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 always recommend that people find something that they enjoy doing to stay in shape. For example, line dancing, walking outside, and riding a bike are all good ways to get active,” says Scott Parker, a health and fitness trainer and a national spokesperson for #GoRedGetFit — an online fitness challenge for women hosted by the AHA and Macy’s. “It’s also important to find other people you like doing the activity with, because that helps you stick with it.”
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.
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).
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A 2013 study published in “Hypertension” concluded that flaxseed lowers blood pressure in hypertensive patients. It is a great home remedy for high blood pressure. More than 100 patients diagnosed with peripheral artery disease, a condition associated with high blood pressure, were assigned to a flaxseed group or a placebo group. The former ate 30 grams of flaxseed every day for 6 months.
Elevated blood pressure refers to an increase in the pressure or tension applied to blood vessels. Blood pressure is measured by providing two different readings, including systolic blood pressure and diastolic pressure. Blood pressure levels that raise beyond 120/80 is considered elevated. At 130/80, a person is considered to be experiencing high blood pressure. High blood pressure is often classified into two stages. State 1 hypertension is diagnosed when blood pressure levels fall between 130-139/80-89. Stage 2 hypertension is diagnosed when a patient’s blood pressure becomes higher than 140/90.
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.
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.
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.
Pickering TG, et al. Recommendations for blood pressure measurement in humans and experimental animals: Part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Hypertension. 2005 Jan;45(1):142-61.

5. Take apple cider vinegar. In addition to lowering blood pressure almost overnight, apple cider vinegar has a myriad of fringe benefits. Apple cider vinegar helps with indigestion, especially if you suffer from diarrhea. It also soothes sore throats, cures hiccups instantly, and lowers cholesterol. Most importantly, it helps with weight loss by improving metabolism and reducing water retention -- and a healthy weight is key to normalizing blood pressure.
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.

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.


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.
Cayenne Pepper is probably the fastest way to lower high blood pressure. Cayenne pepper is a powerful vasodilator, which means it helps expand blood vessels and improve blood flow. This effect naturally lowers blood pressure levels by increasing the rate at which blood flows throughout the circulatory system, which in turn takes some of the pressure off arterial walls. Either mix one teaspoon of cayenne pepper with half a cup of lukewarm water or mix two tablespoons of raw organic honey with two teaspoons of cayenne pepper; boil them with eight ounces of water and drink when it is warm. A side note: Be careful how many Scoville Units your cayenne pepper is. I bought mine, 90,000 Scoville Units, and OMG. I thought I was going to breathe fire.
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.
A lack of vitamin D is common in developed countries and can cause a range of health problems. But this simple and inexpensive supplement may reduce the risk of cardiovascular disease. Taking around 4000IU of a high-quality D3 supplement daily can also support bone health, lower blood pressure, boost your mood and reduce fatigue – and these are just a few of its many health benefits.
Don’t assume that your doctor is aware of these facts. If you are diagnosed with mild, high blood pressure, you likely will be prescribed medication, instructed that it is helpful, and told that you must take it for the rest of your life. But before accepting this potentially dangerous treatment, it may be to your advantage to seek answers to the following questions: “What caused my high blood pressure?” and “Can I remove those causes and reverse this condition?”
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.
7. Cut down on sodium intake: Processed and packaged food needs to go out of your kitchen, if you want healthy levels of blood pressure. This is because processed food is loaded with added preservatives to increase their shelf life. Also, prepare your food with lesser salt as high intake of salt is linked to risks of high blood pressure and stroke.
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.
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 think eggs are not heart healthy, you should know that past studies have shown that yolks don’t raise heart disease risk. Now, recent research has found that egg whites deserve a place on the list of foods to lower blood pressure, according to a study presented at a meeting of the American Chemical Society. As MensHealth.com reported, when rats with high blood pressure were fed a protein found in egg whites, they experienced a drop in blood pressure that was comparable to a low dose of Captopril, a blood-pressure-lowering medication. Although more research is needed, eggs are a solid source of protein, vitamin D, and other healthy nutrients.

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.
According to the Centers for Disease Control and Prevention (CDC), an estimated 75 million Americans have high blood pressure. Many risk factors for high blood pressure are out of your control, such as age, family history, gender, and race. But there are also factors you can control, such as exercise and diet. A diet that can help control blood pressure is rich in potassium, magnesium, and fiber and lower in sodium.
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.

4. Reduce intake of caffeine: In case you constantly need stimulants like tea or coffee to get you through the day, you definitely need to check your health. Moreover, caffeine can cause short-term spike on your blood pressure. Read here to know how many cups of tea or coffee you should have in a day in order to keep your blood pressure under control.
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.

Your blood pressure is said to be “high” when either your systolic blood pressure is 140 or above, or your diastolic blood pressure is 90 or above, or both. So if your blood pressure is found to be 142/88 (systolic = 142, diastolic = 88), you are diagnosed as having high blood pressure, according to current definitions. The same would be true if your blood pressure was found to be 135/92, or 152/95. In each case, either the systolic is high, or the diastolic is high, or both. Any of these findings result in a diagnosis of high blood pressure.


Several Indian studies over the last few years have shown that Arjuna, in animals and in humans, reduces total cholesterol and increases HDL (“good” cholesterol). One study showed that this herb was as effective an antioxidant as vitamin E and that it reduced cholesterol in the human subjects quite substantially. Considering its benefit for cholesterol, it is not surprising that it lowers blood pressure; many cases of high blood pressure in the United States are caused by cholesterol accumulation in the arteries.
Many leafy greens, including everything arugula and kale to spinach and collard greens, contain potassium and magnesium which are key minerals to control blood pressure, according to Harvard Medical School. These nutrients are an important part of the DASH diet (Dietary Approaches to Stop Hypertension, or high blood pressure), which suggests a variety of foods that lower blood pressure. A potassium-rich diet helps the body become more efficient at flushing out excess sodium, which can raise blood pressure, and magnesium helps promote healthy blood flow, according to nutritionist Joy Bauer.
As simple as it sounds, breathing is an effective technique to lower blood pressure. Slow breathing and meditative practices such as yoga can help decrease the stress hormones that elevate renin — a kidney enzyme that raises blood pressure. "Sit in a comfortable chair with armrests. Your body should be as relaxed as possible. Place one hand on a part of your chest or preferably your abdomen. Watch your hand rise and fall with each breath...feel the breath as it moves into your abdomen,” Dr. John M. Kennedy, a cardiologist in Los Angeles, Calif., and author of the book The Heart Health Bible told Medical Daily in an email.  This should be repeated seven times and can become a daily habit by doing deep breathing 10 minutes in the morning.
2. Take the right nutrients. Talk with your chiropractor or other healthcare professional about the wide range of well-studied nutrients that, along with dietary and lifestyle modifications, can help normalize your blood pressure. One meta-analysis found magnesium supplements could lower blood pressure. Likewise, researchers find a small but significant decline in blood pressure for people with hypertension who use fish oil. (You can get all of fish oil’s benefits combined with anti-inflammatory flax oil and GLA in our Optimal Omega.) 
Oatmeal is one of a few semi-processed foods that lower blood pressure. That’s because getting the right amounts of dietary fiber and whole grains is vital to maintaining normal blood pressure, and oatmeal is a tasty source of both. Classic studies have proven that eating oatmeal can lower systolic and diastolic blood pressure. Plus, the fiber can help you maintain a healthy body weight and prevent obesity, a risk factor for high blood pressure. These are the 10 silent signs you could have low blood pressure.

Yoga is an ancient practice of life science and a way of living that was originated thousands of years ago in India. A great way of reducing high blood pressure, yoga is really effective in treating issues naturally. So practice asanas like Sukhasana, Uttanasana, Adho Mukha Svanasana, Vriasana, Baddha Konasana, Supta Padanugusthasana, Setu Bandhanasna, and Shavasana, for lowering down the blood pressure.
Omega-3 fatty acids, such as those found in fish oil supplements, offer a wide variety of health benefits, including the ability to reduce blood pressure by reducing LDL (or “bad”) cholesterol. It is possible to consume enough Omega-3 fatty acids simply by adding more fatty fish to your diet, but it’s much easier to take it in supplement form. The best forms of Omega-3 oil are krill and calamari oils.
Today's episode of the OPP we feature guest Joe Scola, who is the founder of Wise Ape Tea. They specialize in Adaptogenic teas, which regulate stress for your body. We get into some HEAVY Tea Topics like the weirdest blend of tea, the historic origins of tea, and discuss how adding in CBDs affects tea. Wise Ape also partners with many organizations, and for each tea sale they donate a chunk of the proceeds to these organizations which is awesome! Each tea is partnered with a specific charitable organization so go out there, buy your favorite tea, and contribute to a great cause! Two birds with one stone!
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. 

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. 
It sounds to me like the cardiologist is in the process of trying to figure out what is the right dose of BP meds for her at this time, given the current state of her heart. Re the nurse’s recommendation, you may want to call back and make sure they realize that your mother’s SBP is only around 110, even off all BP meds. Ask them what they think her goal BP should be.

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).
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