Your blood pressure measurement takes into account how much blood is passing through your blood vessels and the amount of resistance the blood meets while the heart is pumping.
High blood pressure, or hypertension, occurs when the force of blood pushing through your vessels is consistently too high. In this article, we’ll cover the basics of hypertension, including its symptoms, causes, how it’s treated, and more.
What is high blood pressure?
Narrow blood vessels, also known as arteries, create more resistance for blood flow. The narrower your arteries are, the more resistance there is, and the higher your blood pressure will be. Over the long term, the increased pressure can cause health issues, including heart disease.
Hypertension is quite common. In fact, since the guidelines changed in 2017, nearly half of American adults could now be diagnosed with this condition.
Hypertension typically develops over the course of several years. Usually, you don’t notice any symptoms. But even without symptoms, high blood pressure can cause damage to your blood vessels and organs, especially the brain, heart, eyes, and kidneys.
Early detection is important. Regular blood pressure readings can help you and your doctor notice any changes. If your blood pressure is elevated, your doctor may have you check your blood pressure over a few weeks to see if the number stays elevated or falls back to normal levels.
Treatment for hypertension includes both prescription medication and healthy lifestyle changes. If the condition isn’t treated, it could lead to health issues, including heart attack and stroke.
How to understand high blood pressure readings
Two numbers create a blood pressure reading. Systolic pressure (top number) indicates the pressure in your arteries when your heart beats and pumps out blood. Diastolic pressure (bottom number) is the reading of the pressure in your arteries between beats of your heart.
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Five categories define blood pressure readings for adults:
- Healthy: A healthy blood pressure reading is less than 120/80 millimeters of mercury (mm Hg).
- Elevated: The systolic number is between 120 and 129 mm Hg, and the diastolic number is less than 80 mm Hg. Doctors usually don’t treat elevated blood pressure with medication. Instead, your doctor may encourage lifestyle changes to help lower your numbers.
- Stage 1 hypertension: The systolic number is between 130 and 139 mm Hg, or the diastolic number is between 80 and 89 mm Hg.
- Stage 2 hypertension: The systolic number is 140 mm Hg or higher, or the diastolic number is 90 mm Hg or higher.
- Hypertensive crisis: The systolic number is over 180 mm Hg, or the diastolic number is over 120 mm Hg. Blood pressure in this range requires urgent medical attention. If any symptoms like chest pain, headache, shortness of breath, or visual changes occur when blood pressure is this high, medical care in the emergency room is needed.
A blood pressure reading is taken with a pressure cuff. For an accurate reading, it’s important you have a cuff that fits. An ill-fitting cuff may deliver inaccurate readings.
Blood pressure readings are different for children and teenagers. Ask your child’s doctor for the healthy ranges for your child if you’re asked to monitor their blood pressure.
What are the symptoms of hypertension?
Hypertension is generally a silent condition. Many people won’t experience any symptoms. It may take years or even decades for the condition to reach levels severe enough that symptoms become obvious. Even then, these symptoms may be attributed to other issues.
Symptoms of severe hypertension can include:
- blood spots in the eyes (subconjunctival hemorrhage)
According to the American Heart Association, contrary to popular thought, severe hypertension doesn’t typically cause nosebleeds or headaches — except when someone is in hypertensive crisis.
The best way to know if you have hypertension is to get regular blood pressure readings. Most doctors’ offices take a blood pressure reading at every appointment.
If you only have a yearly physical, talk with your doctor about your risks for hypertension and other readings you may need to help you watch your blood pressure.
For example, if you have a family history of heart disease or have risk factors for developing the condition, your doctor may recommend that you have your blood pressure checked twice a year. This helps you and your doctor stay on top of any possible issues before they become problematic.
What causes high blood pressure?
There are two types of hypertension. Each type has a different cause.
Essential (primary) hypertension
Essential hypertension is also called primary hypertension. This kind of hypertension develops over time. Most people have this type of high blood pressure.
A combination of factors typically play a role in the development of essential hypertension:
- Genes: Some people are genetically predisposed to hypertension. This may be from gene mutations or genetic abnormalities inherited from your parents.
- Age: Individuals over 65 years old are more at risk for hypertension.
- Race: Black non-Hispanic individuals have a higher incidence of hypertension.
- Living with obesity: Living with obesity can lead to a few cardiac issues, including hypertension.
- High alcohol consumption: Women who habitually have more than one drink per day, and men who have more than two drinks per day, may be at an increased risk for hypertension.
- Living a very sedentary lifestyle: lowered levels of fitness have been connected to hypertension.
- Living with diabetes and/or metabolic syndrome: Individuals diagnosed with either diabetes or metabolic syndrome are at a higher risk of developing hypertension.
- high sodium intake: There’s a small association between daily high sodium intake (more than 1.5g a day) and hypertension.
Secondary hypertension often occurs quickly and can become more severe than primary hypertension. Several conditions that may cause secondary hypertension include:
- kidney disease
- obstructive sleep apnea
- congenital heart defects
- problems with your thyroid
- side effects of medications
- use of illegal drugs
- chronic consumption of alcohol
- adrenal gland problems
- certain endocrine tumors
Diagnosing high blood pressure
Diagnosing hypertension is as simple as taking a blood pressure reading. Most doctors’ offices check blood pressure as part of a routine visit. If you don’t receive a blood pressure reading at your next appointment, request one.
If your blood pressure is elevated, your doctor may request you have more readings over the course of a few days or weeks. A hypertension diagnosis is rarely given after just one reading.
Your doctor needs to see evidence of a sustained problem. That’s because your environment can contribute to increased blood pressure, like the stress you may feel by being at the doctor’s office. Also, blood pressure levels change throughout the day.
If your blood pressure remains high, your doctor will likely conduct more tests to rule out underlying conditions. These tests can include:
- cholesterol screening and other blood tests
- test of your heart’s electrical activity with an electrocardiogram (EKG, sometimes referred to as an ECG)
- ultrasound of your heart or kidneys
- home blood pressure monitor to monitor your blood pressure over a 24-hour period at home
These tests can help your doctor identify any secondary issues causing your elevated blood pressure. They can also look at the effects high blood pressure may have had on your organs.
During this time, your doctor may begin treating your hypertension. Early treatment may reduce your risk of lasting damage.
Treatment options for high blood pressure
A number of factors help your doctor determine the best treatment option for you. These factors include which type of hypertension you have and what causes have been identified.
Primary hypertension treatment options
If your doctor diagnoses you with primary hypertension, lifestyle changes may help reduce your high blood pressure. If lifestyle changes alone aren’t enough, or if they stop being effective, your doctor may prescribe medication.
Secondary hypertension treatment options
If your doctor discovers an underlying issue causing your hypertension, treatment will focus on that other condition. For example, if a medication you’ve started taking is causing increased blood pressure, your doctor will try other medications that don’t have this side effect.
Sometimes, hypertension is persistent despite treatment for the underlying cause. In this case, your doctor may work with you to develop lifestyle changes and prescribe medications to help reduce your blood pressure.
Treatment plans for hypertension often evolve. What worked at first may become less useful over time. Your doctor will continue to work with you to refine your treatment.
Many people go through a trial-and-error phase with blood pressure medications. Your doctor may need to try different medications until they find one or a combination that works for you.
Some of the medications used to treat hypertension include:
- Beta-blockers: Beta-blockers make your heart beat slower and with less force. This reduces the amount of blood pumped through your arteries with each beat, which lowers blood pressure. It also blocks certain hormones in your body that can raise your blood pressure.
- Diuretics: High sodium levels and excess fluid in your body can increase blood pressure. Diuretics, also called water pills, help your kidneys remove excess sodium from your body. As the sodium leaves, extra fluid in your bloodstream moves into your urine, which helps lower your blood pressure.
- ACE inhibitors: Angiotensin is a chemical that causes blood vessels and artery walls to tighten and narrow. ACE (angiotensin converting enzyme) inhibitors prevent the body from producing as much of this chemical. This helps blood vessels relax and reduces blood pressure.
- Angiotensin II receptor blockers (ARBs): While ACE inhibitors aim to stop the creation of angiotensin, ARBs block angiotensin from binding with receptors. Without the chemical, blood vessels won’t tighten. That helps relax vessels and lower blood pressure.
- Calcium channel blockers: These medications block some of the calcium from entering the cardiac muscles of your heart. This leads to less forceful heartbeats and a lower blood pressure. These medications also work in the blood vessels, causing them to relax and further lowering blood pressure.
- Alpha-2 agonists: This type of medication changes the nerve impulses that cause blood vessels to tighten. This helps blood vessels to relax, which reduces blood pressure.
Culled from healthline.com