Stage 2 Hypertension Treatment

stage 2 hypertension treatment

The new 2017 Blood Pressure Guidelines, established 2 high blood pressure categories. The second, more serious one is High Blood Pressure Stage 2, aka Stage 2 Hypertension. By using the words Stage 2, they make it sound serious and it is.

Failure to accept and follow up on your treatment can lead to more severe health issues. The next category on the blood pressure chart is hypertensive crisis. Stage 2 is serious enough, the last thing you want is for your blood pressure to reach the next level.

This blog post will cover all of the treatments a physician is likely to recommend. They are taken directly out of the new Blood Pressure Guidelines (r). In addition, I include tables showing estimates on how much your blood pressure can decrease, from the treatments.

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Disclaimer: Some links in this article are affiliate links which means I may earn a small commission at no extra cost to you. As an Amazon associate I earn from qualifying purchases.

Stage 2 Hypertension Treatments

If you’re diagnosed with Stage 2, your healthcare provider will definitely prescribe lifestyle changes. In addition, they are likely to prescribe medication based on your risk of cardiovascular disease, medical history and blood pressure measurements. The following is lifestyle changes and common medication treatments for Stage 2 Hypertension.

1) Heart Healthy Nutrition

If you were only going to make one change in your lifestyle, what you eat may be the most important. Changing your diet can have an immediate impact on your health and start to lower your blood pressure.

Avoid Saturated Fat

You may have heard these words a hundred times, avoid foods high in saturated fats. But why? For years, research has shown saturated fats can increase your risk of heart disease and raise bad cholesterol (r). In addition, more research has concluded reducing fat intake can lower blood pressure (r). So what foods are high in saturated fat?

  • Butter
  • Cheese
  • Cream
  • Fatty meats like pork, lamb and beef
  • Chicken with the skin

Avoid Trans Fat

Artificial Trans fat has been banned by the United States. Unfortunately, it’s still available in some foods even though it’s banned. Confusing right? If you want the explanation to that one, I explain it here in my blog post, Top Foods That Cause High Blood Pressure.

Trans fat has zero benefits for you. They lower good cholesterol and increase the bad cholesterol. In addition, they cause inflammation and increase insulin resistance. All of this can make high blood pressure worse (r). What are the foods that may still contain this banned substance?

  • Fried fast foods
  • Vegetable shortening
  • Certain microwavable popcorn
  • Some frozen pizzas
  • Some potato chips
  • Certain crackers
  • Bakery items made with vegetable shortening
  • Certain non-dairy creamers
  • Some vegetable oils

Be careful! Even if the food label says zero trans fats, it may still contain some. It’s all explained in my foods article linked above.

Reduce Sodium

I’m sure you’ve heard this a million times. Sodium has a bad reputation, but it’s undeserved. It’s actually good for you, and you should not cut it out 100%. The problem most people have is consuming too much of it. When they eat food high in sodium, it is bad for blood pressure because it makes the body retain fluids (r).

The American Heart Association recommends 1,500 mg a day. Some fast food meals alone has more than that in just one sitting. The following foods are the main culprits:

  • Fast food
  • Take out Chinese food
  • Frozen pizza
  • Canned soup
  • Canned tomatoes and tomato sauce
  • Canned beans
  • Ketchup
  • Processed meats and deli meats
  • Pickles

blood pressure and Keto diet

Reduce Added Sugars

Like artificial trans fat, added sugars have zero value for you. The natural sugar found in fruit are okay and recommended. It’s the added sugars found in the following foods you need to avoid:

  • Some breakfast cereals
  • Bakery items
  • Candy
  • Soda
  • Snacks
  • Desserts
  • Processed foods

Added sugar can increase blood sugar and raise insulin levels. This activates the sympathetic nervous system which increases the heart rate and blood pressure (r). Sugar depletes the cells energy stores, which through a series of events constricts your blood vessels (r). A high sugar diet has been shown in studies to increase blood pressure more than sodium. Reducing added sugar and sodium is crucial for Stage 2 Hypertension treatment.

Consume Potassium Rich Foods

The blood pressure guidelines specifically mention potassium intake from food. Potassium helps to offset the negative affects of sodium. The more potassium you consume, the more your body will get rid of excess sodium. Studies have shown potassium can reduce the risk of cardiovascular disease and stroke (r).

Maintaining the proper potassium to salt ratio is crucial for Stage 2 Hypertension treatment. In addition, potassium can help relax blood vessels and keep them from constricting (r). The following foods are potassium rich foods. The guidelines recommend between 3,500-5000 mg per day. Did you know that bananas don’t even crack the top 10 list?

  1. Avocado
  2. Lima beans
  3. Swiss chard
  4. Acorn squash
  5. Spinach
  6. Sweet potato
  7. Wild Caught Salmon
  8. Dried apricots
  9. Pomegranate
  10. Coconut water

Consume Fruits

A 2 year study and analysis concluded fruit consumption in healthy individuals helped to control blood pressure (r). The DASH Diet recommends 4-5 servings of fruit a day:

  • 1 medium fruit
  • 1/2 cup frozen, fresh or canned fruit
  • 1/4 cup dried fruit
  • 6 ounces of fruit juice (avoid juice with added sugar)

Consume Vegetables

Research has shown consuming vegetables and fruit lowers blood pressure, particularly systolic. Diastolic was improved after eating more than 400 g per day (r). DASH Diet recommends 4-5 servings per day:

  • 1 cup of raw, leafy vegetables like spinach or collard greens
  • 1/2 cup of cooked vegetables
  • 6 ounces of vegetable juice (avoid juice with added sugar)

Consume Lean Protein 

Numerous studies have shown a link between consuming lean protein and lower blood pressure. One study concluded adults who consumed more dietary protein from either animal or plant sources had a lower risk of high blood pressure (r).

  • Lean, organic meat
  • Fish like salmon and cod
  • Skinless chicken

Consume These Other Heart Health Foods

  • Whole grains like brown rice and oatmeal
  • Low-fat or fat free dairy foods
  • Healthy fats and oils
  • Seeds
  • Nuts

The table below shows an estimate of how much you can expect your systolic blood pressure to decrease by following the nutrition guidelines. The 1st estimate is if you have high blood pressure and the 2nd estimate is if you have normal pressure. The estimates are taken from the new Blood Pressure Guidelines (r).

Intervention Treatment HBP Normal
Heart Healthy Diet Fruits, Vegetables, Lean Protein,
Reduced Fats, sodium and sugar,
Grains, low-fat dairy, seeds, nuts, potassium
-20mmHg
Systolic
-7mmHg
Systolic

2) Physical Activity

The next blood pressure guideline that may be used to treat Stage 2 Hypertension is increased physical activity. Numerous studies have shown a relationship between physical activity, physical fitness and lowering blood pressure. Even modest physical activities have been proven to benefit pressure levels.

In a physical fitness study of adults, 18 to 30 years old, their risk of developing high blood pressure 15 years later was 33% less. Additional research tracked men, aged 20-90 years of age, for 3 to 28 years. The researchers concluded higher physical fitness lessened the rise of systolic BP over time and delayed the onset of high blood pressure (r).

That study is extremely important because typically, systolic pressure has been known to rise as men get older. This is due to hardening of the arteries and plaque build-up. The following are 3 types of physical activity and exercises recommended by the guidelines. They each have a suggested amount of time to dedicate to each one.

If you’re interested in checking out some home workout fitness plans, fitness expert Jullian Michaels has routines for any skill level. You can check out her website by clicking right here, My Fitness.

Aerobic

Aerobic exercise is cardiovascular conditioning, more commonly known today as cardio. The following are common aerobic exercises:

  • Jogging
  • Brisk walking
  • Bicycle riding
  • Swimming
  • Stationary bike
  • Elliptical machine
  • Treadmill
  • Zumba
  • Kickboxing
  • Jump rope

The guidelines suggest 90 to 150 minutes per week. That’s an average of about 13 to 21 minutes per day. Aerobic and the next 2 activities are flexible, you don’t have to perform each one every day. As long as you satisfy the requirements by the end of the week, you’ll be fine.

Dynamic Resistance

Dynamic resistance is where you perform an exercise moving your joints against some form of weight resistance. The following are some examples:

  • Push ups
  • Pull ups
  • Squats
  • Crunches
  • Dumbbell or barbell exercises
  • Resistance bands
  • Bodyweight exercises

The guidelines suggest 90 to 150 minutes per week. That’s an average of about 13 to 21 minutes per day. A total of 6 exercises is recommended for 3 sets of each and 10 repetitions per set.

Isometric Resistance

Isometric is a fancy way of saying, exercises that make your muscles work and exert tension without moving your joints. Examples of isometric exercises:

  • Planks
  • Wall sit (take a sitting position with your back against a wall and don’t move)
  • Overhead hold (holding a weight overhead without moving your arms)
  • Side hold (holding your arms or a weight straight out to the side without moving your arms)
  • Squat hold (squatting down until your thighs are parallel to the floor and holding that position)

The guidelines recommend 4 different exercises of your choice for 2 minutes each, taking a minute rest between exercises. Perform isometric 3 times a week.

The table below shows an estimate of how much you can expect your systolic blood pressure to decrease by following the physical activity guidelines. The 1st estimate is if you have high blood pressure and the 2nd estimate is if you have normal pressure. The estimates are taken from the new guidelines (r).

Intervention Treatment HBP Normal
Physical Activity Aerobic
Dynamic
Isometric
-14mmHg
Systolic
-8mmHg
Systolic

3) Weight Loss

If you’re performing the first 2 steps in this article, this 3rd step is automatically in motion. The best way to accomplish weight loss is through proper nutrition and physical activity. Being over weight increases your risk of having high blood pressure (r). In fact, as your body weight increases, so does your blood pressure. So, losing weight is a highly effective Stage 2 hypertension treatment.

In addition, you don’t have to worry about weight loss if you’re not over weight. How do you know if you’re overweight or at your target weight? The guidelines suggest using 2 key measures to help you determine, BMI (Body mass index) and waist measurement.

Body Mass Index

The chart below will tell you if your BMI is too high. Overweight is defined as a body mass index of 25 to 29.9. For some people, this may be unaccurate. If you’re heavily muscled or have fluid retention, the body mass index may overestimate your body fat.

bmi chart

Source: Clinical Guidelines on the Identification, Evaluation, and Treatment Of Overweight and Obesity in Adults: The Evidence Report; NIH Pub No. 98-4083

Waist Measurement

The measurement of your waist can be important for 2 reasons. First, if your BMI is over estimating your body fat. Second, too much fat around your middle area increases your risk of cardiovascular disease and high blood pressure. For women, a waist measurement over 35″ is considered high. For men, a measurement over 40″ is too high.

Best Way To Lose Weight

A typical diet doesn’t last long. Your weight gain will be fast, but once you get off it, your weight will bounce back just as fast. Losing weight slowly is the best way to accomplish weight loss. A loss of 1/2 lb. to 2 lbs. a week is the best range, and 1 lb. per week is ideal.

Keep your goals realistic, and your chances of success go up. It’s why this part of Stage 2 Hypertension treatment is called lifestyle changes, not a quick fix.

If you eat less calories than you burn, you will lose weight. If you eat more calories than you burn, you will gain weight. If you find yourself not losing weight or losing weight too fast, make adjustments to the amount of food you eat per day.

If you need some additional encouragement, keep this fact in mind. Once an overweight person loses weight and becomes a normal weight. Their risk of developing high blood pressure falls to a similar level to someone who has never been obese at all!

The table below shows an estimate of how much you can expect your systolic blood pressure to decrease accomplishing weight loss. The 1st estimate is if you have high blood pressure and the 2nd estimate is if you have normal pressure. The estimates are taken from the guidelines (r).

Intervention Treatment HBP Normal
Weight Loss Weight reduction for overweight adults –
Expect about 1mmHg for every 2 lbs. lost
-5mmHg
Systolic
-2mmHg
Systolic

4) Alcohol Limits

The relationship between alcohol consumption and blood pressure was recognized back in 1915. Numerous studies since then continue to show this relationship. In the United States, it’s estimated that alcohol consumption accounts for 10% of all high blood pressure.

The BP guidelines are very clear about alcohol limits and don’t vary with bodyweight, although gender does come into play. For women, the limit on alcohol is equal to or less than one drink per day. For men, the alcohol limit is equal to or less than 2 drinks per day.

You might be wondering what is considered 1 drink. Unfortunately, 1 drink is not considered one of those 32-ounce glasses of beer you may find in some drinking establishments. One standard drink is considered a 12-ounce beer, 5 ounces of wine or 1.5 ounces of a distilled spirit. My advice is to slip slowly and make it last 🙂

The table below shows an estimate of how much you can expect your systolic blood pressure to decrease by following the alcohol limit guidelines. The 1st estimate is if you have high blood pressure and the 2nd estimate is if you don’t. The estimates are taken from the guidelines (r).

Intervention Treatment HBP Normal
Alcohol Limits Reduce alcohol to –
Men: Equal or Less 2 drinks
Women: Equal or Less 1 drink
-4mmHg
Systolic
-3mmHg
Systolic

5) Caffeine Limits

Although caffeine is not known to increase long-term blood pressure, it does right after consuming it. For this reason, it is mentioned as a Stage 2 Hypertension treatment. They suggest to limit caffeine to less than 300 mg a day. In addition, for people with high blood pressure, they recommend zero consumption. I researched the amount of caffeine some of the common drinks contain:

  • Coffee: 95 mg in a 8-ounce cup
  • Tea: 27 mg in a 8-ounce cup
  • Cola drink: 29 mg in a 12 ounce can
  • Energy drink: 89-111mg depending on the brand

6) Avoid These Supplements

The guidelines specifically state to avoid the following supplements:

  • Ephedra: Aka Ma Huang, is an herb and in 2003 was banned by the FDA. This stimulant constricts your blood vessels and causes high blood pressure. It has been blamed for over 150 deaths.
  • St. John’s Wort with MAO inhibitors or yohimbine: This herb supplement is natural and can be purchased in a vitamin store. So why isn’t it recommended? It can affect medications for the heart and heart disease. In addition, there are over 80 negative reports on it.

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7) Recreational Drugs

The Stage 2 Hypertension treatment states to discontinue or avoid use. It specifically mentions cocaine and methamphetamine. Both are highly addictive and are stimulants. They will increase the heart rate and increase blood pressure.

8) Blood Pressure Medication

With Stage 2 Hypertension, in addition to lifestyle changes, your physician is likely to recommend blood pressure medication. Depending on your risk factors, blood pressure levels, family history and medical history, the following drugs may be prescribed:

Diuretics

Diuretics help your body get rid of excess fluid and sodium. They are often used in combination with another therapy.

Calcium Channel Blockers (CCB)

They help prevent calcium from entering the heart and arteries. Decreasing calcium lessens the workload on the heart and reduces the heart rate.

Angiotensin-converting Enzyme (ACE) Inhibitors

ACE inhibitors help the blood vessels to relax and reduce blood pressure. They reduce the production of angiotensin which causes the vessels to narrow.

Angiotensin-receptor Blockers (ARBs)

ARBs block angiotensin receptors to help reduce the constriction of blood vessels.

9) Self-Monitoring

In addition to eating the right foods and performing physical activity, you can help your physician determine the proper treatments. You can do this by monitoring your blood pressure at home and reporting them to your doctor. There are high quality, affordable home monitors you can buy online. I recommend 3 of them in my blog post which you can read right here.

Read Next

Stage 2 Hypertension Causes

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Kevin Garce

Kevin Garce is a Certified Health Coach who encourages people by informing them on blood pressure topics important to them. His years of research and knowledge inspire people to achieve their goals. Read more here About Me

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