High blood pressure — or hypertension — is often called the "silent killer" because it typically causes no symptoms until it has already caused significant damage. In Jordan, hypertension affects a large and growing proportion of the adult population, yet many patients remain undiagnosed or undertreated. Dr. Hanna Makhamreh, Professor of Cardiology at the University of Jordan and Director of Cardiology at Jordan University Hospital, provides this comprehensive guide to understanding and managing high blood pressure effectively.
Blood pressure is the force that blood exerts against the walls of your arteries as your heart pumps. It is measured in two numbers: systolic pressure (when the heart beats) over diastolic pressure (when the heart rests between beats), expressed in millimeters of mercury (mmHg).
A normal reading is below 120/80 mmHg. High blood pressure is defined as a consistently elevated reading of 130/80 mmHg or above. Stage 2 hypertension — readings of 140/90 mmHg or higher — significantly increases the risk of heart attack, stroke, kidney disease, and vision problems.
Because hypertension usually has no symptoms, the only way to know if you have it is to measure it regularly. This is why routine check-ups are so important — especially if you have risk factors such as family history, obesity, diabetes, or a sedentary lifestyle.
Over time, elevated blood pressure damages the walls of your arteries, making them stiff and narrow. This forces the heart to work harder, eventually leading to heart enlargement and heart failure. Damaged arteries are also more vulnerable to the buildup of fatty plaques — a process called atherosclerosis — which can result in heart attacks and strokes.
The kidneys are also highly sensitive to blood pressure. Chronic hypertension is one of the leading causes of chronic kidney disease and kidney failure. In the eyes, it can damage small blood vessels, causing vision deterioration or even blindness. Because all of this can happen silently over many years, many patients only discover the damage when it is already advanced — which is why early diagnosis and consistent treatment are critical.
For patients with mildly elevated blood pressure, lifestyle modifications alone can sometimes bring readings back to normal. Even for those who require medication, lifestyle changes enhance the effectiveness of treatment and may allow for lower doses. The following evidence-based strategies are recommended:
Reduce your salt intake. Salt is the most direct dietary driver of blood pressure. The average Jordanian diet is high in sodium, largely due to processed foods, pickled vegetables, and the generous use of salt in cooking. Aim for less than 2,000 mg of sodium per day. Read food labels, avoid adding salt at the table, and choose herbs and lemon as flavor alternatives.
Follow a heart-healthy diet. The DASH diet (Dietary Approaches to Stop Hypertension) is specifically designed to lower blood pressure. It emphasizes fruits, vegetables, whole grains, low-fat dairy, lean proteins, and nuts — and limits red meat, sweets, and salt. This aligns well with traditional Levantine cuisine when prepared with minimal salt and healthy oils.
Maintain a healthy weight. Even modest weight loss — as little as 5–10% of your body weight — can meaningfully reduce blood pressure. Obesity significantly increases the heart's workload and is closely linked to both hypertension and diabetes.
Exercise regularly. Aerobic exercise is one of the most effective natural blood pressure-lowering interventions. Aim for at least 30 minutes of moderate activity on most days of the week. Walking, cycling, swimming, and light jogging are all excellent options.
Limit alcohol and avoid smoking. Both alcohol and tobacco raise blood pressure and damage blood vessels. Quitting smoking alone can dramatically reduce cardiovascular risk within months.
Manage stress. Chronic psychological stress activates hormonal responses that raise blood pressure over time. Prioritizing adequate sleep, rest, and healthy social connections supports cardiovascular health.
When lifestyle changes are insufficient to control blood pressure, medication is necessary — and it should not be feared. Today's antihypertensive medications are safe, well-studied, and highly effective. There are several classes of medications your cardiologist may prescribe, often in combination:
ACE inhibitors and ARBs relax blood vessels and reduce strain on the heart. They are especially beneficial for patients with diabetes or kidney disease.
Calcium channel blockers relax and widen the arteries, reducing the heart's effort with each beat. They are commonly used and well-tolerated.
Diuretics (water pills) help the kidneys remove excess fluid and salt, reducing blood volume and thereby pressure.
Beta-blockers slow the heart rate and reduce the force of contractions, particularly useful for patients who also have coronary artery disease or heart failure.
Your doctor will select the most appropriate medication — or combination of medications — based on your specific situation, age, other health conditions, and any side effects you may experience. It is important to take your medications exactly as prescribed, even when you feel well. Stopping medication without medical guidance is a common and dangerous mistake that can cause blood pressure to spike suddenly.
Home blood pressure monitoring is a valuable tool that allows you to track your readings between doctor visits and detect any patterns or spikes. When measuring at home:
Use a validated upper-arm cuff monitor rather than a wrist device. Sit quietly for five minutes before measuring. Take two or three readings and record the average. Measure at the same time each day — ideally in the morning and evening. Bring your log to every doctor appointment.
Home monitoring also helps identify "white-coat hypertension" — elevated readings in clinical settings due to anxiety — as well as "masked hypertension," where readings are normal at the clinic but elevated in daily life. Both conditions have important implications for treatment.
You should see a cardiologist if your blood pressure remains above 140/90 mmHg despite lifestyle changes, if your general practitioner has recommended specialist care, if you experience symptoms such as headaches, vision changes, or chest discomfort, or if you have additional risk factors such as diabetes, kidney disease, or a prior cardiac event.
At Jordan University Hospital and his clinic in Amman, Dr. Hanna Makhamreh provides comprehensive hypertension management including detailed cardiovascular assessment, individualized treatment plans, and ongoing monitoring. Early management of high blood pressure is one of the most impactful steps you can take for your long-term health.
To schedule a consultation, please visit our contact page.