What is high blood pressure?

Everything Know About High Blood Pressure (Hypertension)

Your blood pressure measurement takes into account how much blood is 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. 

What is high blood pressure?

Narrow blood vessels, also known as arteries, create more resistance for blood flow. The narrower your arteries are, 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. In fact, since the guidelines changed in 2017, nearly half of American adults could now be diagnosed with this condition.

Hypertension typically develops over the course of several years. Usually, you don’t notice 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 your doctor notice any changes. If your blood pressure is elevated, your doctor may have you check your blood pressure over a few weeks to see if the number stays elevated or falls back to normal levels.

Treatment for hypertension includes both prescription medication and healthy lifestyle changes. If the condition isn’t treated, it could lead to health issues, including heart attack and stroke.

Diagnosis and blood pressure chart

Doctors measure blood pressure in millimeters of mercury (mm Hg).

There are two parts to a blood pressure measurement: Systolic pressure, the top number on a blood pressure reading, is the blood pressure when the heart contracts. Diastolic pressure is the blood pressure between heartbeats. It is the lower number of the measurement and represents the blood pressure when the heart rests between beats.

Therefore, if blood pressure is 120/80 mm Hg, the systolic pressure is 120 mm Hg and the diastolic pressure is 80 mm Hg.

A blood pressure monitor works byTrusted Source stopping the blood flow, usually to the lower arm, and then letting it start again. If a doctor uses a manual sphygmomanometer with a stethoscope, they will not hear any sounds until the blood starts to flow. The first sound they will hear is when the pressure approaches systolic blood pressure. When the sound disappears again, it marks diastolic blood pressure.

                                                        Systolic (mm Hg) Diastolic (mm Hg)

Normal blood pressure               less than 120 less than 80

Elevated blood pressure                       120–129 less than 80

Grade 1 hypertension                                   130–139 80–89

Grade 2 hypertension                         140 and over 90 and over

Healthy: A healthy blood pressure reading is less than 120/80 millimeters of mercury (mm Hg).

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, your doctor 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 any symptoms like chest pain, headache, shortness of breath, or visual changes occur when blood pressure is this high, medical care in the emergency room is needed.

A blood pressure reading is taken with a pressure cuff. For an accurate reading, it’s important you have a cuff that fits. 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’re asked to monitor their blood pressure.

What are the symptoms of hypertension?

Most people with high blood pressure will not experience any symptoms, which is why people often call hypertension the “silent killer.”

However, once blood pressure reaches about 180/120 mm Hg, it becomes a hypertensive crisis, which constitutes a medical emergency.

At this stage, a person may have:

a headache

nausea

vomiting

dizziness

blurred or double vision

nosebleeds

heart palpitations

breathlessness

Anybody who experiences these symptoms should seek immediate medical attention.

Symptoms in females

Hormonal factors mean that the risk of high blood pressure may be different in males and females.

Factors that can increase the riskTrusted Source of high blood pressure in females include:

pregnancy

menopause

using birth control pills

During pregnancy, high blood pressure can indicate preeclampsia, a potentially dangerous condition that can affect both the person and their fetus.

Symptoms of preeclampsia include:

headaches

vision changes

abdominal pain

swelling due to edema

All people should follow the guidelines for screening and attend all health checks, especially during pregnancy.

Symptoms in teens and people in their early 20s

Teenagers can develop high blood pressure due to obesity or an underlying medical condition.

Possible medical factors includeTrusted Source:

aspects of metabolic conditions, such as type 2 diabetes

kidney disease

endocrine disease, which affects the hormones

vascular disease, which affects the blood vessels

a neurological condition

These conditions may have symptoms of their own.

The symptoms of high blood pressure, if they occur, will be the same as for other groups.

A 2021 studyTrusted Source notes that, while death rates from cardiovascular disease have fallen among older adults, the reduction has been less dramatic in those aged 18–39 years. The author suggests there are lower rates of awareness, treatment, and management of high blood pressure in those aged 20–39. With this in mind, they call for more effective identification of high blood pressure in these age groups to help reduce the risk of cardiovascular problems later in life.

Symptoms in children

High blood pressure can affect children. Having obesity and diabetes increases the risk, but other underlying causes include:

a tumor

heart problems

kidney problems

obstructive sleep apnea

a rheumatologic disorder

thyroid problems

a genetic condition, such as Cushing’s syndrome

the use of certain drugs

a diet high in fat and salt

As with adults, high blood pressure does not often cause symptoms in children.

However, if they occur, they may include:

a headache

fatigue

cognitive changes or changes in mental status

vomiting

These symptoms are likely to indicate severe hypertension.

They may also have signs of another condition.

Symptoms in babies

Newborns and very young babies can sometimes have high blood pressure due to an underlying health condition, such as kidney or heart disease.

Clinical tests may showTrusted Source there are problems with blood pressure or the cardiopulmonary system.

Any symptoms may be non-specific or not noticeable, or hypertension may occur alongside symptoms of other conditions.

An infant with high blood pressure may also experience:

seizures

irritability

lethargy

feeding problems

rapid breathing

apnea

Other symptoms will depend on the condition causing the high blood pressure.

What causes high blood pressure?

There are two types of hypertension. Each type has a different cause.

Essential (primary) hypertension

Essential hypertension is also called primary hypertension. This kind of hypertension develops over time. Most people have this type of high blood pressure.

A combination of factors typically play a role in the development of essential hypertension:

Genes: Some people are genetically predisposed to hypertension. This may be from gene mutations or genetic abnormalities inherited from your parents.

Age: Individuals over 65 years old are more at risk for hypertension.

Race: Black non-Hispanic indiviuals have a higher incidence of hypertension.

Living with obesity: Living with obesity can lead to a few cardiac issues, including hypertension.

High alcohol consumption: Women who habitially have more than one drink per day, and men who have more than two drinks per day, may be at an increased risk for hypertension.

Living a very seditary lifestlye: lowered levels of fitness have been connected to hypertension.

Living with diabetes and/or metabolic syndrome: Individuals diagnosed with either diabetes or metabolic syndrome are at a higher risk of developing hypertension.

high sodium intake: There’s a small association between daily high sodium intake (more than 1.5g a day) and hypertension.

Secondary hypertension

Secondary hypertension often occurs quickly and can become more severe than primary hypertension. Several conditionsTrusted Source that may cause secondary hypertension include:

kidney disease

obstructive sleep apnea

congenital heart defects

problems with your thyroid

side effects of medications

use of illegal drugs

chronic consumption of alcohol

adrenal gland problems

certain endocrine tumors

How to lower blood pressure

Treatment will depend on several factors, including how high the blood pressure is and the risk of cardiovascular disease or a stroke.

The doctor will recommend different treatments as blood pressure increases. For slightly high blood pressure, they may suggest making lifestyle changes and monitoring the blood pressure.

If blood pressure is high, they will recommend medication. The options may change over time, according to how severe the hypertension is and whether complications arise, such as kidney disease. Some people may also need a combination of several different medications.

Medications

Conventional drugsTrusted Source for treating high blood pressure include:

Angiotensin converting enzyme inhibitors

Angiotensin converting enzyme (ACE) inhibitors block the actions of some hormones that regulate blood pressure, such as angiotensin II. Angiotensin II causes the arteries to constrict and increases blood volume, increasing blood pressure.

ACE inhibitors can reduce the blood supply to the kidneys, making them less effective. As a result, people taking them need to undergo regular blood tests.

Additionally, individuals should not use ACE inhibitors if they are pregnant or have a condition that affects the blood supply to the kidneys.

ACE inhibitors may cause the following side effects, which usually resolve after a few days:

dizziness

fatigue

weakness

headaches

a persistent dry cough

If the side effects are persistent or too unpleasant to manage, a doctor may prescribe an angiotensin II receptor antagonist instead.

These alternative medications often cause fewer side effects, but they may include dizziness, headaches, and increased potassium levels in the blood.

Calcium channel blockers

Calcium channel blockers (CCBs) aim to decrease calcium levels in the blood vessels. This will relax the vascular smooth muscle, causing the muscle to contract less forcefully, the arteries to widen, and blood pressure to reduce.

However, CCBs may not always be suitable for people with a history of heart disease, liver disease, or blood circulation issues. A doctor can advise on taking CCBs and which type is safe to use.

The following side effects may occur with CCBs, but they usually resolve after a few days:

skin redness, generally on the cheeks or neck

headaches

swollen ankles and feet

dizziness

fatigue

skin rash

swollen abdomen, in rare cases

Thiazide diuretics

Thiazide diuretics help the kidneys remove sodium and water, lowering blood volume and pressure.

The following side effects of taking them can occur, and some may persist:

low blood potassium, which can affect heart and kidney function

impaired glucose tolerance

erectile dysfunction

People taking thiazide diuretics should undergo regular blood and urine tests to monitor their blood sugar and potassium levels.

Beta-blockers

Beta-blockers were once popular for treating hypertension, but doctors now only tend to prescribe them when other treatments are ineffective.

These medications slow the heart rate and reduce the force of the heartbeat, causing a drop in blood pressure.

Side effects from beta-blockers may include:

fatigue

cold hands and feet

slow heartbeat

nausea

diarrhea

Less common side effects are:

disturbed sleep

nightmares

erectile dysfunction

Beta-blockers are often the standard medication for a person with very high blood pressure, known as a hypertensive crisis.

Renin inhibitors

Aliskiren (Tekturna, Rasilez) reduces the production of renin, an enzyme that the kidneys produce.

Renin helps produce a hormone that narrows blood vessels and raises blood pressure. Reducing this hormone causes the blood vessels to widen and blood pressure to fall.

Possible side effects include:

diarrhea

dizziness

flu-like symptoms

fatigue

a cough

It is essential to read the packaging of any medication to check for interactions with other drugs.

Diet

Managing the diet can be an effective way of preventing and treating high blood pressure.

Plant-based foods

A nutritious, balanced diet includes plenty of fruits and vegetables, vegetable and omega oils, and good quality, unrefined carbohydrates, such as whole grains. People who include animal products in their diet should trim the fat off and avoid processed meats.

Lowering salt intake

Experts recommend reducing salt consumption and increasing potassium intake to manage or prevent high blood pressure. Limiting salt intake to less than 5–6 gramsTrusted Source per day could help improve cardiovascular health and reduce systolic blood pressure by 5.6 mm Hg in people with hypertension.

Nutritious fats

In moderation, plant-based sources of fats, such as avocados, nuts, olive oil, and omega oils, can provide benefits. People should limit their intake of saturated fats and trans fats, common in animal-sourced and processed foods.

Alcohol

One study in womenTrusted Source indicated that consuming some alcohol may help lower blood pressure. However, others reportTrusted Source the opposite, noting that even drinking a moderate amount might increase blood pressure levels.

People who regularly drink more than moderate amounts of alcohol will almost always experience elevated blood pressure levels.

Caffeine

Studies into the relationship between caffeine and blood pressure have produced conflicting results. A report published in 2017 concluded that a moderate intake of coffee appears to be safe for people with high blood pressure.

Management and treatment

The AHA recommendsTrusted Source a range of lifestyle adjustments that can help reduce blood pressure, such as:

managing stress

quitting smoking

consuming a nutritious diet

getting exercise

following any treatment plan the doctor prescribes

Discuss any planned lifestyle changes with a healthcare professional before introducing them.

Regular exercise

The AHA notes that most healthy people should do at least 150 minutes of moderate-intensity physical exercise a week. This could be 30 minutes — or three sessions of 10 minutes a day — 5 days per week.

This amount of exercise is also appropriate for those with high blood pressure.

However, a person who has not exercised for a while or who has a new diagnosis should speak with their doctor before starting a new physical activity program to ensure it is suitable.

Losing weight

StudiesTrusted Source have revealed that losing as little as 5–10 pounds in weight can help reduce blood pressure.

Weight loss will also improve the effectiveness of blood pressure medications.

Methods of achieving and maintaining a moderate weight include getting regular exercise and following a diet that emphasizes plant-based foods. A person should also limit their intake of fat and added sugars.

Sleep

Increasing sleep alone cannot treat hypertension, but too little sleep and reduced sleep quality may make it worse.

A 2015 analysisTrusted Source of data from a Korean national health survey found that people who had under 5 hours of sleep per night were more likely to have hypertension.

Natural remedies

According to the National Center for Complementary and Integrative Health (NCCIH), the following may help lowerTrusted Source blood pressure:

meditation, yoga, qi gong, and tai chi

biofeedback and transcendental meditation

supplements such as garlic, flaxseed, green or black tea, probiotics, cocoa, and roselle (Hibiscus sabdariffa)

However, the NCCIH adds that there is insufficient evidence to confirm that these can make a difference.

It also warns that some supplements can have adverse effects, such as raising blood pressure or interacting with medications. The organization states that meditation and exercise therapies are usually safe, but some poses may not be suitable for people with high blood pressure.

Anyone considering an alternative therapy should speak with their doctor first.

Diagnosis

There are different devices for measuring blood pressure. A doctor may use a digital device or a manual sphygmomanometer with a stethoscope. This has a pressure cuff that they put around the person’s arm.

Digital blood pressure-measuring devices suitable for home use are also available for purchase online.

A person will typically need more than one reading to confirm a diagnosis, as various factors can affect the result.

Blood pressure can fluctuate:

according to the time of day

during feelings of anxiety or stress

after eating

However, a doctor will take immediate action if a reading shows very high blood pressure or if there are signs of organ damage or other complications.

What are the effects of high blood pressure on the body?

Because hypertension is often a silent condition, it can cause damage to your body for years before symptoms become obvious. If hypertension isn’t treated, you may face serious, even fatal, complications.

Damaged arteries

Healthy arteries are flexible and strong. Blood flows freely and unobstructed through healthy arteries and vessels.

Hypertension makes arteries tougher, tighter, and less elastic. This damage makes it easier for dietary fats to deposit in your arteries and restrict blood flow. This damage can lead to increased blood pressure, blockages, and, eventually, heart attack and stroke.

Damaged heart

Hypertension makes your heart work too hard. The increased pressure in your blood vessels forces your heart’s muscles to pump more frequently and with more force than a healthy heart should have to.

This may cause an enlarged heart. An enlarged heart increases your risk for the following:

heart failure

arrhythmias

sudden cardiac death

heart attack

Damaged brain

Your brain relies on a healthy supply of oxygen-rich blood to work properly. Untreated high blood pressure can reduce your brain’s supply of blood:

Temporary blockages of blood flow to the brain are called transient ischemic attacks (TIAs).

Significant blockages of blood flow cause brain cells to die. This is known as a stroke.

Uncontrolled hypertension may also affect your memory and ability to learn, recall, speak, and reason. Treating hypertension often doesn’t erase or reverse the effects of uncontrolled hypertension. But it does lower the risks for future problems.

The kidneys: 

High blood pressure can result in kidney damage and chronic kidney disease.

Complications

Without treatment or taking measures to manage blood pressure, excessive pressure on the artery walls can cause damage to the blood vessels, a form of cardiovascular disease. It can also damage vital organs.

Possible complications of high blood pressure include:

stroke

heart disease

heart attack

heart failure

peripheral arterial disease

aortic aneurysm

kidney disease

vascular dementia

Seeking early treatment and managing blood pressure can help prevent many health complications

.

Risk factors

The risk factorsTrusted Source for high blood pressure include the following:

Age: The risk increases with age because the blood vessels become less flexible.

Family history and genetic factors: People who have close family members with hypertension are more likely to develop it.

Obesity and having excess weight: People with overweight or obesity are more likely to develop high blood pressure.

Physical inactivity: A sedentary lifestyle increases the risk.

Smoking: When people smoke, the blood vessels narrow, and blood pressure rises. Smoking also reduces the blood’s oxygen content, so the heart pumps faster to compensate, which also increases blood pressure.

Alcohol intake: Drinking a lot of alcohol increases the risk of blood pressure and its complications, such as heart disease.

Diet: A diet high in unsaturated fat and salt increases the risk of high blood pressure.

High cholesterol: Over 50%Trusted Source of people with high blood pressure have high cholesterol. Consuming nonnutritious fats can contribute to a buildup of cholesterol in the arteries.

Mental stress: Stress can have a severe effect on blood pressure, especially when it is chronic. It can occur due to both socioeconomic and psychosocial factors.

Stress: Persistent stress can lead to high blood pressure. It may also increase the likelihood of practices that can affect health, such as smoking or drinking.

Diabetes: High blood pressure often occurs alongside diabetes. However, following a treatment plan to manage diabetes can reduce the risk. Learn more about hypertension and diabetes.

Pregnancy: High blood pressure is more likely during pregnancy due to hormonal changes. Hypertension is also a symptom of preeclampsia, a potentially severe placental disorder.

Sleep apnea: People with sleep apnea momentarily stop breathing while they sleep. Health experts suggest there are links with hypertension.