High blood pressure
Overview
Your doctor calls it hypertension.
High blood pressure is a common condition. Blood pressure is determined by the amount of blood the heart pumps and the resistance to blood flow in your arteries. The more blood the heart pumps and the narrower your arteries are, the higher your blood pressure will be. You can have high blood pressure (hypertension) for years without any symptoms.
Even if you have no symptoms, damage to your blood vessels and heart continues to occur and can be detected.
Uncontrolled high blood pressure increases the risk of serious health problems, including heart attacks and strokes.
High blood pressure generally develops over the course of many years, and can eventually affect almost anyone.
Fortunately, high blood pressure can be easily detected.
Once you know you have high blood pressure, you can work with your doctor to manage it.
Symptoms
Even if you have no symptoms, damage to your blood vessels and heart continues to occur and can be detected.
Uncontrolled high blood pressure increases the risk of serious health problems, including heart attacks and strokes.
High blood pressure generally develops over the course of many years, and can eventually affect almost anyone.
Fortunately, high blood pressure can be easily detected.
Once you know you have high blood pressure, you can work with your doctor to manage it.
Causes
There are two types of high blood pressure.
1. Primary (essential) hypertension
In most adults, the cause of high blood pressure cannot be identified.
This type of high blood pressure, known as primary (essential) hypertension, tends to develop gradually over the course of many years.
2. Secondary hypertension
Some people have high blood pressure caused by an underlying condition.
This type of high blood pressure, known as secondary hypertension, tends to develop suddenly and results in higher blood pressure than primary hypertension.
Various conditions and medications can cause secondary hypertension, including:
• Obstructive sleep apnea
• Kidney disease
• Adrenal gland tumor
• Thyroid disorders
• Certain abnormalities of the blood vessels that are present from birth (congenital)
• Certain medications, such as birth control pills, cold medicine, decongestants, over-the-counter pain relievers, and some prescription medications
• Illegal drugs, such as cocaine and amphetamines
• Alcohol abuse or chronic alcohol consumption
Risk factors
High blood pressure has many risk factors, including:
1. Age.
The risk of high blood pressure increases with age.
Until early middle age—or around age 45—high blood pressure is more common in men.
Women are more likely to develop high blood pressure after age 65.
2. Race.
High blood pressure is very common among Black people and often develops at a younger age than among White people.
Serious complications, such as stroke, heart attack, and kidney failure, are also more common among Black people.
3. Family History.
High blood pressure tends to run in families.
4. Being overweight or obese.
The more you weigh, the more blood is needed to supply oxygen and nutrients to your body’s tissues.
When the volume of blood circulating through your blood vessels increases, the pressure on your artery walls also increases.
5. Lack of physical activity.
People who are less active tend to have a higher heart rate.
The higher your heart rate, the harder your heart has to work with each contraction, and the greater the pressure exerted on your arteries.
A lack of physical activity also increases the risk of being overweight.
6. Using tobacco.
Smoking or chewing tobacco not only causes a temporary, immediate increase in blood pressure, but the chemicals in tobacco can also damage the lining of your artery walls.
This can cause your arteries to narrow, which raises your blood pressure.
Secondhand smoke can also raise your blood pressure.
7. Too much salt (sodium) in the diet.
Too much sodium in the diet can cause the body to retain fluid, which raises blood pressure.
8. Too little potassium in the diet.
Potassium helps balance the amount of sodium inside your cells.
If you don't get enough potassium from your diet or your body doesn't retain enough potassium, too much sodium can build up in your blood.
9. Too little vitamin D in the diet.
It is not yet clear whether too little vitamin D in the diet can cause high blood pressure. Vitamin D may affect enzymes produced by the kidneys that influence your blood pressure.
10. Drinking too much alcohol.
Over time, excessive alcohol consumption can damage your heart.
Drinking more than two servings of alcohol per day for men and more than one serving per day for women can affect your blood pressure.
If you drink alcohol, do so in moderation.
For healthy adults, this means up to one serving of alcohol per day for women of all ages and men over 65, and up to two servings per day for men 65 or younger. One serving is equivalent to 12 fluid ounces of beer, 5 fluid ounces of wine, or 1.5 fluid ounces of 80-proof spirits.
11. Stress
High stress levels can cause a temporary increase in blood pressure.
If you try to calm yourself by eating more, using tobacco, or drinking alcohol, you may actually make your high blood pressure worse.
12. Certain chronic conditions.
Certain chronic conditions can also increase the risk of high blood pressure, such as kidney disease, diabetes, and sleep apnea.
Pregnancy can sometimes contribute to high blood pressure.
Although high blood pressure is most common in adults, children may also be at risk.
In some children, high blood pressure is caused by problems with the kidneys or heart.
However, among an increasing number of children, unhealthy lifestyle habits—such as poor diet, obesity, and lack of exercise—are contributing to high blood pressure.
Complications
Excessive pressure on the artery walls caused by high blood pressure can damage your blood vessels and organs.
The higher your blood pressure is and the longer it remains uncontrolled, the greater the damage that occurs. Uncontrolled high blood pressure can cause:
1. Heart attack or stroke.
High blood pressure can cause the arteries to harden and thicken (atherosclerosis), which can lead to a heart attack, stroke, or other complications.
2. Aneurysm.
An increase in blood pressure can cause blood vessels to weaken and bulge, forming an aneurysm.
If an aneurysm ruptures, it can be life-threatening.
3. Heart failure.
To pump blood against the higher pressure in your blood vessels, your heart muscle thickens.
Eventually, the thickened muscle may have difficulty pumping enough blood to meet your body’s needs, which can lead to heart failure.
4. Weakened and narrowed blood vessels.
Weakened and narrowed blood vessels in the kidneys can prevent the organ from functioning normally.
Blood vessels in the eye that thicken, narrow, or rupture can cause vision loss.
6. Metabolic syndrome.
This syndrome is a group of metabolic disorders, including:
• increased waist circumference
• high triglyceride levels
• Low levels of high-density lipoprotein (HDL) cholesterol, also known as “good” cholesterol
• high blood pressure; and high insulin levels.
• These conditions make you more likely to develop diabetes, heart disease, and stroke.
7. Difficulty remembering or understanding.
Uncontrolled high blood pressure can also affect your ability to think, remember, and learn. Difficulty remembering or understanding concepts is more common in people with high blood pressure.
Diagnosis
• To measure your blood pressure, a doctor or healthcare professional will usually place an inflatable cuff on your arm and measure your blood pressure using a blood pressure monitor.
• Blood pressure readings, expressed in millimeters of mercury (mm Hg), consist of two numbers. The first number, or top number, measures the pressure in your arteries when your heart beats (systolic pressure). The second number, or the lower number, measures the pressure in the arteries between heartbeats (diastolic pressure).
Blood pressure readings are divided into four general categories:
• Normal blood pressure. Your blood pressure is normal if it is below 120/80 mm Hg.
• Elevated blood pressure. Elevated blood pressure means that the systolic pressure ranges from 120 to 129 mm Hg and the diastolic pressure is below 80 mm Hg. Elevated blood pressure tends to worsen over time if steps are not taken to control it.
• Stage 1 hypertension. Stage 1 hypertension means that systolic blood pressure ranges from 130 to 139 mm Hg or diastolic blood pressure ranges from 80 to 89 mm Hg.
• Stage 2 hypertension. Stage 2 hypertension, which is a more severe form of hypertension, is defined as a systolic blood pressure of 140 mm Hg or higher, or a diastolic blood pressure of 90 mm Hg or higher.
Both numbers in a blood pressure reading are equally important. However, after age 60, the systolic number becomes even more important.
Lifestyle and Home Care
Lifestyle changes can help you manage and prevent high blood pressure, even if you’re currently taking blood pressure medication.
Here are some things you can do:
1. Eat healthy foods. Put this into practice healthy eating habits.
Try the DASH (Dietary Approaches to Stop Hypertension) diet, which emphasizes fruits, vegetables, whole grains, poultry, fish, and low-fat dairy products.
• Get enough potassium, which can help prevent and control high blood pressure.
• Reduce your intake of saturated and trans fats.
• Reduce the amount of salt in your diet.
2. Maintain a healthy weight.
Maintaining a healthy weight—or losing weight if you are overweight or obese—can help control high blood pressure and reduce the risk of related health problems.
If you are overweight, losing just 5 pounds (2.3 kilograms) can lower your blood pressure.
3. Improve physical activity.
Regular physical activity can help lower blood pressure, manage stress, reduce the risk of certain health problems, and keep weight under control.
For most healthy adults, the Department of Health and Human Services recommends at least 150 minutes of moderate-intensity aerobic activity per week or 75 minutes of vigorous-intensity aerobic activity per week, or a combination of moderate- and vigorous-intensity activities.
Try to do strength training at least two days a week.
4. Limit your alcohol intake.
Even if you're healthy, alcohol can raise your blood pressure.
If you choose to drink alcohol, do so in moderation.
For healthy adults, this means up to one standard drink per day for women of all ages and men over 65, and up to two standard drinks per day for men 65 or younger.
5. Do not smoke or quit smoking
Tobacco damages the walls of blood vessels and accelerates the hardening of the arteries. If you smoke, ask your doctor for help to quit.
6. Manage stress.
Reduce stress as much as possible.
Practice healthy stress-management techniques, such as muscle relaxation, deep breathing, or meditation. Regular physical activity and getting enough sleep can also help. Read more on the page stress management.
Monitor your blood pressure at home. Monitoring your blood pressure at home can help you keep a closer eye on it, show whether your medication is working, and even alert you and your doctor to potential complications. Home blood pressure monitoring is not a substitute for a doctor’s visit, and home blood pressure monitors may have some limitations. Even if your readings are normal, do not stop or change your medication or alter your diet without first consulting your doctor.
If your blood pressure is under control, you may be able to reduce the frequency of your doctor visits by monitoring your blood pressure at home.
Practice relaxation or slow, deep breathing. Practice taking deep, slow breaths to help calm yourself. There are several devices that can help with slow, deep breathing. However, it remains unclear whether these devices have a significant effect on lowering blood pressure.
Manage your blood pressure during pregnancy. If you are a woman with high blood pressure, talk to your doctor about how to manage your blood pressure during pregnancy.
Alternative Medicine
Although diet and exercise are the most effective ways to lower blood pressure, some supplements may also help lower it. However, more research is needed to determine their potential benefits. These supplements include:
• Fiber, such as blond psyllium and wheat bran
• Minerals, such as magnesium, calcium, and potassium
• Folic acid
• Supplements or products that increase nitric oxide or dilate blood vessels (vasodilators), such as cocoa, coenzyme Q10, L-arginine, or garlic
• Omega-3 fatty acids, found in fatty fish, fish oil supplements, or flaxseeds