How to lower systolic blood pressure (2023)

Both systolic and diastolic measurements are important when examining the health of your heart. A high systolic reading is the most common form of high blood pressure, especially in older people, due to hardening of the arteries over time.

Isolated Systolic Hypertension

Isolated systolic hypertension is any blood pressure in which the systolic blood pressure is elevated while the diastolic blood pressure is normal. Generally, when health professionals use this term, they are referring to situations where the systolic pressure is significantly higher than normal.

This condition is much more common in the elderly due to the hardening of the arteries that occurs with age. However, isolated systolic hypertension can occur in younger adults and, when it does, is associated with an increased risk of heart disease later in life.

Studies have shown that treating high levels of systolic blood pressure consistently reduces the risk of complications, regardless of how high the diastolic reading is.However, this can be a particularly challenging situation in older adults who experience more side effects from blood pressure medications.

In addition, diastolic pressure is important because coronary arteries fill during diastole, and diastolic pressure less than 60 mm Hg increases the risk of cardiac events.Therefore, people with isolated systolic hypertension whose diastolic pressure is normal may have problems if blood pressure medications lower diastolic pressure too much.

People with high systolic blood pressure may benefit from lowering their blood pressure, including lifestyle changes and medications.

Reasons

High systolic blood pressure can have many causes. As we age, our arteries harden and over time this contributes to an increase in blood pressure. The genes we inherit may also play a role. Certain underlying conditions such as thyroid disease, excess cortisol, and obesity can also cause high blood pressure.

How to lower systolic blood pressure

There are many steps you can take to lower your blood pressure, including lifestyle changes and medications.

Medicines canreduction in systolic blood pressure over a few hours to days. Lifestyle changes, such as exercise and a healthy diet, may take several weeks to make a difference.

Diet to lower blood pressure

The most powerful lifestyle change to lower blood pressure is implementing a healthy diet. Making changes to your diet can lower your systolic blood pressure by up to 11 points.

American Heart Association (AHA) recommendation aDASH Diet (Dietary Approaches to Stop Hypertension)to help lower blood pressure. The DASH diet is low in salt, added sugars, and red and processed meats.

Some additional dietary guidelines include:

• Focus on eating colorful fruits and vegetables, as their high potassium content can help lower blood pressure.
• Choose whole grains whenever possible and limit white flours, such as those found in white bread and pasta.
• Avoid sugary drinks like juices and soft drinks and watch out for salt in processed and canned foods.
• Limit your intake of saturated fat by choosing lean meats such as skinless chicken and turkey.
• Choose low-fat or fat-free dairy.

Excercise

Exercise can help lower systolic blood pressure by 5 to 8 points.

The AHA recommends that all adults get at least 150 minutes of moderate aerobic exercise each week.Aerobic exercise is exercise that increases the heart rate, such as walking, cycling, dancing and water aerobics.

Alcohol limit

Excessive alcohol consumption can contribute to high systolic blood pressure. Limiting alcohol intake can lower systolic blood pressure by up to 4 points.

Alcohol should be limited to no more than two standard drinks per day for men and no more than one drink per day for women. A standard drink is 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of liquor.

stop smoking

Although it is not so clear that quitting smoking directly lowers systolic blood pressure, it will certainly reduce the risk of certain complications of high blood pressure.

The nicotine in cigarettes causes the arteries to constrict, resulting in a temporary increase in blood pressure. Smoking also causes fatty plaque to build up in the arteries, which can lead to strokes and heart attacks.

Caffeine limit

Although chronic caffeine use has not been shown to contribute to high blood pressure, caffeine does cause a temporary increase in blood pressure. This is because caffeine is a vasoconstrictor, which causes blood vessels to narrow.

In people with high blood pressure, caffeine should be limited to no more than 300 milligrams per day.For reference, a 12-ounce "tall" cup of Starbucks coffee contains 235 milligrams of caffeine.

reduce stress

Stress is known to contribute to high blood pressure, and managing stress is an important part of a healthy lifestyle. Both short-term stressors, such as losing your job, and chronic stressors, such as relationship problems, can contribute to high blood pressure.

Although not yet definitively linked to lowering blood pressure, practices such as yoga, meditation, psychotherapy, and breathing exercises can help combat stress that can contribute to high blood pressure.

Getting a good night's sleep can also help relieve stress. Poor sleep quality or lack of sleep can increase stress hormone levels, which can increase blood pressure.

Take antihypertensive medication

The above lifestyle changes can be helpful for anyone with high blood pressure, including those with isolated systolic blood pressure. But people with persistently high systolic blood pressure may need blood pressure-lowering drugs (antihypertensive drugs) to help lower their blood pressure to healthy levels.

Many different classes of drugs may be prescribed by your doctor to lower your systolic blood pressure and reduce your risk of heart disease and stroke.

Some of the most commonly prescribed medications that are effective in lowering blood pressure include:

• diuretics, such as Hygroton (chlorthalidone) and Microzide (hydrochlorothiazide)
• ACE inhibitorsand angiotensin receptor blockers such as Zestril (lisinopril) and Diovan (valsartan)
• Calcium channel blockers, such as Norvasc (amlodipine) and Adalat CC (nifedipine)
• beta blockers, such as Coreg (carvedilol) and Trandate (labetalol)

Blood pressure-lowering medications can pose challenges in older adults with isolated systolic hypertension due to side effects.

orthostatic hypotension, low blood pressure when standing, can cause dizziness and is a more common side effect in older people treated for high blood pressure. It can lead to increased falls and hip fractures, which are thought to be more common in older adults who use blood pressure medications compared to those who do not use blood pressure medications.

The choice of blood pressure medication is important in the elderly with systolic hypertension. However, there does not appear to be any benefit of one drug class over another when only one drug is needed, with the exception of β-blockers.Beta-blockers are not recommended as first-line therapy unless there is another compelling reason, such as coexisting heart failure.

The combination ofACE inhibitorwith a calcium channel blocker has been shown to provide better results than combining an ACE inhibitor with a diuretic. For this reason, many healthcare professionals prefer to first prescribe a long-acting calcium channel blocker, such as Norvasc, to older adults with high blood pressure and add an ACE inhibitor if needed for additional blood pressure control.

Another important part of treating systolic hypertension in older adults is starting new medications at lower doses and increasing the doses more slowly. This is because the elderly have slower metabolism and clearance of the drug and therefore more side effects.

Avoid certain medications and supplements if you have high blood pressure

Avoiding substances that can raise blood pressure is just as important as making lifestyle changes and taking blood pressure medications.

Here is a list of substances to avoid if you have high blood pressure:

• Over-the-counter "decongestant" cold medicines that contain pseudoephedrine or phenylephrine, such as Sudafed
• Chronic use of NSAIDs (nonsteroidal anti-inflammatory drugs) such as Motrin (ibuprofen), Advil (ibuprofen), and Aleve (naproxen)
• black licorice
• Cocaine

Blood pressure monitoring at home

The AHA recommends home monitoring for everyone with high blood pressure. This is to help healthcare professionals determine whether treatments are working.

It is best to use cuff devices instead of wrist devices as they provide more reliable readings. Be sure to read the instructions carefully before use.

When measuring your blood pressure, it is important to:

• Sit quietly for a few minutes before taking a measurement.
• Measure on the skin, not on the clothes
• Avoid taking measurements immediately after eating, smoking or exercising
• Sit in the correct position (feet on the floor with legs uncrossed)
• Stay still while reading
• Take several measurements and record the results.
• Count at the same time every day

When to consult a health care professional

High blood pressure is a serious condition that can lead to stroke, heart attack and even death if left untreated. Although there are many things you can do at home to lower your systolic blood pressure, it's important to follow all of your doctor's treatment recommendations.

If you experience a severe headache, blurred vision, drooping on one side of your face, weakness on one side of your body, chest pain, or other alarming symptoms, seek medical help immediately.

Summary

High systolic blood pressure is a very common condition that can increase your risk of serious health problems, such as stroke and heart attack. Finding out you have high systolic blood pressure can be stressful, but it's also an opportunity to make some healthy changes that can have a significant impact on your overall health.

Dietary changes, exercise, drug use, and starting blood pressure medication can all help. Talk to your doctor about starting a treatment plan.