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Why does my doctor say I have high blood pressure? I’m perfectly healthy

The question: I'm a 55 year old man. I was recently told by my family doctor that my blood pressure is high. But I feel perfectly healthy and don't know why she wants me to start taking medication for something I don't have symptoms for. Is it really necessary for me to treat this now? Isn't there anything else I can do?

The answer: It may seem unnecessary to treat something you don't feel, so it's understandable why you have this concern. But the truth is, even though high blood pressure, or hypertension, doesn't cause symptoms in most people, it's very important to treat as it can lead to damage to the kidneys, eyes, brain and heart.

It is one of the most significant risk factors for dementia, heart disease and stroke, and the longer it goes untreated, the higher the potential damage. It's estimated that 40 per cent of Canadians have high blood pressure that goes undiagnosed.

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What's blood pressure? It's the force that is put on the walls of the arteries as blood flows through them. This pressure is the vital force needed to get nutrients and oxygen in our blood to our organs.

If you've ever had your blood pressure checked, you may know that there are two numbers we use to describe it: The top number (systolic pressure) is the pressure when your heart beats or contracts, and the bottom number (diastolic pressure) is the pressure when the heart relaxes and refills with blood.

A healthy blood pressure is considered to be below 140/90. For people with diabetes or kidney disease, the goal for blood pressure is lower at 130/80. In general, it will take a few visits to confirm that your blood pressure is elevated before your doctor starts medication. In rare cases though, if your blood pressure is very high or there has already been damage to an organ like the kidneys or eyes, your doctor may start treatment on the first visit.

While there are certain factors that are out of our control, such as aging and family history, there are many things within your control that can help keep your blood pressure in the normal range. While medications certainly play a vital role in normalizing it, lifestyle changes are equally as important.

First, reducing your weight can significantly decrease your blood pressure. If you are overweight, every pound you lose helps to normalize it. Aim for a 10-pound weight loss to start. Regular exercise is a good way to achieve that goal. Aim for 30 minutes a day, five days a week.

In addition to getting active, making healthy changes to your diet and watching what you put in your body are crucial in managing blood pressure. Incorporate whole grains, fruits and vegetables into your diet while limiting fatty and processed foods.

When looking at dietary changes, you should keep track and reduce your salt intake. According to Hypertension Canada, 1 in 3 Canadians with high blood pressure would have normal blood pressure if only they consumed a lower, healthy amount of sodium.

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For those with normal blood pressure, the goal is to eat no more than 2,300 milligrams of sodium a day (about 1 teaspoon of salt). But for those with high blood pressure or kidney or heart disease, the threshold is lower, at 1,500 mg a day.

Work to reduce your salt intake by reading food labels and avoiding processed foods and eating out. Simple steps, like washing canned products with water and taking the salt shaker off the dining table, can reduce your salt consumption as well.

Making dietary changes can feel overwhelming, so consider seeing a dietician for support, either in person or through an excellent and free dietician website like

Smoking also plays a significant role in elevated blood pressure. Smoking can increase your blood pressure by 10 points for up to an hour after you smoke; so if you smoke throughout the day, your blood pressure remains consistently high. Managing your alcohol intake can also keep your pressure from rising too high, so avoid binge drinking and limit yourself to two drinks a day.

Finally, reducing your stress will help manage blood pressure. When we feel anxious, our blood pressure can rise temporarily. So it makes sense that when we face chronic stress in daily life, our blood pressure may remain elevated. Build stress-reducing activities into your day, like exercise or meditation, to help manage stress and reduce spikes in blood pressure.

Because high blood pressure increases the potential for heart disease and stroke, it's important to also keep an eye on other potential risk factors, so make sure you've had your cholesterol and blood sugar checked as well.

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The bottom line: High blood pressure is without symptoms in the majority of people, so it becomes important to be checked for it regularly. Medication is only one part of the solution for managing blood pressure; lifestyle changes are just as important.

While these changes may not be easy to implement, they are within reach by simply being aware of what you can control and the possible steps you can take. More information on how you can manage your blood pressure can be found at

Dr. Sheila Wijayasinghe is the medical director at the Immigrant Womens' Health Centre, works as a staff physician at St. Michael's Hospital in their Family Practice Unit and at Hassle Free Clinic, and established and runs an on-site clinic at Women's Habitat Shelter in Etobicoke.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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