High Blood Pressure

Hypertension, or high blood pressure, is a common condition that, according to the Centers for Disease Control and Prevention, affects 116 million American adults — many of whom are not aware they have it. Uncontrolled high blood pressure increases the risk of serious health problems including heart attack, heart failure, kidney disease, peripheral artery disease, vascular dementia and stroke.

What is it?

Hypertension refers to blood pressure that is higher than the normal range. Blood pressure is a measure of the force blood places on blood vessels as it circulates through the body. With each heartbeat, blood is pumped into the arteries creating what is called systolic blood pressure, when blood pressure is highest. As the heart rests between beats, blood pressure decreases, a measurement called diastolic pressure. The two numbers are combined into a blood pressure reading. For example, systolic pressure of 120 and diastolic pressure of 80 is expressed as 120/80, or “120 over 80.

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Understanding Hypertension

Types, Causes & Levels

  • Primary hypertension, also called essential hypertension or idiopathic hypertension, occurs for no clearly identifiable reason. This type accounts for about 95% of all cases, according to the National Library of Medicine.
  • Secondary hypertension is caused by another medical condition. Secondary hypertension may be localized in one body part, such as the liver, lungs or skull.

Though the exact causes of primary hypertension are unclear, it is likely due to a combination of genetic and environmental factors including:

  • a diet high in sodium
  • family history
  • metabolic disorders, such as diabetes
  • lack of physical activity
  • obesity
  • smoking
  • stress
  • unhealthy cholesterol and high triglycerides (a type of fat in the blood)use of substances such as alcohol or cocaine

Secondary hypertension is due to another medical condition, including:

  • adrenal disorders, such as primary aldosteronism
  • cardiovascular issues, such as aortic stenosis or vasculitis
  • autoimmune disorders, such as systemic lupus erythematosus
  • hormonal disorders, such as acromegaly
  • hyperparathyroidism
  • inflammatory disorders, such as rheumatoid arthritis
  • kidney disease
  • obstructive sleep apnea
  • thyroid disorders
  • use of certain medications, such as nonsteroidal anti-inflammatory drugs

The American Heart Association groups blood pressure ranges into five categories:

  • normal — systolic and diastolic pressure less than 120 over 80 or less
  • elevated — systolic pressure between 120-129 and diastolic pressure less than 80
  • stage 1 hypertension — systolic pressure between 130 and 139 and diastolic pressure between 80 and 89
  • stage 2 hypertension — systolic pressure 140 or higher and diastolic pressure 90 or higher
  • hypertensive crisis — systolic and diastolic pressure above 180 and/or 120. A hypertensive crisis requires immediate medical attention.

Signs & Symptoms

High blood pressure usually does not cause any symptoms until it starts to cause health problems. There are some symptoms that may be indirectly associated with high blood pressure. Typically, hypertension does not cause headaches, but nosebleeds may occur during hypertensive crisis, while dizziness may be a sign of impending stroke. Contrary to common belief, however, high blood pressure does not cause symptoms such as facial flushing, nervousness, or sweating.

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How Is Hypertension Diagnosed?

Blood pressure readings that are too high at two or more medical appointments are enough to confirm a diagnosis of high blood pressure. Additional tests may be needed if a secondary cause is suspected.

Treatments for Hypertension

Treatment for hypertension depends on the underlying cause. It may be possible to cure secondary hypertension by treating the underlying cause.

Primary hypertension can be effectively managed with medication called anti-hypertensives, as well as lifestyle modifications such as:

  • eating a heart healthy diet
  • getting more exercise
  • managing weight
  • quitting smoking if necessary