Hypertension, or high blood pressure, is a common condition that affects millions of people worldwide. Blood pressure is often measured in two numbers: systolic (the top number) and diastolic (the bottom number). A blood pressure reading of 135 systolic over 85 diastolic (commonly written as 135/85 mmHg) falls within a category known as elevated blood pressure, but it’s not necessarily considered high enough to require immediate medication. However, this can be a gray area, so let’s explore whether medication is needed for a blood pressure of 135.
Understanding Blood Pressure Readings
To fully understand if 135 blood pressure requires medication, it’s essential to grasp what the numbers mean. Blood pressure is measured in millimeters of mercury (mmHg), and it has two components:
Systolic pressure (top number): This is the pressure exerted on the arteries when the heart beats and pumps blood.
Diastolic pressure (bottom number): This is the pressure in the arteries when the heart rests between beats.
The following categories define blood pressure levels:
Normal: Less than 120/80 mmHg
Elevated: Systolic between 120-129 and diastolic less than 80
Hypertension Stage 1: Systolic between 130-139 or diastolic between 80-89
Hypertension Stage 2: Systolic 140 or higher or diastolic 90 or higher
Hypertensive Crisis: Systolic over 180 and/or diastolic over 120 (emergency medical attention needed)
With a 135/85 mmHg reading, you’re in Hypertension Stage 1 according to the American Heart Association (AHA). Now, let’s look at whether this requires medication.
When Is Medication Necessary?
For many people with a blood pressure of 135, the question of whether to start medication depends on a combination of factors.
1. Other Health Conditions
If you have additional risk factors like diabetes, heart disease, or a history of stroke, your doctor might recommend starting medication earlier. These conditions increase the risk of complications from elevated blood pressure.
2. Age
Older adults are more likely to be prescribed medication for moderately elevated blood pressure like 135, as they tend to have a higher risk of cardiovascular issues. Younger adults might not need medication right away and may focus on lifestyle changes.
3. Risk Assessment
Doctors often use risk assessment tools, such as the ASCVD risk calculator, which considers factors like cholesterol levels, age, gender, and smoking status, to estimate the 10-year risk of cardiovascular disease. A high risk score may prompt your doctor to suggest starting blood pressure medication even at 135/85.
4. Lifestyle Modifications
In many cases, doctors may suggest lifestyle changes before prescribing medication. This includes steps such as:
Reducing sodium intake
Increasing physical activity
Losing weight if you’re overweight
Eating a heart-healthy diet (like the DASH diet)
Limiting alcohol consumption
Managing stress
If these changes are effective, medication might not be necessary. However, if after several months your blood pressure remains elevated, medication might be required.
Why Elevated Blood Pressure Matters
While a blood pressure of 135 might not seem dangerously high, it can still pose long-term risks if left untreated. Elevated blood pressure can slowly damage your blood vessels and organs, including your heart, kidneys, and brain. Over time, this can lead to:
Heart attack or heart failure
Stroke
Kidney disease
Vision loss
Preventing these complications is the main goal of managing elevated blood pressure, whether through lifestyle changes, medication, or a combination of both.
Lifestyle Changes to Lower Blood Pressure
If your blood pressure is around 135, making adjustments to your daily habits can have a significant impact. Here are some evidence-based lifestyle changes that can help bring your blood pressure down:
1. Reduce Sodium Intake
Excess sodium in the diet is a key contributor to high blood pressure. The American Heart Association recommends limiting sodium intake to 1,500 milligrams per day. Reducing processed and packaged foods, which are often high in salt, can make a big difference.
2. Exercise Regularly
Regular physical activity, such as aerobic exercise like walking, running, or swimming, can help lower blood pressure. Aim for at least 150 minutes of moderate exercise per week. Exercise strengthens your heart, allowing it to pump blood more efficiently, which reduces pressure on your arteries.
3. Lose Excess Weight
If you’re overweight, losing even a small amount of weight can significantly reduce your blood pressure. Studies show that losing 1 kilogram (2.2 pounds) can lower blood pressure by about 1 mmHg.
4. Eat a Balanced Diet
The DASH diet (Dietary Approaches to Stop Hypertension) is highly recommended for people with elevated blood pressure. It emphasizes fruits, vegetables, whole grains, and low-fat dairy while limiting saturated fats and sugar.
5. Limit Alcohol and Caffeine
Drinking too much alcohol can raise your blood pressure. Stick to moderate drinking—no more than one drink per day for women and two drinks per day for men. Caffeine can also cause temporary spikes in blood pressure, so it’s wise to monitor your intake.
6. Manage Stress
Chronic stress can contribute to elevated blood pressure. Practicing stress-relief techniques like meditation, deep breathing, or yoga can help lower your stress levels and, in turn, reduce your blood pressure.
See Also: Does Holding Your Breath Lower Your Blood Pressure?
When to Talk to Your Doctor
Even if your blood pressure is 135, and you’re trying to manage it with lifestyle changes, it’s essential to stay in close contact with your healthcare provider. Regular check-ups will allow your doctor to monitor your progress and determine whether further intervention, such as medication, is needed.
You should also see a doctor if you experience any symptoms of high blood pressure, such as:
Headaches
Dizziness
Shortness of breath
Chest pain
These symptoms can be warning signs of dangerously high blood pressure or other heart-related problems that require immediate attention.
What Happens if Lifestyle Changes Don’t Work?
If you’ve implemented the recommended lifestyle changes and your blood pressure remains elevated at 135 or higher, your doctor may prescribe antihypertensive medication. There are several types of medications used to treat high blood pressure, including:
Diuretics: Help the body eliminate excess salt and water
Beta-blockers: Reduce the heart rate and the heart’s output of blood
ACE inhibitors: Help relax blood vessels by blocking a hormone that tightens them
Calcium channel blockers: Prevent calcium from entering the cells of the heart and blood vessel walls, which helps relax the vessels
These medications can be very effective in lowering blood pressure, but they are often prescribed after other methods have been tried first.
Conclusion
For most people with a blood pressure reading of 135/85 mmHg, medication might not be necessary right away. However, it depends on several factors, including your overall health, risk factors, and how effective lifestyle changes are in lowering your blood pressure.
Before deciding on medication, talk with your doctor about all your options. In many cases, small adjustments in your daily habits can make a big difference in your blood pressure and overall health, reducing the need for medication.
By staying proactive and keeping your blood pressure in check, you can avoid long-term complications and lead a healthier life.
