High blood pressure - adults
Blood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Hypertension is the term used to describe high blood pressure.
Untreated high blood pressure can lead to many medical problems. These include heart disease, stroke, kidney failure, eye problems, and other health issues.
Blood pressure readings are given as two numbers. The top number is called systolic blood pressure. The bottom number is called diastolic blood pressure. For example, 120 over 80 (written as 120/80 mm Hg).
One or both of these numbers can be too high. (Note: These numbers apply to people who are not taking medicines for blood pressure and who are not ill.)
- Normal blood pressure is when your blood pressure is lower than 120/80 mm Hg most of the time.
- High blood pressure (hypertension) is when one or both of your blood pressure readings are higher than 130/80 mm Hg most of the time.
- If the top blood pressure number is between 120 and 130 mm Hg, and the bottom blood pressure number is less than 80 mm Hg, it is called elevated blood pressure.
If you have heart or kidney problems, or you had a stroke, your doctor may want your blood pressure to be even lower than that of people who do not have these conditions.
Hypertension - Animation
If your doctor told you that you have high blood pressure, you may have wondered, what's the big deal? Well high blood pressure IS a big deal, because it can lead to a heart attack, stroke, vision loss, and kidney disease, sometimes before you even realize you have it. When you have high blood pressure, you'll want to control it before it can lead to these dangerous complications. Let's talk about high blood pressure, otherwise known as hypertension. Blood pressure measures the force at which your blood rushes against the walls of your arteries as your heart pumps it through your body. The higher the force, meaning the higher your blood pressure, the harder your heart has to work. High blood pressure damages not only your heart but also your arteries. When your doctor or nurse measures your blood pressure, you'll see two numbers. The top number is called systolic blood pressure. That's the force of blood in your arteries whenever your heart beats. The bottom number measures diastolic blood pressure, or the force of blood in between heartbeats. You're more likely to have high blood pressure if you don't exercise regularly, you're obese, you eat too much salt, you have diabetes, you smoke, or you have a family history of high blood pressure. Most of the time, you won't know that you have high blood pressure. That's because high blood pressure usually doesn't cause symptoms. Unless you get your blood pressure checked, you may have no idea there's a problem until you develop heart disease or another complication. If your blood pressure is high, a few simple lifestyle changes can help bring it back down, and prevent its complications. Eat a heart-healthy diet that includes plenty of fresh fruits and vegetables, whole grains, and low-fat dairy, avoid fatty, salty, and sugary foods, exercise at least 30 minutes a day, limit salt to 1,500 milligrams or less a day, that's less than a teaspoon per day, and if you smoke, now is the perfect time to quit. Ask your doctor for tips on how to kick the habit. If these measures don't work, your doctor may prescribe one or more medicines to control your blood pressure. Because high blood pressure can sneak in without warning, stop it before it starts. Stay healthy, and your blood pressure checked at least once a year. If you already have high blood pressure, follow your doctor's advice to get it under control.
Many factors can affect blood pressure, including:
- The amount of water and salt you have in your body
- The condition of your kidneys, nervous system, or blood vessels
- Your hormone levels
You are more likely to be told your blood pressure is too high as you get older. This is because your blood vessels become stiffer as you age. When that happens, your blood pressure goes up. High blood pressure increases your chance of having a stroke, heart attack, heart failure, kidney disease, or early death.
You have a higher risk of high blood pressure if you:
- Are African American
- Are obese
- Are often stressed or anxious
- Drink too much alcohol (more than 1 drink per day for women and more than 2 drinks per day for men)
- Eat too much salt
- Have a family history of high blood pressure
- Have diabetes
Most of the time, no cause of high blood pressure is found. This is called essential hypertension.
High blood pressure that is caused by another medical condition or medicine you are taking is called secondary hypertension. Secondary hypertension may be due to:
- Chronic kidney disease
- Disorders of the adrenal gland (such as pheochromocytoma or Cushing syndrome)
Pheochromocytoma is a rare tumor of adrenal gland tissue. It results in the release of too much epinephrine and norepinephrine, hormones that contro...Read Article Now Book Mark Article
- Pregnancy or preeclampsia
- Medicines such as birth control pills, diet pills, some cold medicines, migraine medicines, corticosteroids, some antipsychotics, and certain medicines used to treat cancer
- Narrowed artery that supplies blood to the kidney (renal artery stenosis)
- Obstructive sleep apnea (OSA)
Is High Blood Pressure Affecting Your Health?
What is blood pressure?Correct AnswerThe correct answer is a measurement of the force against the walls of your arteries as your heart pumps blood through your body. Your blood pressure is reported as two numbers: systolic over diastolic blood pressure. If either number is too high, there will be extra stress on your heart and blood vessels.
A common sign of high blood pressure is:Correct AnswerThe correct answer is none of the above. In most people, high blood pressure does not cause any symptoms. This means you may only find out about the problem when your doctor or nurse checks your blood pressure. Ask your doctor how to prevent high blood pressure.
When blood pressure stays high, it can lead to:Correct AnswerThe correct answer is all of the above. Diagnosing high blood pressure early can help prevent these health problems. Get your blood pressure checked every two years if it was normal at your last reading and at least once a year if it was 120/80 or above. If you have high blood pressure, your doctor may ask you to check it at home.
High blood pressure can cause the heart muscle to thicken.Correct AnswerThe correct answer is true. As the heart muscle works harder, it can become so thick that it doesn't get enough oxygen. This can cause chest pain and may lead to heart failure. Heart failure occurs when the heart can't pump enough blood to the rest of your body. Talk with your doctor about how to lower high blood pressure.
High blood pressure can make the blood vessels wider.Correct AnswerThe correct answer is false. High blood pressure causes blood vessel walls to get thicker. Over time, fat and cholesterol can also build up on vessel walls. These two problems together cause blood vessels to become narrow, so blood can't flow as freely. Reduced blood flow can increase the risk of heart attack and stroke.
Which is a sign of decreased blood flow?Correct AnswerThe correct answer is all of the above. High blood pressure can raise your risk of peripheral artery disease (PAD). This is the narrowing of the vessels that carry blood to the legs and feet. PAD occurs most often in men over age 50. See your doctor if you have high blood pressure and notice any discomfort in your legs or feet.
Which of the following are risk factors for stroke?Correct AnswerThe correct answer is all of the above. High blood pressure is the number one risk factor. A stroke occurs when a blood vessel that supplies the brain bursts or gets blocked by a blood clot. The symptoms depend on which part of the brain is affected. Ask your doctor to explain warning signs of stroke.
Which is NOT a common warning sign of stroke?Correct AnswerThe correct answer is chest pain. If you notice any signs of stroke listed above, call 9-1-1 immediately. Prompt treatment can save your life. If the stroke is caused by a blood clot, a clot-busting drug may be given to dissolve the clot. For this drug to work, you must be treated 3 to 4 1/2 hours after symptoms first started.
If high blood pressure affects your eyes, you might develop:Correct AnswerThe correct answer is all of the above. High blood pressure can damage blood vessels in the retina, the part of the eye that changes images into signals the brain can read. You may not have symptoms at first. Tell your doctor right away if you notice any changes in vision.
Symptoms of kidney disease appear immediately.Correct AnswerThe correct answer is false. Your kidneys remove wastes and excess water from your body. High blood pressure damages the kidneys, making it harder for them to function. Kidney disease often has no symptoms until a lot of damage has occurred. Controlling high blood pressure can protect your kidneys.
Most of the time, there are no symptoms. For most people, high blood pressure is found when they visit their health care provider or have it checked elsewhere.
Because there are no symptoms, people can develop heart disease and kidney problems without knowing they have high blood pressure.
Malignant hypertension is a dangerous form of very high blood pressure. Symptoms may include:
Malignant hypertension is very high blood pressure that comes on suddenly and quickly.Read Article Now Book Mark Article
- Severe headache
- Nausea and vomiting
- Vision changes
Exams and Tests
Tracking your blood pressure at home - Animation
Following your blood pressure at home has gotten a lot easier in the last few years. I'm Dr. Alan Greene. I'd like to share with you a little bit about that. Not too long ago when you wanted to follow your blood pressure at home, you had to have the old fashion sphygmomometer, and the device was a complex as that word sounds. You had to pump something up, and put a stethoscope in your ears, and fumble all these different tubes and even so wouldn't get a very accurate reading. Now, there are simple, high quality, digital blood pressure cuffs. They're easy to use at home. They're built so they snap on the arm very easily, just press a single button, and the chip inside does the work for you. It blows it up, it gives you the reading, and some of the newer models even connect it to your PC and track the readings for you. Now, how accurate are they? They're really pretty good. I wouldn't trust a single reading that much if you get one that's high or low. I wouldn't be either reassured or panicked. But, I would trust the pattern of readings. So, if you have one that tracks it for you, that's great, if not, just write them down what date and time you took it and see what the pattern is over time. If there's anything of concern, be sure to report it to your physician.
Diagnosing high blood pressure early can help prevent heart disease, stroke, eye problems, and chronic kidney disease.
Your provider will measure your blood pressure many times before diagnosing you with high blood pressure. It is normal for your blood pressure to be different based on the time of day.
Measure your blood pressure
Blood pressure is a measurement of the force on the walls of your arteries as your heart pumps blood through your body. You can measure your blood pr...Read Article Now Book Mark Article
All adults over the age of 18 should have their blood pressure checked every year. More frequent measurements may be needed for those with a history of high blood pressure readings or those with risk factors for high blood pressure.
Blood pressure readings taken at home may be a better measure of your current blood pressure than those taken at your provider's office.
- Make sure you get a good quality, well-fitting home blood pressure monitor. It should have a properly sized cuff and a digital readout.
- Practice with your provider to make sure you are taking your blood pressure correctly.
- You should be relaxed and seated for several minutes prior to taking a reading.
- Bring your home monitor to your appointments so your provider can make sure it is working correctly.
Your provider will do a physical exam to look for signs of heart disease, damage to the eyes, and other changes in your body.
Tests may also be done to look for:
- High cholesterol level
- Heart disease, using tests such as an echocardiogram or electrocardiogram
An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...Read Article Now Book Mark Article
- Kidney disease, using tests such as a basic metabolic panel and urinalysis or ultrasound of the kidneys
Basic metabolic panel
The basic metabolic panel is a group of blood tests that provides information about your body's metabolism.Read Article Now Book Mark Article
The goal of treatment is to reduce your blood pressure so that you have a lower risk of health problems caused by high blood pressure. You and your provider should set a blood pressure goal for you.
Whenever thinking about the best treatment for high blood pressure, you and your provider must consider other factors such as:
- Your age
- The medicines you take
- Your risk of side effects from possible medications
- Other medical conditions you may have, such as a history of heart disease, stroke, kidney problems, or diabetes
If your blood pressure is between 120/80 and 130/80 mm Hg, you have elevated blood pressure.
- Your provider will recommend lifestyle changes to bring your blood pressure down to a normal range.
- Medicines are rarely used at this stage.
If your blood pressure is higher than 130/80, but lower than 140/90 mm Hg, you have Stage 1 high blood pressure. When thinking about the best treatment, you and your provider must consider:
- If you have no other diseases or risk factors, your provider may recommend lifestyle changes and repeat the measurements after a few months.
- If your blood pressure remains above 130/80, but lower than 140/90 mm Hg, your provider may recommend medicines to treat high blood pressure.
- If you have other diseases or risk factors, your provider may be more likely to start medicines at the same time as lifestyle changes.
If your blood pressure is higher than 140/90 mm Hg, you have Stage 2 high blood pressure. Your provider will most likely start you on medicines and recommend lifestyle changes.
Before making a final diagnosis of either elevated blood pressure or high blood pressure, your provider should ask you to have your blood pressure measured at home, at your pharmacy, or somewhere else besides their office or a hospital.
You can do many things to help control your blood pressure, including:
- Eat a heart-healthy diet, including potassium and fiber.
- Drink plenty of water.
- Get at least 40 minutes of moderate to vigorous aerobic exercise at least 3 to 4 days a week.
- If you smoke, quit.
- Limit how much alcohol you drink to 1 drink a day for women, and 2 a day for men or less and consider quitting entirely.
- Limit the amount of sodium (salt) you eat. Aim for less than 1,500 mg per day.
- Reduce stress. Try to avoid things that cause you stress, and try meditation or yoga to de-stress.
- Stay at a healthy body weight.
Hypertension is a disorder characterized by chronically high blood pressure. It must be monitored, treated and controlled by medicines, lifestyle changes, or a combination of both.
Your provider can help you find programs for losing weight, stopping smoking, and exercising.
You can also get a referral to a dietitian, who can help you plan a diet that is healthy for you.
How low your blood pressure should be and at what level you need to start treatment is individualized, based on your age and any medical problems you have.
MEDICINES FOR HYPERTENSION
Most of the time, your provider will try lifestyle changes first, and check your blood pressure two or more times. Medicines will likely be started if your blood pressure readings remain at or above these levels:
- Top number (systolic pressure) of 130 or more
- Bottom number (diastolic pressure) of 80 or more
If you have diabetes, heart problems, or a history of a stroke, medicines may be started at lower blood pressure reading. The most commonly used blood pressure targets for people with these medical problems are below 120 to 130/80 mm Hg.
There are many different medicines to treat high blood pressure.
Medicines to treat high blood pressure
Treating high blood pressure will help prevent problems such as heart disease, stroke, loss of eyesight, chronic kidney disease, and other blood vess...Read Article Now Book Mark Article
- Often, a single blood pressure drug may not be enough to control your blood pressure, and you may need to take two or more drugs.
- It is very important that you take the medicines prescribed to you.
- If you have side effects, your doctor can substitute a different medicine.
Most of the time, high blood pressure can be controlled with medicine and lifestyle changes.
When blood pressure is not well-controlled, you are at risk for:
When to Contact a Medical Professional
If you have high blood pressure, you will have regular checkups with your provider.
Even if you have not been diagnosed with high blood pressure, it is important to have your blood pressure checked during your regular check-up, especially if someone in your family has or had high blood pressure.
Contact your provider right away if home monitoring shows that your blood pressure is still high.
Most people can prevent high blood pressure from occurring by following lifestyle changes designed to bring blood pressure down.
Thomas S. Metkus, MD, Assistant Professor of Medicine and Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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