What is Hypertension

Hypertension, commonly called high blood pressure, is when the force of blood pumping through the arteries is too strong. The arteries are the blood vessels that carry blood from the heart throughout the body.

Hypertension forces the heart to work harder to pump blood and may cause arteries to become narrow or stiff. Having untreated or uncontrolled hypertension can cause heart attacks, strokes, kidney disease, and other problems.

A blood pressure reading consists of a higher number over a lower number. Ideally, your blood pressure should be below 120/80. The first (“top”) number is called the systolic pressure. It is a measure of the pressure in your arteries as your heart beats. The second (“bottom”) number is called the diastolic pressure. It is a measure of the pressure in your arteries as the heart relaxes.

Healthy choices can help lower your blood pressure. You may need medicine to help lower your blood pressure if:

• Your blood pressure cannot be lowered with healthy choices.
• Your blood pressure is higher than 130/80.

What are the causes?

The cause of this condition is not known.

What increases the risk?

Some risk factors for high blood pressure are under your control. Others are not.

Factors you can change

• Smoking.
• Having type 2 diabetes mellitus, high cholesterol, or both.
• Not getting enough exercise or physical activity.
• Being overweight.
• Having too much fat, sugar, calories, or salt (sodium) in your diet.
• Drinking too much alcohol.

Factors that are difficult or impossible to change

• Having chronic kidney disease.
• Having a family history of high blood pressure.
• Age. Risk increases with age.
• Race. You may be at higher risk if you are African-American.
• Gender. Men are at higher risk than women before age 45. After age 65, women are at higher risk than men.
• Having obstructive sleep apnea.
• Stress.

What are the signs or symptoms?

Extremely high blood pressure (hypertensive crisis) may cause:

• Headache.
• Anxiety.
• Shortness of breath.
• Nosebleed.
• Nausea and vomiting.
• Severe chest pain.
• Jerky movements you cannot control (seizures).

How is this diagnosed?

This condition is diagnosed by measuring your blood pressure while you are seated, with your arm resting on a surface. The cuff of the blood pressure monitor will be placed directly against the skin of your upper arm at the level of your heart. It should be measured at least twice using the same arm. Certain conditions can cause a difference in blood pressure between your right and left arms.

Certain factors can cause blood pressure readings to be lower or higher than normal (elevated) for a short period of time:

• When your blood pressure is higher when you are in a health care provider’s office than when you are at home, this is called white coat hypertension. Most people with this condition do not need medicines.
• When your blood pressure is higher at home than when you are in a health care provider’s office, this is called masked hypertension. Most people with this condition may need medicines to control blood pressure.

If you have a high blood pressure reading during one visit or you have normal blood pressure with other risk factors:

• You may be asked to return on a different day to have your blood pressure checked again.
• You may be asked to monitor your blood pressure at home for 1 week or longer.

If you are diagnosed with hypertension, you may have other blood or imaging tests to help your health care provider understand your overall risk for other conditions.

How is this treated?

This condition is treated by making healthy lifestyle changes, such as eating healthy foods, exercising more, and reducing your alcohol intake. Your health care provider may prescribe medicine if lifestyle changes are not enough to get your blood pressure under control, and if:

• Your systolic blood pressure is above 130.
• Your diastolic blood pressure is above 80.

Your personal target blood pressure may vary depending on your medical conditions, your age, and other factors.

Follow these instructions at home:

Eating and drinking

• Eat a diet that is high in fiber and potassium, and low in sodium, added sugar, and fat. An example eating plan is called the DASH (Dietary Approaches to Stop Hypertension) diet. To eat this way:
  • Eat plenty of fresh fruits and vegetables. Try to fill half of your plate at each meal with fruits and vegetables.
  • Eat whole grains, such as whole wheat pasta, brown rice, or whole grain bread. Fill about one quarter of your plate with whole grains.
  • Eat or drink low-fat dairy products, such as skim milk or low-fat yogurt.
  • Avoid fatty cuts of meat, processed or cured meats, and poultry with skin. Fill about one quarter of your plate with lean proteins, such as fish, chicken without skin, beans, eggs, and tofu.
  • Avoid premade and processed foods. These tend to be higher in sodium, added sugar, and fat.
• Reduce your daily sodium intake. Most people with hypertension should eat less than 1,500 mg of sodium a day.
• Limit alcohol intake to no more than 1 drink a day for nonpregnant women and 2 drinks a day for men. One drink equals 12 oz of beer, 5 oz of wine, or 1½ oz of hard liquor.

Lifestyle

• Work with your health care provider to maintain a healthy body weight or to lose weight. Ask what an ideal weight is for you.
• Get at least 30 minutes of exercise that causes your heart to beat faster (aerobic exercise) most days of the week. Activities may include walking, swimming, or biking.
• Include exercise to strengthen your muscles (resistance exercise), such as pilates or lifting weights, as part of your weekly exercise routine. Try to do these types of exercises for 30 minutes at least 3 days a week.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Monitor your blood pressure at home as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider. Follow directions carefully. Blood pressure medicines must be taken as prescribed.
• Do not skip doses of blood pressure medicine. Doing this puts you at risk for problems and can make the medicine less effective.
• Ask your health care provider about side effects or reactions to medicines that you should watch for.

Contact a health care provider if:

• You think you are having a reaction to a medicine you are taking.
• You have headaches that keep coming back (recurring).
• You feel dizzy.
• You have swelling in your ankles.
• You have trouble with your vision.

Get help right away if:

• You develop a severe headache or confusion.
• You have unusual weakness or numbness.
• You feel faint.
• You have severe pain in your chest or abdomen.
• You vomit repeatedly.
• You have trouble breathing.

Summary

• Hypertension is when the force of blood pumping through your arteries is too strong. If this condition is not controlled, it may put you at risk for serious complications.
• Your personal target blood pressure may vary depending on your medical conditions, your age, and other factors. For most people, a normal blood pressure is less than 120/80.
• Hypertension is treated with lifestyle changes, medicines, or a combination of both. Lifestyle changes include weight loss, eating a healthy, low-sodium diet, exercising more, and limiting alcohol.