What is high blood pressure?

Blood pressure is the force of blood against artery walls as the heart pumps blood through the body. You may be told that you have high blood pressure (hypertension) if your blood pressure is higher than normal. Hypertension is called essential when no cause for it can be found. When the cause of hypertension is known, such as kidney disease or a tumor, it is called secondary hypertension.

Blood pressure can rise and fall with exercise, rest, or emotions.

• Normal resting blood pressure ranges up to 120/80 (“120 over 80”). The first number (120 in this example) is the pressure when the heart beats and pushes blood out to the rest of the body. The second number (80 in this example) is the pressure when the heart rests between beats.
• Blood pressure is borderline high if it is 120/80 or higher but less than 140/90.
• High blood pressure is 140/90 or higher for most people.
  • If you have diabetes, 140/80 is considered high blood pressure.
  • If you have chronic kidney disease, 130/80 or higher is considered high blood pressure.

Why is high blood pressure a problem?

High blood pressure is a problem in many ways.

• Your heart has to work harder to pump blood through your body. The added workload on the heart causes thickening of the heart muscle. Over time, the thickening damages the heart muscle so that it can no longer pump normally. This can lead to a disease called heart failure.
• The higher pressure in your arteries may cause them to weaken and bleed, resulting in a stroke.
• As you get older, blood vessels may become hardened. High blood pressure speeds up this process. Hardened or narrowed arteries may not be able to supply enough blood to all parts of your body.
• High blood pressure may lead to atherosclerosis, in which deposits of cholesterol, fatty substances, and blood cells clog up an artery. Atherosclerosis is the leading cause of heart attacks. It can also cause strokes.
• Your kidneys, brain, and eyes may also be damaged.

You may need treatment for high blood pressure for the rest of your life. However, proper treatment can control your blood pressure and help prevent heart disease, heart attack, or stroke. It can also help prevent long-term health problems, such as heart failure, kidney failure, blindness, and dementia.

If you already have some complications, such as breathing problems or chest pain, lowering your blood pressure may make these problems less severe.

What is the cause?

There are no clear causes of essential hypertension. However, many things can increase blood pressure, such as:

• Being overweight
• Smoking
• Eating a diet high in salt
• Drinking a lot of alcohol

Other important factors include:

• Race. African Americans are more likely to have high blood pressure.
• Gender. Males have a greater chance of developing high blood pressure than women until age 55. After the age of 75, women are more likely to develop high blood pressure than men.
• Heredity. If you have parents with high blood pressure, you are more at risk.
• Age. The older you get, the more likely you are to have high blood pressure.

Also, some medicines increase blood pressure.

Stress and drinking caffeine can make blood pressure go up temporarily but it’s not clear that they have any long-term effects on blood pressure.

What are the symptoms?

You may have high blood pressure for a long time without symptoms. You may not be able to tell by the way you feel that your blood pressure is high. The only way to find out if your blood pressure is high is to have it measured. That’s why it’s important to have your blood pressure checked at least once a year.

When high blood pressure does cause symptoms, they may include:

• Headaches
• Nosebleeds
• Getting tired easily
• Blurred vision
• Dizziness
• Lightheadedness
• Feeling like your heart is racing or fluttering
• Shortness of breath
• Chest pain
• Memory problems
• Daytime sleepiness

How is it diagnosed?

Blood pressure is checked at most healthcare visits. High blood pressure is usually discovered during one of these visits. If your blood pressure is high, you will be asked to return for follow-up checks. Your healthcare provider will ask about your personal and family medical history and examine you. Tests to look for a possible cause of high blood pressure may include:

• Urine and blood tests
• Chest X-ray
• Electrocardiogram (ECG), which measures and records your heartbeat

You may be asked to use a portable blood-pressure measuring device, which will take your pressure at different times during day and night.

How is it treated?

If your blood pressure is borderline high, you may be able to bring it down to a normal level without medicine. Weight loss, changes in your diet, and exercise may be the only treatment you need.

If lifestyle changes don’t lower your blood pressure enough, your healthcare provider may prescribe medicine. Many people need to take 2 or more medicines to bring their blood pressure down to a healthy level. It may take several weeks or months to find the best treatment for you.

How can I take care of myself?

If you have high blood pressure, there are things you can do now to take care of yourself and to prevent problems in the future:

• Follow your treatment plan and know how to take your medicines.
  • Work with your healthcare provider to find what lifestyle changes and medicines are right for you.
  • Follow the directions that come with your medicine, including information about food or alcohol. Make sure you know how and when to take your medicine. Do not take more or less than you are supposed to take.
  • Many medicines have side effects. A side effect is a symptom or problem that is caused by the medicine. Ask your healthcare provider or pharmacist what side effects your medicine may cause and what you should do if you have side effects. Ask if you should avoid some nonprescription medicines.
  • Be careful with nonprescription medicines or herbal supplements. Some can raise blood pressure. This includes diet pills, cold and pain medicines, and energy boosters. Read labels or ask your pharmacist if the medicine or supplement affects blood pressure. Some illegal drugs, like cocaine, can also affect blood pressure.
  • Check your blood pressure (or have it checked) as often as your provider advises. Keep a diary of the readings. A diary is also a good place to note your exercise, weight, salt intake, types of food you are eating, and your feelings. This can help you learn how these things can affect your blood pressure. Take your diary with you when you visit your provider.
• Don’t smoke.
• Eat a healthy diet that is low in salt, saturated fat, trans fat, and cholesterol. Include lots of fruits, vegetables, and fat-free or low-fat milk and milk products.
• Get regular exercise, according to your healthcare provider’s advice. For example, you might walk, bike, or swim at least 30 minutes 3 to 5 times a week.
• Limit the amount of alcohol you drink. Moderate drinking is up to 1 drink a day for women and up to 2 drinks for men.
• Lose weight if you need to.
• Try to reduce the stress in your life or learn how to deal better with situations that make you feel anxious.
• Ask your healthcare provider:
  • How and when you will hear your test results
  • How long it will take to recover
  • What activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them
• Make sure you know when you should come back for a checkup.

How can I help prevent high blood pressure?

You can help prevent this disease with a heart-healthy lifestyle:

• Eat a healthy diet and keep a healthy weight.
• Stay fit with the right kind of exercise for you.
• Decrease stress.
• Don’t smoke.
• Limit your use of alcohol.

Talk to your healthcare provider about your personal and family medical history and your lifestyle habits. This will help you know what you can do to lower your risk for high blood pressure.