Why it matters even if you feel fine
High blood pressure (hypertension) usually causes no symptoms, which is why it is called a silent condition. Over years it strains the arteries, heart, kidneys and brain, and it is one of the leading causes of heart attacks and strokes worldwide.
The encouraging part is that it responds well to everyday changes. The 2025 blood pressure guideline from the American Heart Association (AHA) and the American College of Cardiology (ACC) puts lifestyle change first for most people with mildly raised readings.
What the numbers mean
A reading has two numbers: systolic (the pressure when your heart beats) over diastolic (the pressure between beats), measured in mm Hg.
| Category (AHA/ACC) | Systolic | Diastolic | |
|---|---|---|---|
| Normal | Under 120 | and | Under 80 |
| Elevated | 120–129 | and | Under 80 |
| High blood pressure, stage 1 | 130–139 | or | 80–89 |
| High blood pressure, stage 2 | 140 or higher | or | 90 or higher |
Guidelines in some countries, including the UK and much of Europe, set the threshold for hypertension at 140/90 for clinic readings. If you are unsure which applies to you, ask your doctor.
A reading above 180/120 with symptoms such as chest pain, shortness of breath, severe headache, weakness or problems with vision or speech is a medical emergency. Seek help immediately.
The changes with the strongest evidence
1. Cut down on salt (sodium)
This is often the single most effective dietary change. The AHA/ACC guideline recommends keeping sodium below 2,300 mg a day, about one teaspoon of salt, with an ideal of 1,500 mg for most adults with high blood pressure.
Most salt is already in the food before you add any. The biggest sources are bread, processed meats, instant noodles, packaged snacks, pickles and chutneys, sauces and stock cubes, and restaurant and fast food.
Practical steps:
- Read labels and choose lower-sodium versions.
- Cook more at home, and flavour with herbs, spices, lemon and garlic.
- Taste before adding salt at the table.
2. Follow a DASH-style eating pattern
The DASH diet (Dietary Approaches to Stop Hypertension) emphasises:
- Plenty of vegetables, fruit and whole grains
- Low-fat dairy, beans, lentils, nuts and seeds
- Fish and poultry in place of red and processed meat
- Less sugar, sweetened drinks and saturated fat
It works partly by increasing potassium, which helps balance the effect of sodium. Potassium-rich foods include bananas, potatoes, spinach, beans, lentils, yoghurt and tomatoes. People with kidney disease should check with their doctor before increasing potassium.
3. Lose weight if you are carrying extra
Even modest weight loss lowers blood pressure in many people. Losing 5% of body weight, around 4 kg for someone weighing 80 kg, can make a measurable difference.
4. Move more
Aim for at least 150 minutes a week of moderate activity, such as brisk walking, cycling or swimming. That works out at 30 minutes on five days. Strength exercises on two days a week also help. Regular walking is one of the easiest places to start.
5. Limit alcohol
Drinking less lowers blood pressure, and current guidance is that less is better for heart health. If you do not drink, there is no health reason to start.
6. Sleep well and manage stress
Short or poor sleep is linked to higher blood pressure, and untreated sleep apnoea is a common, overlooked cause. Aim for 7 to 9 hours. If you snore loudly and wake unrefreshed, talk to a doctor. Our sleep guide covers practical habits.
7. Stop smoking
Smoking raises blood pressure temporarily and damages blood vessels long term. Stopping is one of the best things you can do for your heart.
Measure it properly at home
A home blood pressure monitor helps you and your doctor see real patterns.
- Use a validated upper-arm monitor with the right cuff size.
- Sit quietly for 5 minutes first, with your back supported, feet flat and arm resting at heart level.
- Avoid caffeine, exercise and smoking for 30 minutes before.
- Take two readings a minute apart, morning and evening, for a week, and write them down.
When to see a doctor
- Your readings are repeatedly at or above 130/80 (or the threshold your doctor uses).
- You have diabetes, kidney disease or heart disease.
- Lifestyle changes have not brought your numbers down after a few months.
Medication is not a failure. For many people it is the safest way to reach a healthy level, alongside the changes above.
This article is general information, not medical advice. Always follow the guidance of your doctor, and never stop or change prescribed medication without speaking to them.