You may be more likely to have high blood pressure due to your genetics, age, and whether you have certain health conditions. Treatment may include medication and lifestyle changes.
Your blood pressure measurement takes into account the amount of blood passing through your blood vessels and the amount of resistance the blood meets while the heart is pumping.
High blood pressure, or hypertension, occurs when the force of blood pushing through your vessels is consistently too high. In this article, we’ll cover the basics of hypertension, including its symptoms, causes, how it’s treated, and more.
Narrow arteries create more resistance for blood flow out of the heart. The narrower your arteries, the more resistance there is, and the higher your blood pressure will be. Over the long term, the increased pressure can cause health issues, including heart disease.
Hypertension is quite common. Since guidelines changed in 2017,
Hypertension typically develops over several years, usually without causing any symptoms. But even without symptoms, high blood pressure can cause damage to your blood vessels and organs, especially the brain, heart, eyes, and kidneys.
Early detection is important. Regular blood pressure readings can help you and a doctor notice any changes. If your blood pressure is elevated, a doctor may have you check your blood pressure over a few weeks to see if the number stays elevated or falls back to typical levels.
Treatment for hypertension includes both prescription medication and healthy lifestyle changes. Without treatment, it could lead to health issues, including heart attack and stroke.
Your blood pressure reading consists of two numbers:
- Systolic pressure (top number): the pressure in your arteries when your heart beats and pumps out blood
- Diastolic pressure (bottom number): the pressure in your arteries between beats of your heart
Five categories define blood pressure readings for adults:
- Healthy: A healthy blood pressure reading is a systolic pressure of less than 120 millimeters of mercury (mm Hg) and a diastolic pressure of less than 80 mm Hg. This is typically written as 120/80 or spoken as “120 over 80.”
- Elevated: The systolic number is between 120 and 129 mm Hg, and the diastolic number is less than 80 mm Hg. Doctors usually don’t treat elevated blood pressure with medication. Instead, they may encourage lifestyle changes to help lower your numbers.
- Stage 1 hypertension: The systolic number is between 130 and 139 mm Hg, or the diastolic number is between 80 and 89 mm Hg.
- Stage 2 hypertension: The systolic number is 140 mm Hg or higher, or the diastolic number is 90 mm Hg or higher.
- Hypertensive crisis: The systolic number is over 180 mm Hg, or the diastolic number is over 120 mm Hg. Blood pressure in this range requires urgent medical attention. If symptoms, such as chest pain, headache, shortness of breath, or visual changes occur when blood pressure is this high, medical care in an emergency department is needed.
A blood pressure reading is taken with a pressure cuff. It’s important to have a cuff that fits for an accurate reading. An ill-fitting cuff may deliver inaccurate readings.
Blood pressure readings are different for children and teenagers. Ask your child’s doctor for the healthy ranges for your child if you need to monitor their blood pressure.
There are two types of hypertension. Each type has a different cause.
Essential (primary) hypertension
Essential hypertension, also called primary hypertension, develops over time. Most people have this type of high blood pressure.
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- Genes: Some people are genetically predisposed to hypertension. This may be from gene mutations or inherited from your parents.
- Age: People
over 65 years old are more at risk for hypertension. - Race: Black people have a higher incidence of hypertension in the United States.
Research suggests that systemic, cultural, and genetic factors contribute to this inequity. - Living with obesity: Living with obesity can lead to a few cardiovascular issues, including hypertension.
- High alcohol consumption:
Research shows that even one drink per day can increase your risk of hypertension, with higher alcohol consumption further increasing your risk. - Living a sedentary lifestyle:
Sedentary behaviors have links to several cardiovascular issues, including hypertension. - Living with diabetes or metabolic syndrome: People diagnosed with either diabetes or metabolic syndrome are at a higher risk of developing hypertension.
- High sodium intake: There’s a
close link between daily high sodium intake (more than 5 grams a day) and hypertension.
Secondary hypertension
Secondary hypertension often occurs quickly and can become more severe than primary hypertension. Several
- kidney disease
- obstructive sleep apnea
- structural heart issues present from birth
- problems with your thyroid
- adrenal gland problems
- certain endocrine tumors
Secondary hypertension may also be a side effect of
Hypertension is generally a silent condition. Many people won’t experience any symptoms. It may take years or even decades for the condition to reach levels severe enough that symptoms become apparent. Even then, some people may attribute these symptoms to other causes.
Getting regular blood pressure readings is the best way to know if you have hypertension. Most doctors’ offices take a blood pressure reading at every appointment.
Symptoms of severe hypertension, such as in a hypertensive crisis, can
- headaches
- nausea
- vomiting
- visual disturbances
- chest or back pain
- difficulty breathing
Read more: “Symptoms of High Blood Pressure (Hypertension)”
Because hypertension is often a silent condition, it can cause damage to your body for years before symptoms become obvious. Without treatment, you may face serious, even fatal, complications.
Hypertension can damage your arteries, making them tougher, tighter, and less elastic. This damage makes it easier for deposits to collect in your arteries and restrict blood flow through your body, affecting multiple systems.
Complications of hypertension
- stroke
- heart attack
- heart failure
- arrhythmia
- sudden cardiac death
- kidney disease or failure
- vision loss
- sexual dysfunction
- cognitive issues, including dementia
Read more: “The Effects of Hypertension on the Body”
High blood pressure during pregnancy
People with hypertension may be more likely to experience challenges during pregnancy or childbirth,
- decreased kidney function
- preeclampsia
- low birth weight
Some people may develop hypertension during pregnancy. This often resolves once the baby is born. However, developing hypertension during pregnancy may
Read more: “Controlling Blood Pressure in Preeclampsia”
Diagnosing hypertension is as simple as taking a blood pressure reading. Most doctors’ offices check blood pressure as part of a routine visit. If you don’t receive a blood pressure reading at your next appointment, feel free to request one.
If your blood pressure is elevated, a doctor may request more readings over the course of a few days or weeks. Doctors rarely diagnose hypertension after just one reading. They’ll need to see evidence of a sustained problem.
That’s because your environment can contribute to increased blood pressure, like the stress you may feel by being at the doctor’s office (known as “white coat syndrome”). Also, blood pressure levels change throughout the day.
If your blood pressure remains high, a doctor will likely conduct more tests to rule out underlying conditions. These tests can include:
- cholesterol screening and other blood tests
- test of your heart’s electrical activity with an electrocardiogram (EKG, sometimes referred to as an ECG)
- ultrasound of your heart or kidneys
- home blood pressure monitor to monitor your blood pressure over a 24-hour period at home
If a doctor diagnoses you with primary hypertension, lifestyle changes may help reduce your high blood pressure. If lifestyle changes alone aren’t enough, or if they stop being effective, they may prescribe medication.
Medications for hypertension
Many people go through a trial-and-error phase with blood pressure medications. A doctor may need to try different medications until they find one or a combination that works for you.
Some of the medications used to treat hypertension include:
- beta-blockers
- diuretics, aka water pills
- angiotensin converting enzyme (ACE) inhibitors
- angiotensin II receptor blockers (ARBs)
- calcium channel blockers
- alpha-2 agonists
Read more: “11 Common Blood Pressure Medications”
Treating secondary hypertension
If a doctor discovers an underlying issue causing your hypertension, treatment will focus on that other condition. For example, if a medication you’ve started taking is causing increased blood pressure, your doctor will try other medications that don’t have this side effect.
Sometimes, hypertension is persistent despite treatment for the underlying cause. In this case, a doctor may work with you to develop lifestyle changes and prescribe medications to help reduce your blood pressure.
Treatment plans for hypertension often evolve. What worked at first may become less useful over time. Your doctor will continue to work with you to refine your treatment.
Healthy lifestyle changes can help you control the factors that cause hypertension. Experts recommend the following:
- consuming a heart-healthy diet, emphasizing fruits, vegetables, whole grains, and lean proteins like fish
- increasing physical activity, aiming for
150 minutes of moderate activity each week - maintaining a moderate weight
- managing stress
- quitting smoking if you do
- limiting alcohol consumption
Read more: “7 Home Remedies for Managing High Blood Pressure”
If you have risk factors for hypertension, you can take steps now to lower your risk for the condition and its complications, such as:
- eating
4 servings of fruit and 5 servings of vegetables each day - limiting the amount of refined sugar you consume
- reducing your daily sodium intake to
1.5 to 2.3 grams - setting weight loss goals if you have overweight or obesity
- monitoring your blood pressure regularly
Read more: “12 Causes of High Blood Pressure (and How to Prevent It)”
High blood pressure, also known as hypertension, is a common health issue in the United States. Treatment for hypertension varies depending on factors such as the severity of your condition and which medications a doctor thinks will work best for you.
In many cases of hypertension, lifestyle changes can be powerful tools for managing — or even reversing — high blood pressure. These changes include incorporating more nutritious fruits and vegetables into your diet, getting more physical activity, limiting your sodium intake, and limiting your alcohol consumption.
Because hypertension often presents with no symptoms, checking your blood pressure regularly is important. Severe hypertension can cause serious health issues, so the sooner you receive a diagnosis, the sooner you can begin to manage it.
