americans over age 20, 1 in 3 adults, have high blood pressure, and many don’t even know they have it. Not treating high blood pressure is dangerous. High blood pressure increases the risk of heart attack and stroke. You can live a healthier life if you treat and manage it! There are many ways to do so, taking natural remedies is just one of them.
Common painkillers (so-called non-steroidal anti-inflammatory drugs, NSAID), can increase your blood pressure by inhibiting the production of salt in your kidneys. This includes over-the-counter pills such as Ipren, Ibumetin, Ibuprofen, Diklofenak and Naproxen as well as the prescription drug Celebra. Painkillers with the active substance paracetamol are better for your blood pressure.
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.
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
For instance, in the ground-breaking SPRINT trial of intensive BP lowering in older adults, the researchers checked BP by having participants first rest quietly in a room for five minutes. Then an automatic monitor checked BP three times in a row, with a one-minute interval between each check. The average of these three readings was then used to assess BP and make changes to hypertension medications, if necessary.
Blood pressure is written as two numbers, such as 112/78 mm Hg. The top, systolic, number is the pressure when the heart beats. The bottom, diastolic, number is the pressure when the heart rests between beats. Normal blood pressure is below 120/80 mm Hg. If you’re an adult and your systolic pressure is 120 to 139, or your diastolic pressure is 80 to 89 (or both), you have pre-hypertension. High blood pressure is a pressure of 140 systolic or higher and/or 90 diastolic or higher that stays high over time.
According to the American College of Cardiology and the American Heart Association, the goal of blood pressure treatment is to attain a blood pressure reading that's less than 130/80 mmHg systolic and less than 80mmHg diastolic. In general, if you have hypertension, it is likely that you will need to be treated for the duration of your life to maintain this target blood pressure. 
Eat potassium- and magnesium-rich foods. Potassium can help regulate your heart rate and can reduce the effect that sodium has on your blood pressure. Foods like bananas, melons, oranges, apricots, avocados, dairy, leafy green vegetables, tomatoes, potatoes, sweet potatoes, tuna, salmon, beans, nuts, and seeds have lots of potassium.  Magnesium is thought to help blood vessels relax, making it easier for blood to pass through. Foods rich in magnesium include vegetables, dairy, chicken, legumes, and whole grains. It’s better to get vitamins and minerals from food, and a heart-healthy diet like the one we described above is a good way to ensure you get plenty of nutrients. However, you may want to talk to your doctor about whether taking certain supplements might help your blood pressure. 

Editor’s Note: Considerable controversy exists about whether fat or cholesterol are, per se, drivers of atherosclerosis. They are implicated in some studies, while others indicate that quality of fat, and placement in a wider dietary pattern, may be more significant to ultimate impact. What seems clear, however, is that a diet high in animal products, sugar, and processed foods is often a recipe for high blood pressure and heart disease.

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If you are in this 130/80 range, reducing your blood pressure can help protect you from heart attack, stroke, kidney disease, eye disease, and even cognitive decline. The goal of the new guidelines is to encourage you to treat your high blood pressure seriously and to take action to bring it down, primarily using lifestyle interventions. "It is well documented that lifestyle changes can lower blood pressure as much as pills can, and sometimes even more," says Dr. Fisher.
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.
When was the last time you thought about your blood pressure? If you're like most people, it probably hasn't been since your doctor mentioned it during your last checkup. But high blood pressure (hypertension) is a serious condition that can lead to life-threatening problems, like heart attack and stroke. The good news is that you can lower your risk of hypertension with lifestyle changes.
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.
Get moving at least a little bit every day, with a standard recommendation of 30-60 minutes a day, 3-5 times a week. Get your heart pumping at a moderate intensity for a few times a week, and mix it up with some strength training. Because life happens, on the days when you can’t fit it in, try to build more activity into your day by parking further away, taking the stairs instead of the elevator, or even just doing a quick sprint or two up and down the block. Every little bit helps.
About 80 million Americans over age 20, 1 in 3 adults, have high blood pressure, and many don’t even know they have it. Not treating high blood pressure is dangerous. High blood pressure increases the risk of heart attack and stroke. You can live a healthier life if you treat and manage it! There are many ways to do so, taking natural remedies is just one of them.
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).
CoQ10 is a naturally occurring enzyme. It contains antioxidants that are good for maintaining cardiac health. CoQ10 has been shown to decrease blood pressure and reduces the thickening of the heart muscle (hypertrophy). There are no known side effects of CoQ10 since it naturally occurs in the body. According to the Mayo Clinic, for the treatment of hypertension, take 60-360 milligrams daily for 8-12 weeks.

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 potassium- and magnesium-rich foods. Potassium can help regulate your heart rate and can reduce the effect that sodium has on your blood pressure. Foods like bananas, melons, oranges, apricots, avocados, dairy, leafy green vegetables, tomatoes, potatoes, sweet potatoes, tuna, salmon, beans, nuts, and seeds have lots of potassium.  Magnesium is thought to help blood vessels relax, making it easier for blood to pass through. Foods rich in magnesium include vegetables, dairy, chicken, legumes, and whole grains. It’s better to get vitamins and minerals from food, and a heart-healthy diet like the one we described above is a good way to ensure you get plenty of nutrients. However, you may want to talk to your doctor about whether taking certain supplements might help your blood pressure.
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.

Flavonoids have been linked to lower blood pressure and hypertension. That’s why berries like blueberries and blackberries are good to have on hand to add to oatmeal, yogurt, or smoothies. One study found that people with hypertension who had the highest intake of antioxidants via berries reduced their risk of high blood pressure by 8 percent. Here are 6 serious health dangers of even slightly high blood pressure.


What is a normal blood pressure? Blood pressure is essential to life because it forces the blood around the body, delivering all the nutrients it needs. Here, we explain how to take your blood pressure, what the readings mean, and what counts as low, high, and normal. The article also offers some tips on how to maintain healthy blood pressure. Read now
If you’re feeling overwhelmed about how to make changes to your diet or if you’re trying to lose weight, you may want to consider working with a registered dietitian-nutritionist (RDN). Some people work with an RDN if they have a health condition like type 2 diabetes. In fact, high blood pressure is a risk factor for type 2 diabetes. This is partly because they share similar modifiable risk factors, like being overweight or obese, following an unhealthy diet, and having a lack of physical activity.
While making these changes may not mean you can immediately go off your blood pressure medications or never have to take them, they will improve your overall health and reduce your risk for developing other diseases, including diabetes and possibly even cancer. Making healthy lifestyle changes can reduce your risk of stroke, heart attack or kidney damage, and reduce the likelihood that your dose of blood pressure medication will need to be increased in the future.
If you’re feeling overwhelmed about how to make changes to your diet or if you’re trying to lose weight, you may want to consider working with a registered dietitian-nutritionist (RDN). Some people work with an RDN if they have a health condition like type 2 diabetes. In fact, high blood pressure is a risk factor for type 2 diabetes. This is partly because they share similar modifiable risk factors, like being overweight or obese, following an unhealthy diet, and having a lack of physical activity.
This technique is known to surprisingly few health professionals, though it has proved valuable in the treatment of a wide variety of health problems. Recently, this powerful technique has been shown to be an extremely effective method for allowing the body to rapidly normalize high blood pressure more effectively than any other treatment reported in the scientific literature.
1. Concentrate on foods that lower blood pressure. Sugary, processed foods contain salt, sugar, damaged fats, and food sensitivities like gluten that contribute to or exacerbate high blood pressure. Shifting to a whole, unprocessed foods diet can dramatically impact your blood pressure. Many whole, unprocessed foods are rich in potassium, a mineral that supports healthy blood pressure. Some research shows that too much sodium and low amounts of potassium – can contribute to high blood pressure. Research shows people with high blood pressure can benefit from increased potassium in foods including avocado, spinach, wild-caught salmon, and sweet potatoes.
What is a normal blood pressure? Blood pressure is essential to life because it forces the blood around the body, delivering all the nutrients it needs. Here, we explain how to take your blood pressure, what the readings mean, and what counts as low, high, and normal. The article also offers some tips on how to maintain healthy blood pressure. Read now
7. Visit your chiropractor. A special chiropractic adjustment could significantly lower high blood pressure, a placebo-controlled study suggests. “This procedure has the effect of not one, but two blood–pressure medications given in combination,” study leader George Bakris, MD, told WebMD. Your chiropractor can create an effective protocol that helps normalize blood pressure without medication or other invasive procedures.

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.
Kiwis are another fruit that positively impacts blood pressure. Some researchers studied how the fruit fares compared to apples. They found that eating three kiwis a day over eight weeks reduced blood pressure in people with slightly high blood pressure more so than eating one apple per day during the same time. A daily serving of kiwi was also found to reduce blood pressure in people with only mildly elevated levels. Kiwis are also an excellent source of vitamin C which can also also improve blood pressure. 
High blood pressure over an extended period can lead to potentially dangerous complications. This can cause damage to organs, leading to microalbuminuria, cognitive dysfunction, and left-ventricular hypertrophy, as noted by one study. Additionally, the risk of renal failure, dementia and suffering a heart attack also dramatically increases in the population with elevated blood pressure levels.
Eat potassium- and magnesium-rich foods. Potassium can help regulate your heart rate and can reduce the effect that sodium has on your blood pressure. Foods like bananas, melons, oranges, apricots, avocados, dairy, leafy green vegetables, tomatoes, potatoes, sweet potatoes, tuna, salmon, beans, nuts, and seeds have lots of potassium.  Magnesium is thought to help blood vessels relax, making it easier for blood to pass through. Foods rich in magnesium include vegetables, dairy, chicken, legumes, and whole grains. It’s better to get vitamins and minerals from food, and a heart-healthy diet like the one we described above is a good way to ensure you get plenty of nutrients. However, you may want to talk to your doctor about whether taking certain supplements might help your blood pressure.
People who cooked with a blend of the two oils (available at health food stores) saw a drop in blood pressure almost comparable with the decrease that results from taking medication, according to research from the American Heart Association’s Scientific Sessions. Researchers believe the effect is due to the oils’ fatty acids and antioxidants such as sesamin, sesamol, sesamolin, and oryzanol.
Hypertension can be effectively treated with lifestyle modifications, medications, and natural remedies. Most people with hypertension experience improvement with prescription treatment such as diuretics, ACE inhibitors, beta-blockers, or other options, and some may require more than one prescription medication to reach optimal blood pressure. If your hypertension has a medical cause (secondary hypertension), you may also need treatment for medical issues that are contributing to your high blood pressure.

Clinicians do sometimes prescribe still higher doses of a BP medication, especially if adding another agent doesn’t seem to be a good option. However, the BP may not improve much in response, although the risk of side-effects (such as electrolyte disturbances) usually does go up. You can ask your usual healthcare provider or a pharmacist to review potential side-effects with you, so that you’ll know what to monitor for.
CoQ10 is a naturally occurring enzyme. It contains antioxidants that are good for maintaining cardiac health. CoQ10 has been shown to decrease blood pressure and reduces the thickening of the heart muscle (hypertrophy). There are no known side effects of CoQ10 since it naturally occurs in the body. According to the Mayo Clinic, for the treatment of hypertension, take 60-360 milligrams daily for 8-12 weeks.
A study shows that drinking 2 cups of a mix of three parts beetroot and one part apple juice can make your systolic blood pressure (the top number) go down in just a few hours. Men may see a bigger benefit than women. High systolic pressure can raise your chances of strokes. Cooked beets and beet greens, which pack lots of potassium, are a good alternative.
One of the easiest ways to manage your blood pressure is simply making healthy life choices such as eating low-sodium diet, committing to a regular exercise routine, and avoiding (excessive) alcohol. Smoking is one of the worst things that you can do to your cardiovascular system, and it’s important that you take steps to quit as soon as possible to avoid hypertension, even if you don’t yet suffer from it yet. 

Add olive oil to your blood pressure shopping list. The main reason for this benefit is because of polyphenols. These compounds are known for fighting inflammation and reducing blood pressure, according to UCDavis. That’s why olive oil is a key part of the DASH diet and one of the foods that lower blood pressure. Next, check out the 11 things you need to know about the DASH diet. 

Speaking of BP meds that effect potassium, my potassium is usually around 3.3 which is below the threshold. My doctor thinks this is due to the diuretic chlorthalidone and recommends a supplement like KLOR. I also take lisinopril and amlodipine. I have no symptoms of hypoglycemia and have put off taking the supplement. Perhaps switching to a potassium sparing diuretic would be the way to go, but I tolerate my current meds very well. I am a very active 75 year old man. Thank you so much for your good work with this blog.

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