High Blood Pressure Fact Sheet

Toolkit for Implementing the Chronic Care Model in an Academic Environment

Summa Health System developed this fact sheet for patients with high blood pressure. Care providers give it to patients during diabetes planned visits, and it is part of the Diabetes Planned Visit Notebook.
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High Blood Pressure—What You and Your Family Should Know

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High Blood Pressure

Blood pressure is the pressure needed to circulate blood through the body. When too much of this force is pressing against the artery walls, it is called high blood pressure.

The only way to tell if you have high blood pressure is to have it measured with a blood pressure cuff. You can look and feel terrific and still have high blood pressure.

No one knows for sure why some people have high blood pressure. But one out of four adults in the United States has it.

Don't Let High Pressure Fool You

You can be a calm, relaxed person and still have high blood pressure. Hypertension is the medical term for high blood pressure; it does not refer to being nervous or upset or having an emotional condition. Follow your treatment plan daily even when you feel great.

How to Control High Blood Pressure

Most high blood pressure cannot be cured, but it can be controlled with lifestyle changes and medications. Controlling blood pressure can help prevent a heart attack, stroke, or kidney failure. Daily treatment usually must be continued for life in order to get your blood pressure down and keep it down.

Pills Are Just Part of the Treatment

If your doctor has prescribed medication, you must take it daily to lower your blood pressure. Make efforts to lose weight (those extra few pounds may raise your blood pressure). Cut back on salt, and your pressure may fall or help the medication work more effectively. Exercise in moderation may also help you control your blood pressure.

Blood Pressure Categories for Adults Age 18 and Older*

CategorySystolic (mm Hg)Diastolic (mm Hg)
NormalUnder 120Under 80
Pre-hypertensionBetween 120-13980-89
High Blood Pressure  
Stage 1140-15990-99
Stage 2160 or higher100 or higher

*For those not taking medicine for high blood pressure and not having a short-term serious illness.

Know Your Blood Pressure Treatment Goal

GroupSystolicDiastolic
Most peopleUnder 140Under 90
People with Diabetes or Kidney problemsUnder 130Under 80

Some Things to Remember

  1. High blood pressure cannot be cured.
  2. Treatment for high blood pressure includes lifestyle changes like:
    • Using less salt in the foods you eat.
    • Losing weight.
    • Stopping smoking.
    • Exercising more.
    • Using less alcohol (one drink per day).
  3. Treatment may require medication.
  4. If prescribed, take your high blood pressure pills every day.
  5. Tell your family and friends about your high blood pressure.
  6. Know you blood pressure treatment goal

Once you have high blood pressure, you will probably need to be under a doctors care. If you treat it, it can be kept under control. You can be healthy, live a full life, and continue your normal activities even though you are following treatment.

From the Family Practice Center of Akron, Summa Health System. Adapted from National High Blood Pressure Education Program; National Heart, Lung, and Blood Institute; National Institutes of Health; Public Health Service; U.S. Department of Health and Human Services, NIH Publication No. 88-2025, September 1988.

Help Control Blood Pressure With Life Style Changes

Lifestyle changes that can help control blood pressure or reduce the amount of medication that you need to take. Lifestyle changes that lower blood pressure include weight loss, exercise, decreasing salt use and limiting alcohol.

Weight Loss

Losing just a small amount of weight can help lower your blood pressure. By losing excess weight, you will not only help to reduce your blood pressure but also feel better, be more able to exercise, and reduce your chance of having a heart attack.

Don't try to see how fast you can lose weight. Its best to do it slowly. "Fad" diets do not work over the long haul because they cannot be followed for life, and people regain the weight.

Try to lose about ½ to 1 pound a week. This isn't as hard as it sounds. One pound equals 3,500 calories—or 7 times 500. So if you cut 500 calories a day by eating less and being more active, you should lose about 1 pound in a week. For example, in one day if you replace a chocolate candy bar at lunch with a small apple, have a piece of baked chicken instead of fried chicken at dinner, and then take a 15-minute brisk walk after lunch and dinner instead of lingering at the table, you can cut your calories by 500. Making these kind of changes every day will help you to lose about a pound a week.

Steps to help you lose weight:

  1. Eat fewer calories by choosing low calorie and low fat foods

    Low-calorie foods are great for losing weight. But you may not know that healthy low-fat foods can also be low in calories. Fat, no matter what kind it is, saturated or unsaturated, is a concentrated source of calories. So if you replace fatty foods with less fatty foods, but keep the same portion sizes, you'll eat fewer calories. For example, save calories by eating baked fish instead of fried fish or low-fat yogurt instead of ice cream

    Fats, especially "saturated fats", play a role in raising the cholesterol in your bloodstream. A high blood cholesterol level is a risk factor that increases your chance of developing heart disease.

    Fatty foods to cut down on include: butter and margarine, fatty meats, whole-milk dairy foods (such as cheese), fried foods, and many sweets and snacks. Try some of the enjoyable low-fat alternatives for fatty foods.

    Foods low in fat also include those high in starch and fiber. These foods also are good sources of vitamins and minerals. Examples of some foods high in starch and/or fiber include pasta, whole grain cereals and breads, vegetables and fruits. Try to replace foods higher in fat with these kinds of items.

  2. Limit Your Serving Size

    To reduce your daily calorie intake, you'll need to watch how much you eat, not just what. This means cutting down on portion sizes.

    Try to take only mid-sized helpings of foods high in starch and fiber, and only small helpings of fatty foods, such as cheese and high-fat meats. And don't go back for seconds.

Exercise

Be physically active. Regular activity does more than help you lose weight: It makes you feel and look better, helps lower high blood pressure, and can reduce your risk of having a heart attack.

You don't have to run marathons to benefit from physical activity. Any activity, if done at least 30 minutes a day over the course of most days, can help.

Certain forms of activity are best for conditioning your heart and lungs. Called "aerobic", they cause the body to use oxygen more efficiently. Examples include brisk walking, swimming, bicycling, and running. The activity should be done for at least 30 minutes, three or four times a week.

Whatever the activity, if you don't have 30 minutes, try two 15-minute periods or even three 10-minute sessions. But do something!

Start slowly, if necessary, and work up to a comfortable pace and schedule. You may want to start doing an activity only twice a week. Then build up to three or four times a week. The key is to begin and stay with it.

Limit Alcohol

Limit your alcohol intake. Alcohol can harm the liver, brain, and heart. Two or more drinks of alcohol per day can raise blood pressure. It is possible for people with high blood pressure to have an occasional drink. If you drink, limit your daily alcohol intake to no more than two drinks a day.

Use Less Salt

Sodium is a part of salt. It also is a part of mixtures used to flavor and preserve foods. You can make a few simple changes to help you and your family eat less salt and sodium.

When you Shop

  • Buy fruits and vegetables for snacks instead of salty chips and salty crackers.
  • Read food labels. Buy foods that say "reduced sodium", "low in sodium", "sodium free" or "no salt added".
  • Choose fewer regular canned and processed foods like sausage, bologna, pepperoni, salami, ham, canned or dried soups, pickles, and olives.

When You Cook

  • Each day cut back a little on the amount of salt you add to foods. You will soon get used to eating less salt.
  • Use spices instead of salt. Season your food with herbs and spices such as pepper, cumin, mint, or cilantro.
  • Use garlic powder and onion powder instead of garlic salt and onion salt.
  • Use less bouillon cubes, soy sauce, and ketchup.

When You are at the Table

  • Take the salt shaker off the table.

Prescription for a Healthy Heart

Ways to Increase Exercise

Take a walk
Use the stairs
Work in the yard or garden
Ride a bike
Park further away from the store or office
Get off the bus one or two stops early and walk the rest of the way
Go dancing
Go bowling
Carry your own groceries

Ways to Use Less Salt

Try these spices instead of salt to season food

For beef... Try bay leaf, garlic, marjoram, basil, pepper, thyme, cilantro.
For chicken... Try marjoram, oregano, rosemary, sage, tarragon.
For fish... Try curry powder, dill, parsley.

Limit Alcohol to Two or Less Drinks Daily

One Drink of Alcohol Means
1 ½ ounces of 80-proof or 1 ounce of 100-proof whiskey, or
5 ounces of wine, or
12 ounces of beer (regular or light)

Choose Low Fat Foods

Baked, broiled, or poached:
  Chicken and turkey (without the skin)
  Fish
Lean cuts of meat (like round or sirloin)
Skim or 1% milk, evaporated skimmed milk
Lower-fat, low-sodium cheeses
Low-fat yogurt, ice milk
Fresh, frozen, or canned fruit
Fresh, frozen, or no salt added canned vegetables (without cream or cheese sauces)
Plain rice and pasta
Fruits
Whole-grain cereals
Vegetables
Pasta and rice
Whole-grain bread
Dry peas and beans
I recommend these things to improve your health:
___Take the salt shaker off the table
___Limit alcohol to 1 drink or less each day
___Season foods with spices instead of salt
___Eat more fruits and vegetables
___Limit fast food meals
___Get off the bus 1 or 2 stops early and walk the rest of the way
___Walk each day
___Use the stairs
___Stop smoking
___Decrease portion size
___Choose low fat foods
 

Physician Signature: _________________________________________________________

From the Family Practice Center of Akron, Summa Health System. Adapted from National High Blood Pressure Education Program; National Heart, Lung, and Blood Institute; National Institutes of Health; Public Health Service; U.S. Department of Health and Human Services, NIH Publication No. 88-2025, September 1988.

No Added Salt Diet

Reduced sodium (salt) is suggested for those with certain medical conditions:

  • Limit prepared foods such as packaged casserole or stuffing mixes, frozen dinners, and canned soups and stews.
  • Select meals with less than 800 milligrams (mg) of sodium per serving, such as frozen entrees.
  • Do not use the salt shaker. use salt sparingly in cooking, if at all.
  • Use the following guidelines to plan your food choices.
Food GroupGood Low-Sodium ChoicesAvoid
DairyMilk, yogurt, regular cheese, ricotta, and cream cheese (2 oz daily); low-sodium cheese as desiredBlue cheese, cheese spreads, processed cheese, Romano, Parmesan
Meat or SubstituteFresh or frozen beef, chicken, lamb, veal, pork, turkey, fish, or shellfish; dried beans, peas, eggs, unsalted peanut butter, low-sodium water packed tuna; kosher poultrySmoked, dried, or cured meat such as ham, bacon, sausage, cold cuts, hot dogs, corned beef, kosher meats; fish such as anchovies, sardines, salted cod, smoked herring
Fruits and VegetablesFresh, dried, frozen, or canned fruit and juices; fresh or frozen vegetables; low-sodium canned vegetables; low-sodium tomato or vegetable juiceRegular tomato or vegetable juice, sauerkraut, pickled beets, "boil in bag" vegetables, sauce-covered vegetables, regular canned vegetables
SoupsHomemade or low-sodium soups or stew, low-sodium bouillon or broth, low-sodium canned soupsCanned, frozen, dried or condensed soups, bouillon, or broth
Potatoes and Potato substitutesWhite or sweet potatoes; squash; enriched rice, barley, noodles, spaghetti, macaroni, and other pastas; homemade bread stuffingCommercially prepared potato, rice, or pasta mixes; commercial bread stuffing
Breads and CerealsEnriched white, wheat, rye, and pumpernickel breads and rolls; biscuits, muffins, cornbread, pancakes, waffles, and most dry cereals and cold cereals; unsalted crackers and bread sticksBreads, rolls, and crackers with salted tops; instant hot cereals; instant potato and rice mixes
Seasonings, Sauces, CondimentsMayonnaise, catsup, salad dressings (in limited amounts), mustard, hot pepper sauce, herbs and spices such as bay leaf, fresh garlic, lemon, parsley, pepper, onion or garlic powder, oregano, rosemary, sage, thyme, vinegarMiso, monosodium glutamate (MSG), meat tenderizers, olives, packaged or canned sauces, or gravies, pickles, soy sauce, steak sauce, tamari
SnacksUnsalted nuts, unsalted popcorn, and other unsalted snack food itemsSalted potato chips, salted pretzels, salted nuts, corn curls, salted popcorn, and other salted snacks
  • Dining out: Order individually prepared food items and ask for no salt, etc., in the preparation. (Check table above for condiments to avoid).
  • Air travel: Request low-sodium (low-salt) meals when reserving your flight.
  • Medications: Avoid medications that are high in sodium such as Alka Seltzer, Brioschi, Bromo Seltzer, and Rolaids. Discuss a low-sodium alternative medication with your health care provider.

Sodium in Foods

Type of FoodSodium (mg)Type of FoodSodium (mg)
Meat, Poultry, Fish, & Shellfish Breads, Cereals, Rice, Dry Peas & Beans, Pasta, 

Fresh meat (including lean cuts of beef, pork, lamb & veal), poultry, finfish, cooked, 3 oz.
Shellfish, 3 oz
Tuna, canned, 3 oz
*Sausage, 2 oz.
*Bologna, 2 oz.
*Frankfurter, 1 1/2 oz.
Boiled ham, 2 oz
Lean ham, 3 oz.

Eggs
Egg white, 1
*Whole egg, 1
Egg substitute, 1/4; cup= 1 egg

Dairy Products
Milk
* Whole milk, 1 cup
Skim or 1% milk, 1 cup
Buttermilk (salt added), 1 cup
Cheese
*Natural cheese:
*Swiss Cheese , 1 oz.
*Cheddar cheese, 1 oz
*Blue cheese, 1 oz
Low-fat cheese, 1 oz
*Processed cheese and cheese spreads, 1 oz
Lower-sodium and lower-fat versions
*Cottage cheese (regular), 1/2; cup
Cottage cheese (low-fat), 1/2; cup
Yogurt

*Yogurt, whole milk, plain, 8 oz
Yogurt, fruited or flavored, low-fat or nonfat, 8 oz.
Yogurt, nonfat or low-fat, plain, 8 oz

Vegetables
Fresh or frozen vegetables, or no salt added canned (cooked without salt), 1/2 cup
Vegetables, canned, no sauce,  1/2 cup
*Vegetables, canned or frozen with sauce, 1/2 cup
Tomato juice, canned, 3/4 cup


Less than 90
100-325
300
515
535
560
750
1,025


55
65
80-120


120
125
260


75
175
395
150
340-450
Read the label

455
460
105
120-150
160-175


Less than 70

55-470
Read the label
660

Breads and crackers
Bread, 1 slice
English muffin, 1/2
Bagel, 1/2;
Cracker, saltine type, 5 squares
*Baking powder biscuit, 1
Cereals
Ready-to-eat
Shredded wheat, 3/4 cup
Puffed wheat & rice cereals, 1-1/2 to 1-2/3 cup
Granola-type cereals, 1/2 cup
Ring & nugget cereals, 1 cup
Flaked cereals, 2/3 to 1 cup
Cooked
Cooked cereal (unsalted), 1/2 cup
Instant cooked cereal, 1 packet = 3/4 cup
Pasta and Rice
Cooked rice and pasta, *unsalted), 1/2 cup
*Flavored rice mix, cooked 1/2 cup
Beans and peas

Peanut butter, unsalted, 2 tbsp.
Peanut butter, 2 tbsp.
Dry beans, home cooked, (unsalted), or no salt added canned, 1/2 cup
Dry beans, plain canned, 1/2 cup

*Dry beans, canned in added fat or meat, 1/2 cup

Fruits
Fruits (fresh, frozen, canned), 1/2 cup

Fats and Oils
Oil, 1 tbsp.
*Butter, unsalted, 1 tsp.
*butter, salted, 1 tsp.
Margarine, unsalted, 1 tsp.
Margarine, salted, 1 tsp.
Imitation mayonnaise, 1 tbsp.
*Mayonnaise, 1 tbsp.
Prepared salad dressings, low calorie, 2 tbsp.
*Prepared salad dressings, 2 tbsp.

Snacks
Popcorn, chips and nuts
Unsalted nuts, ¼ cup
Salted nuts, 1/4 cup
*Unsalted potato chips and corn chips, 1 cup
*Salted potato chips and corn chips, 1 cup

Unsalted popcorn, 2 1/2 cups
Salted popcorn, 2 1/2 cups

Candy
Jelly beans, 10 large
*Milk chocolate bar, 1 ounce bar

Frozen Desserts
*Ice Cream, ½ cup
Frozen Yogurt, low-fat or nonfat, 1/2 cup
Ice milk, 1/2 cup

Condiments
Mustard, chili sauce, hot sauce, 1 tsp.
Catsup, steak sauce, 1 tbsp.
Salsa, tartar sauce, 2 tbsp.
Salt, 1/6 tsp.
Pickles, 5 slices
Soy sauce, lower-sodium, 1 tbsp.
Soy sauce, 1 tbsp.

Convenience foods
**Canned and dehydrated soups, 1 cup
**Lower-sodium versions
***Canned and frozen main dishes, 8 oz.
***Lower-sodium versions


110-175
130
190
195
305

Less than 5
Less than 5
5-25
170-310
170-360

Less than 5
180

Less than 10
250-390

Less than 5
150

Less than 5
350-590
425-630

Less than 10


0
1
25
Less than 5
50
75
80
50-310
210-440



 

Less than 5
185
Less than 5
170-285

Less than 10
330


5
25


35-50
40-55
55-60


35-65
100-23-
200-315
390
280-460
600
1,030


600-1,300
Read the label
500-1,570
Read the label

From the Family Practice Center of Akron, Summa Health System. Adapted from National High Blood Pressure Education Program; National Heart, Lung, and Blood Institute; National Institutes of Health; Public Health Service; U.S. Department of Health and Human Services, NIH Publication No. 88-2025, September 1988.

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Page last reviewed January 2008
Internet Citation: High Blood Pressure Fact Sheet: Toolkit for Implementing the Chronic Care Model in an Academic Environment. January 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/education/curriculum-tools/chroniccaremodel/chronic2a12e.html