Hypertension

Related Video: High Blood Pressure and the DASH Diet

Related Video: Controlling Your High Blood Pressure

Overview

Definition

Blood pressure is the force that blood puts on the blood vessel walls. Blood pressure measurements include 2 numbers:

  • Systolic pressure: top number, normal reading is 120 millimeters of mercury (mmHg) or less
  • Diastolic pressure: bottom number, normal reading is 80 mmHg or less

There is a range of what high blood pressure is. Your doctor will talk to you about what your pressure should be. An example of blood pressure ranges from the American Heart Association (AHA) include:

  • Blood pressure is considered elevated, but not yet hypertension (abnormally high blood pressure) when the:
    • Systolic pressure is 120-129 mmHg and the
    • Diastolic pressure is 80 mmHg
  • Stage 1 hypertension:
    • Systolic pressure is 130-139 mmHg and/or
    • Diastolic pressure is 80-89 mmHg
  • Stage 2 hypertension:
    • Systolic pressure is greater than or equal to 140 mmHg and/or
    • Diastolic pressure is greater than or equal to 90 mmHg

High blood pressure puts stress on the heart, lungs, brain, kidneys, and blood vessels. Over time, it can cause severe damage and illness.

Organs Impacted by High Blood Pressure
High blood pressure and organs
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Causes

The body has a number of steps to help keep blood pressure in a healthy range. It is not clear what changes happen that lead to hypertension. Factors that may play a role include:

  • Genetics
  • Low physical activity levels
  • Dietary choices
  • Overweight or obesity

Risk Factors

High blood pressure develops over time. It is most common in older adults, especially postmenopausal women.

Factors that may increase the risk of high blood pressure include:

  • Overweight
  • Excess alcohol use
  • Smoking
  • Use of oral contraceptives (birth control pills)
  • Sedentary lifestyle
  • Family history
  • Kidney disease
  • Diabetes
  • High-fat, high-salt diet
  • Stress

SymptomsandDiagnosis

Symptoms

High blood pressure usually does not cause symptoms.

If blood pressure reaches extreme levels, symptoms may include:

  • Headache
  • Blurry or double vision
  • Abdominal pain
  • Chest pain
  • Shortness of breath
  • Lightheadedness

Diagnosis

High blood pressure is often found during a doctor's visit. Blood pressure is measured using an arm cuff and a special device. If the reading is high, you will come back for repeat checks. High blood pressure will be confirmed after more than 2 readings over more than 2 visits.

A doctor's office can make some people anxious. This can cause higher than normal blood pressure. You may be asked to measure your blood pressure at home or in another location.

Treatments

Treatment

Treatment will focus on reducing blood pressure. Improving the blood pressure will help to decrease the stress on important organs. It can also decrease the risk of:

  • Heart disease
  • Heart attack
  • Stroke
  • Kidney damage

Treatment may need to be adjusted over time. Options may include:

Lifestyle Changes

Lifestyle changes may be helpful in reducing blood pressure. It is often the first approach. Recommended steps include:

  • Reach and keep a healthy weight.
  • Exercise on a regular basis. Start an exercise program if you don't already exercise.
  • If you smoke, talk to your doctor about ways to quit .
  • Eat a healthful diet. The DASH diet is one known to decrease blood pressure. Heart healthy diets should be:
    • Low in fat, salt, and processed foods
    • Rich in fiber, fruits, and vegetables
  • If you drink alcohol, do so in moderation. Moderate is 2 or fewer drinks per day for men and 1 or fewer drinks per day for women and older adults.
  • Reduce stress levels. Try relaxation techniques like meditation or breathing exercises.

Medicine

Medicine may be needed. It may be needed if lifestyle changes were not effective enough. Some medicine options include:

  • Diuretics—decreases the amount of fluid in the blood
  • Beta blockers—decreases the force and rate of heart beat
  • Medications that help keep blood vessels from tightening and narrowing such as:
    • Angiotensin converting enzyme inhibitors (ACE inhibitors)
    • Angiotensin receptor blockers
    • Calcium channel blockers
    • Alpha blockers
    • Vasodilators
  • Aldosterone blockers—increases amount of salt that is lost out of urine

Prevention

To help reduce the risk of high blood pressure:

  • Eat a well-balanced diet. It should be rich in fruits, vegetables and low-fat dairy foods. It should also be low in saturated fat, total fat, and cholesterol.
  • Be physically active often. Aim for at least 3-4 days per week. Some activity everyday is best.
  • Maintain a healthy weight.
  • If you smoke, talk to your doctor about ways to quit.
  • If you drink alcohol, do so in moderation. Moderate is 2 or fewer drinks per day for men and 1 or fewer drinks per day for women and older adults.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

a (Blood Pressure, High; High Blood Pressure; Idiopathic Hypertension; Primary Hypertension)

Animation Movie Available Related Media: Controlling Your High Blood Pressure

RESOURCES

American Heart Association http://www.heart.org 

National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov 

CANADIAN RESOURCES

Canadian Cardiovascular Society http://www.ccs.ca 

Heart and Stroke Foundation of Canada http://www.heartandstroke.ca 

References

Chobanian AV. Clinical practice. Isolated systolic hypertension in the elderly. N Engl J Med. 2007;357:789-796.

High blood pressure or hypertension. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/High-Blood-Pressure-or-Hypertension%5FUCM%5F002020%5FSubHomePage.jsp. Accessed October 2, 2018.

Hypertension. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T115345/Hypertension . Updated September 12, 2018. Accessed October 2, 2018.

What is high blood pressure? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/Hbp/HBP%5FWhatIs.html. Updated September 10, 2015. Accessed October 2, 2018.

Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2018 May 15;71(19):e127

9/2/2009 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T115345/Hypertension : Forman J, Stampfer M, Curhan G. Diet and lifestyle risk factors associated with incident hypertension in women. JAMA. 2009;302(4):401-411.

1/5/2018 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T115345/Hypertension : Whelton PK, Carey RM, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2017 Nov 13. [Epub ahead of print].