High blood pressure is a common
condition in which the force of the
blood against your artery walls is
high enough that it may eventually
cause health problems, such as
heart disease.
Blood pressure is determined 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.
You can have high blood pressure (hypertension) for years
without any symptoms. Uncontrolled high blood pressure
increases your risk of serious health problems, including heart
attack and stroke.
High blood pressure typically develops over many years, and it
affects nearly everyone eventually. 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.
Symptoms
Most people with high blood pressure have no signs or
symptoms, even if blood pressure readings reach dangerously
high levels.
Although a few people with early-stage high blood pressure
may have dull headaches, dizzy spells or a few more
nosebleeds than normal, these signs and symptoms typically
don’t occur until high blood pressure has reached a severe —
even life-threatening — stage
When to see a doctor
You’ll likely have your blood pressure taken as part of a
routine doctor’s appointment.
Ask your doctor for a blood pressure reading at least every
two years starting at age 18. He or she will likely recommend
more frequent readings if you’ve already been diagnosed with
high blood pressure or other risk factors for cardiovascular
disease. Children age 3 and older will usually have their blood
pressure measured as a part of their yearly checkups.
If you don’t regularly see your doctor, you may be able to get a
free blood pressure screening at a health resource fair or
other locations in your community. You can also find machines
in some stores that will measure your blood pressure for
free, but these machines can give you inaccurate results.
Causes
There are two types of high blood pressure.
1. Primary (essential) hypertension
For most adults, there’s no identifiable cause of high blood
pressure. This type of high blood pressure, called essential
hypertension or primary hypertension, 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, called secondary
hypertension, tends to appear suddenly and cause higher
blood pressure than does primary hypertension. Various
conditions and medications can lead to secondary
hypertension, including:
Kidney problems
Adrenal gland tumors
Certain defects in blood vessels you’re born with (conprivate
part)
Certain medications, such as birth control pills, cold remedies,
decongestants, over-the-counter pain relievers and some
prescription drugs
Illegal drugs, such as cocaine and amphetamines
Blood Pressure Measurement
Blood pressure measurements fall into four general
categories:
1. Normal blood pressure. Your blood pressure is normal if it’s
below 120/80 mm Hg. However, some doctors recommend
115/75 mm Hg as a better goal. Once blood pressure rises
above 115/75 mm Hg, the risk of cardiovascular disease
begins to increase.
2. Prehypertension. Prehypertension is a systolic pressure
ranging from 120 to 139 mm Hg or a diastolic pressure
ranging from 80 to 89 mm Hg. Prehypertension tends to get
worse over time.
3. Stage 1 hypertension. Stage 1 hypertension is a systolic
pressure ranging from 140 to 159 mm Hg or a diastolic
pressure ranging from 90 to 99 mm Hg.
4. Stage 2 hypertension. More severe hypertension, stage 2
hypertension is a systolic pressure of 160 mm Hg or higher or
a diastolic pressure of 100 mm Hg or higher.
Both numbers in a blood pressure reading are important. But
after age 50, the systolic reading is even more significant.
Isolated systolic hypertension — when diastolic pressure is
normal but systolic pressure is high — is the most common
type of high blood pressure among people older than 50.
Medications to treat high blood pressure
1. Thiazide diuretics. Diuretics, sometimes called water pills,
are medications that act on your kidneys to help your body
eliminate sodium and water, reducing blood volume. Thiazide
diuretics are often the first — but not the only — choice in
high blood pressure medications. If you’re not taking a diuretic
and your blood pressure remains high, talk to your doctor
about adding one or replacing a drug you currently take with a
diuretic.
2. Beta blockers. These medications reduce the workload on
your heart and open your blood vessels, causing your heart to
beat slower and with less force. When prescribed alone, beta
blockers don’t work as well in blacks or in older adults — but
they’re effective when combined with a thiazide diuretic.
3. Angiotensin-converting enzyme (ACE) inhibitors. These
medications help relax blood vessels by blocking the formation
of a natural chemical that narrows blood vessels.
Angiotensin II receptor blockers (ARBs). These medications
help relax blood vessels by blocking the action — not the
formation — of a natural chemical that narrows blood vessels.
4. Calcium channel blockers. These medications help relax the
muscles of your blood vessels. Some slow your heart rate.
Calcium channel blockers may work better for blacks and older
adults than do ACE inhibitors or beta blockers alone. A word of
caution for grapefruit lovers, though. Grapefruit juice
interacts with some calcium channel blockers, increasing blood
levels of the medication and putting you at higher risk of side
effects. Talk to your doctor or pharmacist if you’re
concerned about interactions.
5. Renin inhibitors. Aliskiren (Tekturna) slows down the
production of renin, an enzyme produced by your kidneys that
starts a chain of chemical steps that increases blood
pressure. Tekturna works by reducing the ability of renin to
begin this process. Due to a risk of serious complications,
including stroke, you shouldn’t take aliskiren with ACE
inhibitors or ARBs.
Prevention
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:
1. Eat healthy foods. Try the Dietary Approaches to Stop
Hypertension (DASH) diet, which emphasizes fruits,
vegetables, whole grains and low-fat dairy foods. Get plenty
of potassium, which can help prevent and control high blood
pressure. Eat less saturated fat and total fat.
2. Decrease the salt in your diet. A lower sodium level —
1,500 milligrams (mg) a day — is appropriate for people 51
years of age or older, and individuals of any age who are
African-American or who have hypertension, diabetes or
chronic kidney disease. Otherwise healthy people can aim for
2,300 mg a day or less. While you can reduce the amount of
salt you eat by putting down the saltshaker, you should also
pay attention to the amount of salt that’s in the processed
foods you eat, such as canned soups or frozen dinners.
3. Maintain a healthy weight. If you’re overweight, losing even
5 pounds (2.3 kilograms) can lower your blood pressure.
4. Increase physical activity. Regular physical activity can help
lower your blood pressure and keep your weight under
control. Strive for at least 30 minutes of physical activity a
day.
5. Limit alcohol. Even if you’re healthy, alcohol can raise your
blood pressure. If you choose to drink alcohol, do so in
moderation — up to one drink a day for women and everyone
older than age 65, and two drinks a day for men.
6. Don’t smoke. Tobacco injures blood vessel walls and speeds
up the process of hardening of the arteries. If you smoke, ask
your doctor to help you quit.
7. Manage stress. Reduce stress as much as possible.
Practice healthy coping techniques, such as muscle relaxation
and deep breathing. Getting plenty of sleep can help, too.
8. Monitor your blood pressure at home. Home blood pressure
monitoring can help you keep closer tabs on your blood
pressure, show if medication is working, and even alert you
and your doctor to potential complications. If your blood
pressure is under control, you may be able to make fewer
visits to your doctor if you monitor your blood pressure at
home.
9. Practice relaxation or slow, deep breathing. Practice taking
deep, slow breaths to help relax. There are some devices
available that can help guide your breathing for relaxation;
however, it’s questionable whether these devices have a
significant effect on lowering your blood pressure
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