High blood pressure (hypertension) in Puerto Rico: control, medicines and video visits
You have high blood pressure when your readings are 130/80 mm Hg or higher most of the time. It rarely causes symptoms, so it has to be measured. If you are already diagnosed and stable, the doctor can follow you by video in Puerto Rico, review your home readings and refill your medicines. A reading above 180/120, or high blood pressure with chest pain, shortness of breath, weakness or trouble speaking, is an emergency: call 911.
Can we help by telehealth? Yes, we can help by telehealth.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Blood pressure above 180/120
- Chest pain or pressure
- Shortness of breath
- Weakness, numbness or drooping on one side of the body
- Trouble speaking, confusion or sudden vision changes
- A sudden, very severe headache
Help lines:
- 911 — Emergencies
- 1-800-981-0023 — Línea PAS (mental-health crisis line)
- 988 — Suicide & Crisis Lifeline
- 1-800-222-1222 — Poison Help
What high blood pressure is, and why it often has no symptoms
Blood pressure is the force of blood against the walls of your arteries. It is written as two numbers: the top (systolic) and the bottom (diastolic), for example 120/80 mm Hg.
Most people with high blood pressure feel nothing. That is why many don’t know they have it, and over the years it can damage the heart, kidneys, eyes and brain without warning. The only way to know is to measure it.
Blood pressure numbers
These categories apply to adults who are not taking blood pressure medicine and are not ill:
- Normal: under 120 and under 80.
- Elevated: 120 to 129 and under 80.
- Stage 1 high blood pressure: 130 to 139, or 80 to 89.
- Stage 2 high blood pressure: 140 or higher, or 90 or higher.
- Hypertensive crisis: higher than 180, or higher than 120. Get medical care right away.
Symptoms of very high blood pressure
High blood pressure usually causes no symptoms. But extremely high blood pressure (malignant hypertension) is an emergency and can cause:
- Severe headache
- Nausea and vomiting
- Confusion
- Vision changes
- Nosebleeds
How to measure your blood pressure at home
Home readings can be a better measure of your real blood pressure than office readings, and a diagnosis should be confirmed with readings taken outside the office. Use a digital upper-arm monitor with a cuff that fits you. Follow these CDC steps:
- Don’t eat or drink anything for 30 minutes before.
- Empty your bladder.
- Sit with your back supported for at least 5 minutes first.
- Keep both feet flat on the floor, legs uncrossed.
- Rest your arm on a table at chest height.
- Put the cuff on bare skin, not over clothing.
- Don’t talk during the reading.
- Take at least two readings 1 or 2 minutes apart, at the same time every day, and write them down.
Bring your log to the visit: the doctor reviews it with you by video.
High blood pressure treatment and medicines
Treatment usually starts with lifestyle changes: a heart-healthy diet with less salt (under 1,500 mg of sodium a day), at least 150 minutes of exercise a week, a healthy weight, limiting alcohol and quitting smoking.
If that isn’t enough, or if you have stage 2 blood pressure, diabetes or heart disease, medicines are added. The most used types are diuretics, ACE inhibitors, angiotensin II receptor blockers (ARBs) and calcium channel blockers. Many people need more than one.
Never change your dose or stop a medicine on your own. If you have side effects such as dizziness, cough or tiredness, tell your doctor: there is almost always another option.
Follow-up by telehealth and prescription refills
If your blood pressure is already diagnosed and stable, the doctor can follow you in an online doctor visit: she reviews your home readings, your medicines and any side effects, and orders lab tests when needed, for example to check your kidneys.
If appropriate, the doctor can prescribe medication. We do not prescribe controlled substances. See prescription refills and chronic care. This service is for adults; in children and teens blood pressure is judged against norms for age, height and sex, and should be assessed by their own doctor in person.
High blood pressure in Puerto Rico
Diabetes raises the risk of high blood pressure, and according to the CDC, Puerto Rico had the highest rate of diagnosed diabetes among adults of any U.S. state or territory in 2021: 14.4%. If you have diabetes or high cholesterol, controlling your blood pressure matters even more; see also type 2 diabetes.
During hurricane season, plan ahead so you don’t run out of your blood pressure pills. Read medications and hurricanes. If you have moved to Puerto Rico or are visiting and need a refill, a video visit can help while you are on the island.
When to be seen in person or go to the ER
Call 911 or go to the ER if your blood pressure is above 180/120, or if you have high blood pressure with chest pain, shortness of breath, weakness or numbness on one side, trouble speaking, vision changes, confusion or a very severe headache. Get an in-person evaluation if your home readings stay high despite treatment, or if you have new swelling in your legs.
Video visit: US$79 · Pay by card · See the price and what is included
Before you book
- You must be physically in Puerto Rico during the visit (visitors and tourists are welcome).
- We see patients from 6 months old. Patients under 21: a parent or legal guardian must be on camera for the whole visit.
- Real-time video only; we do not do phone-call visits.
- We do not prescribe controlled substances.
Frequently asked questions
- What are the symptoms of high blood pressure?
- Usually none, which is why it should be checked regularly. When blood pressure rises to extreme levels it can cause a severe headache, nausea, confusion, vision changes or nosebleeds, and that is an emergency.
- What blood pressure is dangerous?
- Above 180/120 is a hypertensive crisis and needs medical care right away. If you also have chest pain, shortness of breath, weakness or trouble speaking, call 911.
- Can I get my blood pressure medicine refilled by telehealth in Puerto Rico?
- Yes, if your blood pressure is diagnosed and stable and the doctor considers it appropriate after reviewing your readings and history. She may order lab tests before refilling. You must be physically in Puerto Rico during the visit.
Sources
- High blood pressure in adults – hypertension (MedlinePlus, NIH) (accessed 2026-09-30)
- High Blood Pressure (MedlinePlus, NIH) (accessed 2026-09-30)
- High blood pressure medications (MedlinePlus, NIH) (accessed 2026-09-30)
- Malignant hypertension (MedlinePlus, NIH) (accessed 2026-09-30)
- Measuring Your Blood Pressure (CDC) (accessed 2026-09-30)
- About High Blood Pressure (CDC) (accessed 2026-09-30)
- Prevalence of Self-Reported Diagnosed Diabetes Among Adults, 2019–2022 (CDC, Preventing Chronic Disease) (accessed 2026-09-30)