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.
Arteries are naturally flexible and smooth, which allows blood to easily move throughout the body. High blood pressure creates extra force against the artery walls, which damages the lining of the arteries. As they become narrower and harder, this restricts blood flow, and when blood flow is lowered, the heart has to work harder to pump it through the body, which only makes the problem worse.
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.)

Loading up on potassium-rich fruits and vegetables is an important part of any blood pressure-lowering program, says Linda Van Horn, PhD, RD, a professor of preventive medicine at Northwestern University Feinberg School of Medicine. Potassium encourages the kidneys to excrete more sodium through urination, and that sodium excretion can help lower blood pressure.
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.

“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.”
The heartening news is that most people can effectively control their blood pressure without the need for medications by following a healthy lifestyle like the Pritikin Program.  “Those who still need medications usually require a lower dose and/or fewer drugs, thereby reducing their risk of suffering adverse side effects from the medications,” states Dr. Fruge.
Having a bad day can impair our judgment and lead to most of us making not-so-wise lifestyle choices like binge eating, smoking, or drinking. These unhealthy habits done in excess can negatively affect our health, especially our blood pressure. As one in four Americans continue to suffer from the epidemic of high blood pressure, it is imperative for us to effectively avoid and reduce this highly preventable disease associated with heart attack and stroke, aneurysms, cognitive decline, and kidney failure. Fortunately, there are ways to bring down blood pressure without the use of medication.
Johns Hopkins researchers have identified the genes responsible for aortic ballooning and the sequence of events leading to aortic aneurysms. Dr. Hal Dietz currently conducts clinical trials of therapies for people with inherited aortic aneurysms to improve health and quality of life for these patients.Learn more about Dr. Deitz and his aortic ballooning therapies.

Exercise is the soulmate to eating right. You’re more likely to lose weight if you exercise and follow a healthy diet. Official recommendations call for at least half an hour of exercise most days of the week. The effects can be dramatic: Blood pressure drops of 4 to 9 points. Remember that exercise isn’t just going to the gym. It can be gardening, washing your car, or housework. But things that get your heart rate up -- aerobic activities -- like walking, dancing, jogging, riding your bike, and swimming are best for your heart.
High blood pressure—hypertension—plays a role in more than 15 percent of deaths in the United States, and people are increasingly seeking methods to lower their blood pressure naturally and quickly. Having this chronic disease increases the risk of developing heart attacks and even strokes: some of the most common reasons for sudden death today. Poorly managed high blood pressure may also lead to aneurysms, cognitive decline, and kidney failure. The American Heart Association estimates that 28 percent of Americans have high blood pressure and don’t even know it.
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.
Blood pressure fluctuates throughout the day, so measuring it in the morning might yield a different number than, say, the afternoon. Conditions like stress and lack of sleep can also fluctuate blood pressure. Visiting your doctor might feel nerve-wracking, which can elevate your blood pressure and create a condition called white coat hypertension.
A study, done in December of 2009, was published in the Indian Journal of Biochemistry & Biophysics. They gave a group of participants 1 teaspoon of cardamom powder daily for several weeks. The results showed a significant reduction in blood pressure. Combined with ginger and cinnamon, both warming spices that improve circulation, you can make a lovely tea to help your heart get healthy.

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.


Explore the articles below to learn more about blood pressure control and healthy living, and to start developing your own personal guide to lowering blood pressure. Even better, book a health vacation at Pritikin, recently described by The New York Times as the “granddaddy of health-based wellness spas.” Make a personal investment in what matters most – a longer life, a better life.
One of the most important lifestyle changes to adapt when hypertension affects a patient is a more active daily routine. Exercise is reported to be an exceptionally useful method for controlling blood pressure levels and for reducing blood pressure in patients diagnosed with hypertension. Additionally, patients who regularly participate in physical activities are also at a lower risk of developing a complication or complications due to high blood pressure.
Developed thousands of years ago in India, Ayurveda is the sister philosophy of yoga, the medication form of it. The therapies and treatments work after the identification of an individual’s Dosha- Vata, Pitta, and Kapha. Dosha imbalance is the foremost reason for any health issues and hypertension is the result of the imbalance of the two doshas- Vata and Pitta.
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.
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.

Scientists have long debated the effects of caffeine on blood pressure. But an analysis of 34 studies seems to have delivered a verdict. On average, consuming 200 to 300 mg caffeine (the amount found in one or two cups of coffee) raises systolic blood pressure by 8 mmHg and diastolic blood pressure by 6 mmHg. And the effects can last for up to three hours. (For reference, 8 ounces of drip coffee contain 100-125 mg of caffeine; the same amount of tea, 50 mg; an equal quantity of cola, about 40 mg.)
A diet that’s low in fat and carbohydrates can improve artery function, according to a 2012 study by Johns Hopkins researchers. After six months, those on the low-carb diet had lost more weight, and at a faster pace. But in both groups, when weight was lost—and especially when belly fat shrank—the arteries were able to expand better, allowing blood to travel more freely. The study shows that you don’t have to cut out all dietary fat to shrink belly fat. For heart health, simply losing weight and exercising seems to be key. 
People with high blood pressure who drank about eight ounces of beetroot juice experienced a decrease in blood pressure of about 10 mm Hg, according to a study published in April 2013 in the American Heart Association journal Hypertension. The magic ingredient? Nitrate, which turns into nitric oxide, a gas that widens blood vessels and aids blood flow. A glass a day could help keep blood pressure at a lower, healthier level. Here are 31 things you can do right now to avoid high blood pressure.
There are more worrisome facts about medications, notes Dr. Fruge.  Drug treatment frequently has annoying and sometimes dangerous side effects, and never cures the disease.  All too often, blood pressure problems grow progressively worse despite the use of medications.  That’s deeply troubling because hypertension is a major risk factor for heart attacks, strokes, heart failure, cardiac arrhythmia, and premature death.

Fish are a great source of lean protein. Fatty fish like mackerel and salmon are high in omega-3 fatty acids, which can lower blood pressure, reduce inflammation, and lower triglycerides. In addition to these fish sources, trout contains vitamin D. Foods rarely contain vitamin D, and this hormone-like vitamin has properties that can lower blood pressure.
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.
Scientists have long debated the effects of caffeine on blood pressure. But an analysis of 34 studies seems to have delivered a verdict. On average, consuming 200 to 300 mg caffeine (the amount found in one or two cups of coffee) raises systolic blood pressure by 8 mmHg and diastolic blood pressure by 6 mmHg. And the effects can last for up to three hours. (For reference, 8 ounces of drip coffee contain 100-125 mg of caffeine; the same amount of tea, 50 mg; an equal quantity of cola, about 40 mg.)

A long-term study concluded in 2014 found that people who ate more protein had a lower risk of high blood pressure. For those who ate an average of 100 grams of protein per day, there was a 40 percent lower risk of having high blood pressure than those on a low-protein diet (33). Those who also added regular fiber into their diet saw up to a 60 percent reduction of risk.
The American Heart Association considers 120/80 to be a normal blood pressure reading. Unless you have been diagnosed with high blood pressure you may not realize anything is wrong so it is important to get tested each time you see your doctor, or more frequently if you have a family history of hypertension. Often, hypertension has no obvious symptoms, but it could be quietly causing damage and threatening your health. This condition overworks the heart and damages the walls of the blood vessels. If left untreated, it can lead to tears, ruptures, or increased plaque build-up in your heart, which increases your risk for heart failure, heart attack or stroke.
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.
4) Raw cacao. Rich in flavonoids and other anti-inflammatory nutrients, raw cacao is another food-based weapon against hypertension that you will want to keep readily stocked in your health arsenal. Not only do the flavonoids in cacao function as adaptogens to help the body better deal with stress, which is a common cause of hypertension, but they also help regulate stress hormone levels throughout the body, which play a critical role in blood pressure regulation.
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

Taking a few moments to concentrate on breathing deeply can be a great help. Meditation and yoga are other great activities to reduce stress. We recommend Yoga Burn, by Zoe Bray Cotton for an amazing at-home yoga workout.  In the long term, creating a routine that including one or more of these stress reduction techniques will be important to keep your blood pressure down in normal levels. [2]

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.


Flavanols an anti-inflammatory and heart-protective antioxidant found in raw cacao may protect against cardiovascular disease, reduce the risk of stroke, and help improve blood circulation. Thus lowering your blood pressure. Cacao contains over 700 compounds and the complex antioxidants found in it known as polyphenols help reduce ‘bad cholesterol’ and prevent hardening of the arteries.
Bananas are one great source of potassium, but there are other tasty ways to get your fill. Potatoes actually pack more potassium than the yellow fruit (and you might be surprised to learn there are plenty of other health benefits of potatoes, too). Sweet potatoes, tomatoes, orange juice, kidney beans, peas, cantaloupe, honeydew, and dried fruits like prunes or raisins are other good sources. In all, you should aim to get 2,000 to 4,000 mg of potassium a day, Van Horn recommends.

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.
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.
Your circulatory system is very much like the hot tub’s. Your blood is like the water. Your heart is like the pump, and your blood vessels are like the pipes. Your heart pumps your blood through the circulatory system in order to feed oxygen and nutrients to cells throughout your body, and to remove waste products. By circulating through the system, your blood is filtered and re-utilized, again and again.
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

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. 
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.
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.
This cruciferous veggie is a good source of the blood pressure-regulating minerals magnesium, calcium, and potassium. In fact, high amounts of those three minerals is a telltale sign of many foods to lower blood pressure. Previous research in animals has found that a diet high in broccoli sprouts may help reduce blood pressure, cardiovascular disease, and stroke. Broccoli sprouts are high in compounds that may help reduce damage to arteries, which may play a role in high blood pressure. 

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.
While medication can lower blood pressure, it may cause side effects such as leg cramps, dizziness, and insomnia. The good news is that most people can bring their numbers down naturally without drugs. “Lifestyle changes are an important part of prevention and treatment of high blood pressure,” says Brandie D. Williams, MD, FACC, a cardiologist at Texas Health Stephenville and Texas Health Physicians Group.
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.
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