High Blood Pressure (Hypertension)

Medically Reviewed by Poonam Sachdev on September 29, 2024
9 min read

High blood pressure, or hypertension, is when your blood puts too much force on your blood vessels. Over time, the high pressure can cause other health problems.

Blood pumping through the circulatory system is under pressure, much like the water in the pipes of a house. And just as too much water pressure can damage pipes and faucets, elevated blood pressure can spell trouble for your body.

How common is high blood pressure?

High blood pressure is a big problem in both men and women. About 1 in every 2 adult Americans have high blood pressure. Many more are at a risk of it. High blood pressure is especially dangerous because you can have it for years without knowing. In fact, 1 in 3 Americans with the condition don't know it.

Despite these gloomy statistics, high blood pressure is not inevitable. There's plenty you can do to prevent, delay, and treat the condition.

Blood pressure usually rises with age. Your risk of high blood pressure begins to climb when you hit age 45, although it can happen when you're younger. Black people tend to get it at younger ages and often have worse hypertension.

High blood pressure risk factors

Many factors can lead to high blood pressure. Your diet plays a role. Too much salt, too little potassium, and too much alcohol have all been found to raise the risk of high blood pressure. Too much stress and too little physical activity both raise the danger of developing high blood pressure, as does being overweight or obese. And as with many chronic illnesses, high blood pressure tends to run in families, suggesting that genetics plays a role.

If you eat foods high in salt, or use medications like nonsteroidal anti-inflammatory drugs (such as ibuprofen and aspirin) or decongestants, you also have a higher risk of high blood pressure. Illegal drugs like cocaine also can raise blood pressure.

It's more common if you are:

High blood pressure and other health conditions

In some people, high blood pressure is related to other medical problems or can be a side effect of certain drugs. This form of the disease is called secondary hypertension because it happens secondary to other medical conditions.

Different conditions can make your blood pressure more likely to go up, including:

  • Heart problems that affect your blood vessels
  • Adrenal gland disorders
  • Kidney problems
  • Sleep apnea
  • Thyroid disease
  • Illegal substance use, such as cocaine or amphetamines

High blood pressure and medications

Some medicines that may raise blood pressure include:

  • Birth control pills
  • Cold or allergy medicine
  • Over-the-counter pain relievers with caffeine

Some prescription drugs also make high blood pressure more likely. Ask your doctor if any medicines you're taking may come with more risk of high blood pressure.

High blood pressure is usually diagnosed using the familiar blood pressure test that involves a cuff wrapped around the upper arm. The cuff is inflated and then sensors measure the pressure of blood beating against your arteries.

Understanding your blood pressure readings:

Systolic blood pressure. This first number measures the pressure of your blood against your arteries when it beats.

Diastolic blood pressure. This second number measures the pressure when your heart is resting between beats.

Interpreting your blood pressure measures:

Normal. Your blood pressure is normal when it's less than 120 over less than 80.

Elevated. Your blood pressure is elevated if the first number is 120-129 and the second number is less than 80.

Stage 1 hypertension. You have stage 1 hypertension if the first number of your blood pressure is 130-139 and the second number is 80-89.

Stage 2 hypertension. You have stage 2 hypertension if the first number is 140+ and the second number is 90+.

Hypertensive crisis. Your blood pressure reading is a number greater than 180 over a number greater than 120.

Normal variation in blood pressure

Normal blood pressure goes up from about 64/40 at birth to about 120/80 in a healthy adult. If someone were to take your blood pressure right after you gave a speech or jogged five miles, it'd probably be slightly high. This isn't necessarily cause for alarm: It's natural for blood pressure to rise and fall with changes in activity or emotional state.

It's also normal for blood pressure to vary from person to person, even from one area of the body to another. But if your blood pressure stays high, you should talk with your doctor about treatment. Hypertension forces the heart to work far beyond its capacity. Along with injuring blood vessels, it can damage your brain, eyes, and kidneys.

Prehypertension

Your doctor could also tell you that you have something called prehypertension. That's when your blood pressure is just a bit higher than 120 over less than 80. About 75 million Americans fall into this category. Prehypertension can raise your risk of damage to your arteries, heart, brain, and kidneys. Many doctors say prehypertension should be treated. Still, there's no evidence that it provides long-term help.

High blood pressure doesn't usually show any signs. The only way to know for sure if your blood pressure is high is by having it checked. It's a good idea to watch it over time if you think you have high blood pressure or may be at risk.

If your blood pressure is very high, you may have signs including:

  • Headaches that are severe
  • Pain in your chest
  • Feeling dizzy
  • Trouble breathing
  • Nausea or vomiting
  • Vision changes or blurred vision
  • Anxiety
  • Confusion
  • Buzzing sound in your ears
  • Nosebleeds
  • Abnormal heartbeat or rhythm

Many people who have high blood pressure don't realize they have it. It's often called "the silent killer" because it rarely causes symptoms, even as it causes serious damage to the body.

Over time, elevated pressure can cause a wide range of problems. Small bulges, called aneurysms, may form in blood vessels. The heart can become enlarged, raising the danger of heart attack and heart failure. Damage to blood vessels in the kidneys can cause them to fail. Because tiny blood vessels in the eyes are especially vulnerable to damage, hypertension can lead to vision problems and even blindness.

Left untreated, hypertension can lead to serious problems, such as:

Critically ill patients who have very high blood pressure may have "malignant hypertension." It is a medical emergency, and you should be treated in the emergency room. Symptoms might include chest pain, shortness of breath, vision changes, headache, and weakness.

Fortunately, high blood pressure can be controlled. The first step is to have your blood pressure checked regularly.

When to get immediate help

Your doctor may consider your blood pressure high if you get a high reading at least twice. If yours is 180/120 or higher, that's a hypertensive crisis. You need to get medical attention right away.

In as many as 95% reported high blood pressure cases in the U.S., the underlying cause can't be determined. This is essential hypertension.

High blood pressure tends to run in families. Age and race also play a role.

More than 40% of all Black people in the U.S. have high blood pressure.

Diet and lifestyle also play a big role in essential hypertension. The link between salt and high blood pressure is especially noteworthy. People living on the northern islands of Japan eat more salt than anyone else in the world. They're also most likely to get hypertension.

Many people with high blood pressure are "salt sensitive." That means anything more a minimal amount will raise their blood pressure.

Other things associated with essential hypertension include:

When a direct cause of high blood pressure can be identified, that's secondary hypertension. Kidney disease is the most common cause.

Hypertension can also be caused by tumors or conditions that cause the adrenal glands (the small glands that sit atop your kidneys) to release large amounts of hormones that raise blood pressure.

Birth control pills — specifically those that have estrogen — and pregnancy can boost blood pressure. Other medicines can, too. Check with your doctor to see if anything you take may cause your numbers to go up.

Doctors have a wide range of high blood pressure medicines available to treat high blood pressure. These high blood pressure treatments include:

  • Diuretics or "water pills"
  • Beta-blockers
  • Calcium channel blockers
  • Angiotensin-converting enzyme inhibitors
  • Angiotensin II receptor blockers

As effective as these drugs can be at controlling blood pressure, if you get to the point of needing them, you may have to take them for the rest of your life. That is one more good reason to focus on prevention.

You can lower or prevent high blood pressure and lower your odds of getting heart disease by making a few changes in your lifestyle.

High blood pressure and your diet

A healthy diet can go a long way toward preventing high blood pressure. Trying following the Dietary Approaches to Stop Hypertension eating plan, also known as the DASH diet, which emphasizes plenty of fruits and vegetables and low-fat or nonfat dairy products. Studies conducted by the National Institutes of Health have shown that the DASH diet can lower blood pressure. And the results show up fast — often within 2 weeks. Stay away from salt and saturated fats and eliminate trans fats. Focus instead on foods that are high in fiber, calcium, and magnesium.

The National High Blood Pressure Education Program recommends no more than 2,300 milligrams — equal to 1 teaspoon — of sodium a day. The ideal is even lower — only 1,500. For the average person, who consumes about 4,200 milligrams a day, that requires a big change. But studies show that the lower your salt intake, the lower your blood pressure.

Exercise for high blood pressure

Regular aerobic workouts condition the heart and keep blood vessels working properly. It's also wise to be as active as possible throughout your day, apart from your workout. Researchers at the University of Minnesota published results from a study of almost 4,000 people aged between 15 and 30 years who were followed over time. The more active they were, the lower their risk of hypertension.

High blood pressure and weight

If you're overweight, try to trim down. Even shedding a few pounds can make a big difference.

High blood pressure, smoking, and alcohol

If you smoke or drink a lot of alcohol, now's the time to stop. Your doctor can give you advice about the most effective ways to do that.

Manage your stress

Take steps to cope with everyday stressors and improve your mental health. Try relaxation, counseling, or a support group.

Sleep well

Aim for 7-9 hours of sleep every night. It's best to go to bed and wake up at regular times and to sleep in a calm, darkened room.

High blood pressure comes with risk factors for many other health conditions, but you could have it and not even know it. See a doctor to have your blood pressure checked. There are many healthy steps you can take to lower or prevent high blood pressure. Your doctor can also suggest treatment if you need it.

How can I bring my blood pressure down quickly?

Relaxing and lowering stress can lower your blood pressure quickly. But if you have chronic high blood pressure, you should talk to your doctor about steps to keep it low.

How do you feel when you have high blood pressure?

Most of the time, having high blood pressure doesn't feel like anything at all. Many people have it and don't even know. If your blood pressure goes very high, you could have a severe headache or other symptoms. See a doctor for a blood pressure reading.

When should I worry about my blood pressure?

It's a good idea to take steps to lower your blood pressure if you have high blood pressure or hypertension. If you get a blood pressure reading that's over 180/120, it's a medical emergency. See a doctor right away.

What causes your blood pressure to suddenly get high?

Stress can make your blood pressure go up suddenly. To get a good blood pressure reading, don't eat or drink right beforehand. Use the bathroom and sit quietly in a comfortable chair for at least 5 minutes first with both of your feet on the floor. It's best to check your blood pressure more than once to make sure you're getting an accurate reading.