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.

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.

When the cause of hypertension is known, such as kidney disease or a tumor, it is called secondary hypertension.

What is the cause?

Many medical conditions, diseases, and medicines can cause secondary hypertension, including:

• Narrowing of the arteries to the kidneys
• Narrowing of the aorta, a large blood vessel that supplies blood to the lower body
• Kidney disease
• High levels of some hormones in the blood
• An adrenal gland tumor (your adrenal glands are located near the top of each kidney and they make several different hormones)
• Thyroid problems and some other autoimmune diseases
• Medicines such as estrogen and oral contraceptives
• Abuse of drugs such as amphetamines, alcohol, or diet pills
• Pregnancy

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
• Blurred vision
• Dizziness
• Lightheadedness
• Shortness of breath
• Chest pain
• Memory problems

How is it diagnosed?

Your healthcare provider will ask about your symptoms and 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
• An ECG (also called an EKG or electrocardiogram), 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?

You will be treated for the condition causing the high blood pressure. For example, if you have a thyroid problem, treating it can lower your blood pressure.

Your healthcare provider may also prescribe medicines to lower blood pressure. You may need more than one medicine to control your blood pressure.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Make sure you know how and when to take your medicine. Do not take more or less than you are supposed to take.
• 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.
• Make sure to take your blood pressure when you are seated and after resting for at least 5 minutes in a quite location. Have your feet flat on the ground and your back supported. Place your arm at heart level resting on a table or chair. Take your blood pressure 3 times (30 seconds in between each reading) and record the 3 reading.
• Take care of your health. Try to get at least 7 to 9 hours of sleep each night. If you smoke, try to quit. If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink. Learn ways to manage stress. Exercise according to your healthcare provider’s instructions.
• 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.
• Lose weight if you are overweight.
• Ask your healthcare provider:
  • How and when you will hear your test results
  • How long it will take to recover
  • If there are 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. Keep all appointments for provider visits or tests.

How can I help prevent secondary hypertension?

Most of the conditions that cause secondary hypertension cannot be prevented. However, regular checkups can help find many conditions before they become serious, including those that can lead to high blood pressure.