(Everything you need to know about hypertension (high blood pressure)

Hypertension is another name for high blood pressure. It can lead to severe health complications and increase the risk of heart disease, stroke, and sometimes death.

Blood pressure is the force that a person’s blood exerts against the walls of their blood vessels. This pressure depends on the resistance of the blood vessels and how hard the heart has to work.

Almost half of all adultsTrusted Source in the United States have high blood pressure, but many may not know they have it.

Hypertension is a primary risk factor for cardiovascular disease, including stroke, heart attack, heart failure, and aneurysm. Managing blood pressure is vital for preserving health and reducing the risk of these dangerous conditions.

Read on to learn why blood pressure can increase, how to monitor it, and ways to keep it within a typical range.

Management and treatment

Lifestyle adjustments are the standard, first-line treatment for hypertension. Some recommendations are as follows:

Regular physical exercise

Current guidelines recommend that all people, including those with hypertension, engage in at least 150 minutesTrusted Source of moderate-intensity, aerobic exercise every week, or 75 minutes per week of high-intensity exercise.

Alongside 150 minutes of exercise, most adults will benefit from engaging in strength training at least twice per week.

People should exercise at least 5 days every week.

Examples of suitable activities are:

• walking
• jogging
• cycling
• swimming

Stress reduction

Avoiding or learning to manage stress can help a person control blood pressure.

A few relaxation techniques that can help relieve stress are:

• meditation
• warm baths
• yoga
• going on long walks

People should avoid consuming alcohol and recreational drugs to cope with stress, as these can contribute to elevated blood pressure and the complications of hypertension.

Smoking can also increase blood pressure. Avoiding or quitting smoking reduces the risk of hypertension, serious heart conditions, and other health issues.

Medication

People can use specific medications to treat hypertension. Doctors will often recommend a low dose at first. Antihypertensive medications will usually only have minor side effects.

Eventually, people with hypertension may need to combine two or moreTrusted Source drugs to manage their blood pressure.

Medications for hypertension include:

• diuretics, including thiazides, chlorthalidone, and indapamide
• beta-blockers and alpha-blockers
• calcium-channel blockers
• central agonists
• peripheral adrenergic inhibitor
• vasodilators
• angiotensin-converting enzyme (ACE) inhibitors
• angiotensin receptor blockers

The choice of medication depends on the individual and any underlying medical conditions they may experience.

Diet

People can prevent high blood pressure by following a heart-healthy diet.

Reducing salt intake

High sodium consumption contributesTrusted Source to high blood pressure. The main source of sodium in the diet is salt.

The American Heart Association recommends that people without hypertension consume less than 2,300 milligrams (mg)Trusted Source of sodium per day. This roughly equates to one teaspoon. People with hypertension should consume less than 1,500 mg of sodium per day to manage their condition.

Lowering salt intake can benefitTrusted Source people with and without hypertension.

Moderating alcohol consumption

Moderate to excessive alcohol consumption can increase blood pressure.

The American Heart Association recommends a maximum of two alcoholic drinksTrusted Source per day for men, and one for women.

The following would count as one drink:

• a 12-ounce (oz) bottle of beer
• 4 oz of wine
• 1.5 oz of 80-proof spirits
• 1 oz of 100-proof spirits

A healthcare professional can help people reduce consumption if they find it difficult to moderate their alcohol intake.

Eating more fruits and vegetables and less fat

People who have high blood pressure or people at high risk for developing high blood pressure should reduce their intake of saturated fats in favor of unsaturated forms.

Learn more about saturated and unsaturated fats here.

Experts recommendTrusted Source that those with high blood pressure prioritize more heart-healthy foods, such as:

• whole grain, high fiber foods
• a variety of fruits and vegetables
• pulses, such as chickpeas, beans, and lentils
• nuts
• fish rich in omega-3 twice per week
• nontropical vegetable oils, such as olive oil
• skinless poultry and fish
• low fat dairy products

If a person has high blood pressure or wished to maintain moderate blood pressure, it is important to avoid trans fats, hydrogenated vegetable oils, animal fats, and processed fast foods when creating a diet plan.

However, omega-3 fatty acids, such as those in oily fish and olive oil, have protective effects on the heart. However, these are still fats. While they are typically healthful, people with a risk of hypertension should still include them in their total fat intake.

Learn more about following a healthful diet here.

Managing body weight

Excess body weight can contributeTrusted Source to hypertension. A fall in blood pressure usually follows weight loss, as the heart does not have to work so hard to pump blood around the body.

A balanced diet with a calorie intake that matches the individual’s size, sex, and activity level will help.

The DASH diet

The U.S. National Heart, Lung, and Blood Institute (NHLBI) recommends the DASH dietTrusted Source for people with high blood pressure. DASH stands for Dietary Approaches to Stop Hypertension.

DASH is a flexible and balanced eating plan with a firm grounding in research by the NHLBI, who says that the diet:

• lowers high blood pressure
• improves levels of fats in the bloodstream
• reduces the risk of cardiovascular disease

The NHLBI produces a cookbook called Keep the Beat Recipes that provides meal ideas to help reduce blood pressure.

Other dietary interventions may help reduce a person’s risk of hypertension. For example, research from 2014Trusted Source suggests that using probiotic supplements for 8 weeks or more may benefit people with hypertension.

Q: Is hypertension genetic?

A: A family history of hypertension “likely” plays a role in a person developing the condition. Family environmental factors may also play a part. For example, if a person lives in a household with an older relative with hypertension, they may be more likely to share lifestyle habits that increase their risk of hypertension.Centers for Disease Control and PreventionTrusted Source

Q: Is high blood pressure considered heart disease?

A: Hypertension is not a type of heart disease. However, the condition may increase a person’s risk for developing heart disease, heart attack, and stroke. The term “hypertensive heart disease” refers to heart conditions resulting from hypertension.Tackling, G., et al. (2021)Trusted Source

Causes

The cause of hypertension is often not known. In many cases, it is the result of an underlying condition.

High blood pressure that is not due to another condition or disease is known as primary or essential hypertension. If an underlying condition is a cause of increased blood pressure, doctors call this secondary hypertension.

Primary hypertension can result from multiple factors, including:

• having obesity
• insulin resistance
• high salt intake
• excessive alcohol intake
• having a sedentary lifestyle
• smoking

Secondary hypertension has specific causes and is a complication of another health problem.

Chronic kidney disease (CKD) is a common cause of high blood pressure, as the kidneys no longer filter out fluid. This excess fluid leads to hypertension. Hypertension can also cause CKD.

Other conditions that can lead to hypertension include:

• diabetes, due to kidney problems and nerve damage
• pheochromocytoma, a rare cancer of an adrenal gland
• Cushing’s syndrome
• congenital adrenal hyperplasia, a disorder of the cortisol-secreting adrenal glands
• hyperthyroidism, or an overactive thyroid gland
• hyperparathyroidism, which affects calcium and phosphorous levels
• pregnancy
• sleep apnea
• obesity

Risk factors

A number of factors increase the risk of hypertension.

• Age: Hypertension is more common in people who are more than 65 years of ageTrusted Source. Blood pressure can increase steadily with age as the arteries stiffen and narrow due to plaque buildup.
• Ethnicity: Some ethnic groups are more prone to hypertension than others. African Americans have a higher riskTrusted Source than other ethnic groups, for example.
• Weight: Having obesity is a primary risk factor for hypertension.
• Alcohol and tobacco use: Regularly consuming large quantities of alcohol or tobacco can increase blood pressure.
• Sex: According to a 2018 reviewTrusted Source, males have a higher risk of developing hypertension than females. However, this is only until after females reach menopause.
• Existing health conditions: Cardiovascular disease, diabetes, chronic kidney disease, and high cholesterol levels can lead to hypertension, especially as people age.

Symptoms

A person with hypertension may not noticeTrusted Source any symptoms, and so people often call it a “silent killer.” Without detection, hypertension can damage the heart, blood vessels, and other organs, such as the kidneys.

It is vital to check blood pressure regularly.

In rare and severe cases, high blood pressure can cause:

• sweating
• anxiety
• sleeping problems
• blushing

However, most people with hypertension will experience no symptoms at allTrusted Source.

If high blood pressure becomes a hypertensive crisis, a person may experience headaches and nosebleeds.

Complications

Long-term hypertension can cause complications through atherosclerosis, where plaque develops on the walls of blood vessels, causing them to narrow.

This narrowing makes hypertension worse, as the heart must pump harder to circulate the blood.

Hypertension-related atherosclerosis can lead to:

• heart failure and heart attacks
• aneurysm, or an atypical bulge in the wall of an artery that can burst
• kidney failure
• stroke
• amputation
• hypertensive retinopathies in the eye, which can lead to blindness

Regular blood pressure monitoring can help people avoid these more severe complications.

Signs

A sphygmomanometer, or blood pressure monitor, can help people keep track of their blood pressure.

A doctor’s visit is not always necessary for blood pressure monitoring.

Home blood pressure monitors are available for purchase online.

Having high blood pressure for a short time can be a normal response to many situations. Acute stress and intense exercise, for example, can briefly elevate blood pressure in an otherwise healthy person.

For this reason, a diagnosis of hypertension requires several readings that show sustained high blood pressure over time.

The International Society of Hypertension defines hypertension as blood pressure that is consistently higher than 140 over 90 millimeters of mercury (mm Hg)Trusted Source.

The systolic reading of 130 mm Hg refers to the pressure as the heart pumps blood around the body. The diastolic reading of 80 mm Hg refers to the pressure as the heart relaxes and refills with blood.

The International Society of Hypertension 2020 guidelines define the following ranges of blood pressure:

If the reading indicates a hypertensive crisis, wait 2 or 3 minutes and then repeat the test.

If the reading is the same or higher, this indicates a medical emergency.

The person should seek immediate assistance at the nearest hospital.

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Summary

A person has hypertension when their blood pressure is consistently high. The International Society of Hypertension defines grade 1 hypertension as a consistent reading of at least 140/90 mm Hg.

However, the American College of Cardiology and the American Heart Association recommend that people with hypertension maintain their blood pressure below 130/80 mm HgTrusted Source.

Hypertension can increase a person’s risk of developing a range of heart-related conditions, such as heart disease, heart attacks, and stroke.

Family history and lifestyle factors are often the cause of hypertension, while dietary and activity changes can help people maintain a healthy blood pressure level.

Doctors may also recommend a combination of medications in order to manage a person’s blood pressure level.