Discharge instructions for high blood pressure (hypertension)

You have been diagnosed with high blood pressure. This is known as hypertension. It means the force of blood against your artery walls is too strong. Your heart is working too hard to move blood. High blood pressure usually has no symptoms. But over time, it can cause serious health problems. High blood pressure raises your risk for these problems:

• Heart attack

• Stroke

• Heart disease

• Heart failure

• Kidney disease

• Vision loss

With help from your healthcare provider, you can manage your blood pressure and protect your health.

Blood pressure measurements are given as 2 numbers.

Systolic blood pressure is the upper number. This is the pressure when the heart contracts or pumps.

Diastolic blood pressure is the lower number. This is the pressure when the heart relaxes between beats.

Blood pressure is grouped like this:

• Normal blood pressure. Systolic is less than 120 and diastolic is less than 80 at rest.

• Elevated blood pressure. Systolic is 120 to 129 and diastolic is less than 80 at rest.

• Stage 1 high blood pressure. Systolic is 130 to 139 or diastolic is between 80 to 89 at rest.

• Stage 2 high blood pressure. Systolic is 140 or higher or diastolic is 90 or higher at rest.

Taking medicine

• Learn to measure your own blood pressure. Keep a record of your results. Ask your healthcare provider which numbers mean you need medical care.

• Take your blood pressure medicine exactly as directed. Don’t skip doses. Missing doses can cause your blood pressure to get out of control.

• Ask your healthcare provider what to do if you miss a dose.

• Don't take medicines that contain heart stimulants. This includes over-the-counter medicines. Check for warnings about high blood pressure on the label. Ask the pharmacist before buying a medicine you haven't used before.

• Check with your healthcare provider before taking a decongestant. This includes medicines with pseudoephedrine or phenylephrine on the label. Ask the pharmacist if you are not sure. These can make high blood pressure worse.

• If you take medicine to have sex, talk to your healthcare provider. Taking these medicines with a type of blood pressure medicine called nitrates can be dangerous. Your blood pressure can drop too low.

Lifestyle changes

• Keep a healthy weight. Get help to lose any extra pounds. Meeting with a dietitian can help you make diet changes to help with weight loss.

• Cut back on salt. To do this:

  • Limit canned, dried, packaged, and fast foods.

  • Don’t add salt to your food at the table.

  • Season foods with herbs instead of salt when you cook.

  • Ask for no added salt when you eat out.

  • Have no more than 1,500 mg a day of sodium. You can make a positive change by cutting back to even 2,300 mg of sodium a day. Read all food labels to see how much sodium they have. 

• Follow the DASH eating plan. DASH stands for Dietary Approaches to Stop Hypertension. This plan advises a way to eat for healthy blood pressure. The diet includes vegetables, fruits, whole grains, and other healthy foods.

• Begin an exercise program. Talk with your healthcare provider before you get started. Work up to at least 150 minutes of moderate-intensity physical activity each week. It doesn't have to be done all at once. You can do 30-minute sessions, 5 days a week. This can help lower blood pressure. Even simple activities can help blood pressure. These include walking or gardening.

• If you smoke, work to stop. Enroll in a stop-smoking program. This will improve your chance of success. Ask your healthcare provider about programs and medicines to help you stop smoking.

• Never take stimulants such as amphetamines or cocaine. These drugs can be deadly for a person with high blood pressure.

• Work to lessen your stress. You can learn ways to manage stress.

• Get enough quality sleep. Most adults need 7 to 9 hours of sleep per day.

• Don't drink alcohol or limit how much you drink. This means no more than 1 drink a day for women and 2 drinks a day for men.

Follow-up care

Make a follow-up appointment as directed.

When to call your healthcare provider

Call your healthcare provider right away if you have any of these:

• Moderate headache

• Extreme drowsiness

• Pulsating or rushing sound in your ears

• Unexplained nosebleed

• Blood pressure measured at home that is 180/120 or higher without any other symptoms of target organ damage, or as directed by your healthcare provider.

Call 911

Call 911 right away if you have any of these symptoms:

• Blood pressure measured at home that is higher than 180/120 and you are having other symptoms of target organ damage, such as those listed below, or as directed by your healthcare provider.

• Chest pain or shortness of breath

• Severe headache

• Severe back pain

• Weakness, tingling, or numbness of your face, arms, or legs (especially on 1 side of the body)

• Change in vision

• Confusion, trouble speaking, or trouble understanding speech

• Dizziness or fainting