High blood pressure (hypertension) is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, such as stroke, heart failure, kidney failure and other medical conditions.
Blood pressure is determined both by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure. A blood pressure reading is given in millimeters of mercury (mm Hg). It has two numbers.
You can have high blood pressure for years without any symptoms. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke. Fortunately, high blood pressure can be easily detected. And once you know you have high blood pressure, you can work with your doctor to control it.
For example, a blood pressure of 110/70 is within the normal range, but a blood pressure of 135/85 is stage 1 (mild) hypertension, and so on.
|Normal||Under 130/80 mmHg|
|Elevated blood pressure||Systolic pressure of 120-129 mm Hg/ diastolic pressure below (not above) 80 mm Hg|
|Stage I Hypertension (mild)||130-139/OR diastolic between 80-89 mmHg|
|Stage 2 Hypertension (moderate)||140/90 mmHg or higher|
|Hypertensive Crisis (get emergency care)||180/120 mmHg or higher|
Hypertension is known as a “silent killer”. Most people with hypertension are unaware of the problem because it may have no warning signs or symptoms. For this reason, it is essential that blood pressure is measured regularly.
When symptoms do occur, they can include
Severe hypertension can cause:
The only way to detect hypertension is to have a health professional measure blood pressure. Having blood pressure measured is quick and painless. Although individuals can measure their own blood pressure using automated devices, an evaluation by a health professional is important for assessment of risk and associated conditions.
There are two types of high blood pressure.
1- Primary (essential) hypertension
In most adults, there’s no identifiable cause of high blood pressure. This type of high blood pressure is called primary (essential) hypertension. It tends to develop gradually over many years.
2- Secondary hypertension
Some people have high blood pressure caused by an underlying condition. This type of high blood pressure is called secondary hypertension. It tends to appear suddenly and cause higher blood pressure than does primary hypertension. Various conditions and medications can lead to secondary hypertension, including:
High blood pressure has many risk factors, including:
Sometimes pregnancy contributes to high blood pressure as well.
Untreated hypertension may lead to serious health issues including:
Since high blood pressure doesn’t have symptoms, your doctor will ask about your medical history and perform a physical examination. The doctor, nurse or any other medical assistant will need to check your blood pressure with a blood pressure cuff around your arm using a measuring gauge. Your blood pressure generally should be measured in both arms to determine if there is a difference.
Providers usually check your blood pressure at every annual checkup or appointment. If you have high blood pressure readings at two appointments or more, your provider may tell you that you have high blood pressure and recommends tests to confirm.
Changing your lifestyle can help control and manage high blood pressure. Your doctor may recommend that you make lifestyle changes. They may include:
The type of medication your doctor prescribes for high blood pressure depends on your blood pressure measurements and overall health. The ideal blood pressure treatment goal can vary with age and health conditions, particularly if you’re older than age 65. Medications used to treat high blood pressure include:
Diuretics. Diuretics, sometimes called water pills, are medications that help your kidneys eliminate sodium and water from the body. These drugs are often the first medications tried to treat high blood pressure.
Angiotensin-converting enzyme (ACE) inhibitors. These medications — such as lisinopril (Prinivil, Zestril), benazepril (Lotensin), captopril and others — help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels.
Angiotensin II receptor blockers (ARBs). These medications relax blood vessels by blocking the action, not the formation, of a natural chemical that narrows blood vessels. ARBs include candesartan (Atacand), losartan (Cozaar) and others.
Calcium channel blockers. These medications — including amlodipine (Norvasc), diltiazem (Cardizem, Tiazac, others) and others — help relax the muscles of your blood vessels. Some slow your heart rate. Calcium channel blockers may work better for older people and people of African heritage than do ACE inhibitors alone.
Avoid eating or drinking grapefruit products when taking calcium channel blockers. Grapefruit increases blood levels of certain calcium channel blockers, which can be dangerous.
Lifestyle changes can help you control and prevent high blood pressure, even if you’re taking blood pressure medication. Here’s what you can do:
Since high blood pressure doesn’t cause many symptoms at first, you probably won’t feel any different with a high blood pressure diagnosis. But it’s important to follow your provider’s instructions to bring your blood pressure down so it doesn’t cause serious illnesses later in life. Exercising and eating healthy foods also helps lower your blood pressure.
If you have primary high blood pressure, you’ll need to control it for the rest of your life.
If you have secondary high blood pressure, your blood pressure will most likely come down after you receive treatment for the medical problem that caused it. If a medication caused your high blood pressure, switching to a different medicine may lower your blood pressure.