High blood pressure, or hypertension, is often called the “silent killer” because it usually causes no symptoms – yet it’s one of the biggest risk factors for heart disease, stroke, and premature death¹. In Canada, around 1 in 4 adults have hypertension².

The good news? It’s largely preventable, modifiable, and manageable². The challenge is that diagnosis and control rates have declined in recent years², which is why new Canadian guidelines have been released to help everyone take clearer, more effective steps to protect heart health.

As chiropractors, we’re in a unique position to help screen, support, and empower patients to take charge of their cardiovascular health – while also knowing when to refer them back to their family doctor for further evaluation or medical care.

Understanding Blood Pressure: What Do Those Numbers Mean?

You’ve probably seen a reading like 120/80 mmHg before, but what do those numbers actually mean?

The top number (systolic pressure) measures the force in your arteries when your heart beats and pushes blood out – that’s the peak pressure.

The bottom number (diastolic pressure) measures the pressure when your heart is resting between beats, filling with blood.

A healthy blood pressure is generally below 120/80 mmHg. According to the new guidelines, hypertension is defined as 130/80 mmHg or higher.

Even though high blood pressure usually doesn’t cause symptoms, it’s the number one risk factor for stroke and a major contributor to heart disease¹. The risk goes up as we age, so it’s important to check your blood pressure regularly¹. Those numbers might seem small, but they have a big impact on your health.

What is the Definition for Hypertension?

The new guidelines have lowered the threshold for hypertension from 140/90 mmHg to 130/80 mmHg, emphasizing the importance of early detection and treatment². Accuracy is key, so using validated automated blood pressure monitors is recommended – especially since only a small percentage of devices worldwide are validated². In Canada, most devices sold in pharmacies are reliable, but nearly half of those sold online may not be².

Sometimes one reading in the clinic isn’t enough. Out-of-office blood pressure assessment is recommended to confirm the diagnosis of hypertension or to detect white-coat hypertension (when blood pressure is elevated in office but not out of office, which is present in 15%-30% of people with elevated office blood pressure) and masked hypertension (when blood pressure is elevated out of office but not in office, which is present in 10%-15% of people)².

The goal is to keep systolic blood pressure under 130 mmHg. If your blood pressure is 130/80 mmHg or higher, intervention is required².

Lifestyle Changes: The First and Most Powerful Step

When it comes to managing blood pressure, lifestyle changes are the front line – and often the most effective intervention. Chiropractors are well-positioned to support this through education, recommendations, and ongoing follow-up.

1. Eat Smart²

• Cut sodium intake to under 2 grams/day(Hint: most of it comes from processed foods)
• Increase potassium intake to at least 5 grams/day by consuming more fresh fruits and veggies (Important: potassium should be monitored in people with chronic kidney disease or who take certain medications)
• Reduce alcohol consumption – for adults consuming 3+ drinks per day, cutting back to just 1-2 drinks daily can help lower your blood pressure

2. Get Moving²

• Aim for 150–300 minutes of moderate aerobic activity per week – think: walking, biking, swimming – whatever you enjoy!
• Exercise helps lower blood pressure and improves heart health across the board

3. Maintain a Healthy Weight²

• High blood pressure and excess weight often go hand in hand
• Even a modest weight losscan significantly improve your blood pressure readings

4. Quit Smoking²

• Smoking slightly increases blood pressure – but massively increases cardiovascular morbidity and death
• Quitting is one of the best things you can do for your heart

Not sure where to start when it comes to making some of these lifestyle changes to help manage your blood pressure? Ask your chiropractor for guidance today – we’re here to help.

When Lifestyle Isn’t Enough: Collaborating with Your Doctor on Medications

While lifestyle is the foundation, the guidelines recommend that adults who are diagnosed with hypertension and their blood pressure is ≥ 140/90 mmHg, pharmacologic treatment should be initiated². The guidelines further recommend that pharmacologic treatment should also be started for adults with systolic blood pressure 130–139 mmHg who are at high risk of cardiovascular disease².

High cardiovascular disease risk conditions include but are not limited to, established cardiovascular disease (such as coronary artery disease, heart failure, cerebrovascular disease, and peripheral artery disease), Diabetes mellitus (type 1 or type 2), chronic kidney disease, and/or age ≥ 75 years².

Even when medication is necessary, lifestyle changes remain a vital part of managing high blood pressure². In fact, healthy habits can sometimes reduce the amount of medication required – or even help eliminate the need for it over time². While chiropractors can help to support these lifestyle strategies, it’s important to note that prescribing or managing medications falls outside of the chiropractic scope of practice. And of course, patients should never stop or adjust any prescribed medication without first consulting their family doctor.

The Chiropractor’s Role: Beyond the Spine

You might be surprised when your chiropractor takes your blood pressure, but it’s an important part of assessing and monitoring your overall health. Chiropractors can screen and track blood pressure, educate about lifestyle changes, refer you to your family doctor when needed, and encourage you to be an active participant in your health journey.

A Few Exceptions to Keep in Mind

There are some exceptions to these new guidelines: these guidelines don’t apply to children, pregnant individuals, or those trying to become pregnant². Also, people with irregular heart rhythms may need manual blood pressure checks for accuracy².

Take Charge of Your Heart Health

Hypertension is often silent, but it’s far from harmless. The sooner we catch it, the better our chances of preventing serious complications down the line.

What you can do today:

• Know your numbers – get your blood pressure checked regularly
• Use a validated monitorif checking at home
• Prioritize movement, nutrition, sleep, and stress management
• Team up with your chiropractor and family doctor

Remember, you don’t have to be perfect – you just have to be proactive. Your heart will thank you for it.