Blood pressure under control, without the guesswork.
Medication optimized to minimize side effects, real monitoring instead of a single office reading, and lifestyle tools that actually move the number.
What treatment includes
Real Monitoring
Consistent home readings, and — when 24-hour ambulatory monitoring is warranted — coordination with our cardiology colleagues to arrange it, plus screening for sleep apnea, a common hidden cause of resistant hypertension.
Medication Optimization
Dosing built to minimize side effects, with dietary sodium and potassium balance assessed alongside it.
Cardiovascular Risk, Analyzed
We weigh your whole cardiovascular risk — not just the number — and modify it with evidence-based treatment when the data supports doing so. For patients set against medication, we may use select Chinese herbs, sparingly.
Weight & Exercise
Weight loss support (losing 10 lbs can drop pressure roughly 10 mmHg) and exercise prescriptions matched to your fitness level.
Understanding your blood pressure numbers
Blood pressure is read as two numbers — systolic (the pressure when your heart beats) over diastolic (the pressure between beats). Knowing which category you fall into is the difference between watchful waiting and active treatment.
Elevated
120–129 systolic and under 80 diastolic. Not yet hypertension, but a clear signal — this is the ideal moment for lifestyle change before medication is ever needed.
Stage 1 Hypertension
130–139 over 80–89. We look at your overall cardiovascular risk to decide whether lifestyle change alone is enough or medication should start now.
Stage 2 Hypertension
140/90 or higher. This usually calls for medication alongside lifestyle change, and closer monitoring to protect your heart, kidneys, and eyes.
Hypertensive Crisis
Over 180/120. This is a medical emergency — if you're seeing readings this high, especially with chest pain, shortness of breath, or vision changes, seek care immediately.
How we diagnose and monitor
A single reading in a rushed office visit is the wrong way to diagnose — or dismiss — high blood pressure. We build a real picture of your pressure over time, and check whether something treatable is driving it:
- Proper measurement: the right cuff size and technique — seated, arm supported, after a few minutes of rest — because sloppy readings send people to unnecessary medication
- Home & ambulatory monitoring: consistent home readings, and — when 24-hour ambulatory monitoring is warranted — we coordinate with cardiology to arrange it, catching white-coat and masked hypertension that a single office reading misses
- Secondary-cause workup: kidney function, thyroid, and screening for sleep apnea and hormonal causes when your pressure is high, sudden, or resistant to treatment
- End-organ checks: kidney function (eGFR), an EKG when warranted, and cholesterol testing, since hypertension strains the heart, kidneys, and blood vessels over time
- Diabetes screening: because diabetes and high blood pressure so often occur together and sharply compound cardiovascular risk
Know your real numbers, not just an office reading.
Most new patients are seen within a week, in person or via telemedicine.
Blood pressure medication options
There are several proven classes of blood pressure medication, and the best choice depends on your age, your other conditions, and how you tolerate each. Often a low dose of two medications works better, with fewer side effects, than a high dose of one.
ACE Inhibitors & ARBs
Lisinopril, losartan, and similar medications relax blood vessels and are especially protective for patients with diabetes or kidney disease. Often a first-line choice.
Calcium Channel Blockers
Amlodipine and others ease the arteries open. Well tolerated and particularly effective for many older adults and Black patients.
Thiazide Diuretics
Low-dose "water pills" like chlorthalidone or HCTZ help the body shed excess sodium and fluid — inexpensive, proven, and a common partner to the classes above.
Beta-Blockers & Others
Used when there's a specific reason — certain heart conditions, for example — along with additional agents for resistant cases that need a tailored combination.
The goal isn't just a number on target — it's a number on target that you can live with comfortably. We adjust doses around your side effects and monitoring, and as weight loss and lifestyle changes take hold, many patients are able to reduce or stop medication safely, under supervision.
Related services that support heart health
Cholesterol Control
Blood pressure and cholesterol are the two biggest modifiable drivers of heart attack and stroke — we manage them together.
Learn moreDiabetes Care
Diabetes and hypertension multiply each other's risk to the heart and kidneys — controlling both is far more protective than either alone.
Learn moreWeight Management
Losing even 10 pounds can drop blood pressure by roughly 10 mmHg — often enough to reduce or avoid medication entirely.
Learn moreFrom Our Blog: Lower Blood Pressure Naturally
The DASH diet, sodium, exercise, and weight — plus when lifestyle isn't enough and medication genuinely helps.
Read the guideHigh blood pressure questions
What blood pressure is too high?
Normal is under 120/80. Elevated is 120–129 over under 80. Stage 1 is 130–139 over 80–89. Stage 2 is 140/90 or higher. A reading over 180/120 is a crisis — seek care immediately.
Can I stop taking blood-pressure medication?
Some patients can, through weight loss, exercise, diet, and stress control. Never stop pills on your own — we taper gradually as lifestyle changes take hold.
Why is my pressure high only at the doctor's office?
"White-coat hypertension" is real. We start with consistent home readings, and when 24-hour ambulatory monitoring is warranted we coordinate with cardiology to arrange it — so decisions are based on your true home, sleep, and daytime patterns instead of one nervous office reading.
Does stress really cause high blood pressure?
Yes. Chronic stress releases hormones that raise blood pressure. Stress management, acupuncture, and mind-body techniques can lower both stress hormones and blood pressure.
What causes high blood pressure?
Most high blood pressure is "primary" — it develops gradually over years from a mix of genetics, weight, diet, activity, and stress, with no single cause. A smaller share is "secondary," driven by an underlying issue like kidney disease, thyroid problems, sleep apnea, or a hormonal condition. When your pressure is unusually high, resistant to treatment, or appears suddenly, we screen for these secondary causes rather than just adding another pill.
Which blood pressure medication is best?
There's no single best medication — ACE inhibitors, ARBs, calcium channel blockers, and thiazide diuretics are all proven first-line options, and the right one depends on your age, other conditions (like diabetes or kidney disease), and how you tolerate each. Many patients do best on a low dose of two medications rather than a high dose of one. We adjust based on real monitoring and side effects, not a one-size-fits-all protocol.
How often should I check my blood pressure at home?
When we're first getting your pressure under control or adjusting medication, we usually ask for readings once or twice a day at consistent times. Once you're stable, a few readings a week is enough to catch drift early. Home readings are often more accurate than office ones, and we'll show you the correct technique — seated, feet flat, arm supported, no caffeine or exercise beforehand.
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