High blood pressure (hypertension)
High blood pressure (hypertension)
High blood pressure is a common condition in which the force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease.
Blood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure.
You can have high blood pressure (hypertension) for years without any symptoms. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke.
High blood pressure typically develops over many years, and it affects nearly everyone eventually. Fortunately, high blood pressure can be easily detected. And once you know you have high blood pressure, you can work with your doctor to control it.
Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels.
Although a few people with early-stage high blood pressure may have dull headaches, dizzy spells or a few more nosebleeds than normal, these signs and symptoms typically don't occur until high blood pressure has reached a severe — even life-threatening — stage.
When to see a doctor
Ask your doctor for a blood pressure reading at least every two years starting at age 20. He or she will likely recommend more frequent readings if you've already been diagnosed with high blood pressure or other risk factors for cardiovascular disease. Children age 3 and older will usually have their blood pressure measured as a part of their yearly checkups.
If you don't regularly see your doctor, you may be able to get a free blood pressure screening at a health resource fair or other locations in your community. You can also find machines in some stores that will measure your blood pressure for free, but these machines can give you inaccurate results.
There are two types of high blood pressure.
Primary (essential) hypertension
High blood pressure has many risk factors, including:
Sometimes pregnancy contributes to high blood pressure, as well.
Although high blood pressure is most common in adults, children may be at risk, too. For some children, high blood pressure is caused by problems with the kidneys or heart. But for a growing number of kids, poor lifestyle habits — such as an unhealthy diet and lack of exercise — contribute to high blood pressure.
The excessive pressure on your artery walls caused by high blood pressure can damage your blood vessels, as well as organs in your body. The higher your blood pressure and the longer it goes uncontrolled, the greater the damage.
Uncontrolled high blood pressure can lead to:
Preparing for your appointment
If you think you may have high blood pressure, make an appointment with your family doctor to have your blood pressure checked.
No special preparations are necessary to have your blood pressure checked. You might want to wear a short-sleeved shirt to your appointment so that the blood pressure cuff can fit around your arm properly. You might want to avoid caffeinated drinks right before your test. You should also use the toilet before having your blood pressure measured.
Because some medications — such as over-the-counter cold medicines, antidepressants, birth control pills and others — can raise your blood pressure, it might be a good idea to bring a list of medications and supplements you take to your doctor's appointment. Don't stop taking any prescription medications that you think may affect your blood pressure without your doctor's advice.
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For high blood pressure, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
What you can do in the meantime
Tests and diagnosis
Blood pressure is measured with an inflatable arm cuff and a pressure-measuring gauge. A blood pressure reading, given in millimeters of mercury (mm Hg), has two numbers. The first, or upper, number measures the pressure in your arteries when your heart beats (systolic pressure). The second, or lower, number measures the pressure in your arteries between beats (diastolic pressure).
Blood pressure measurements fall into four general categories:
Both numbers in a blood pressure reading are important. But after age 50, the systolic reading is even more significant. Isolated systolic hypertension (ISH) — when diastolic pressure is normal but systolic pressure is high — is the most common type of high blood pressure among people older than 50.
Your doctor will likely take two to three blood pressure readings each at two or more separate appointments before diagnosing you with high blood pressure. This is because blood pressure normally varies throughout the day — and sometimes specifically during visits to the doctor, a condition called white-coat hypertension. Your doctor may ask you to record your blood pressure at home and at work to provide additional information.
If you have any type of high blood pressure, your doctor may recommend routine tests, such as a urine test (urinalysis), blood tests and an electrocardiogram (ECG) — a test that measures your heart's electrical activity. Your doctor may also recommend additional tests, such as a cholesterol test, to check for more signs of heart disease.
Taking your blood pressure at home
Treatments and drugs
Your blood pressure treatment goal depends on how healthy you are.
*Although 120/80 mm Hg or lower is the ideal blood pressure goal, doctors are unsure if you need treatment (medications) to reach that level.
If you're an adult age 80 or older and your blood pressure is very high, your doctor may set a target blood pressure goal for you that's slightly higher than 140/90 mm Hg.
Changing your lifestyle can go a long way toward controlling high blood pressure. But sometimes lifestyle changes aren't enough. In addition to diet and exercise, your doctor may recommend medication to lower your blood pressure. Which category of medication your doctor prescribes depends on your stage of high blood pressure and whether you also have other medical problems.
Medications to treat high blood pressure
If you're having trouble reaching your blood pressure goal with combinations of the above medications, your doctor may prescribe:
Once your blood pressure is under control, your doctor may have you take a daily aspirin to reduce your risk of cardiovascular disorders.
To reduce the number of daily medication doses you need, your doctor may prescribe a combination of low-dose medications rather than larger doses of one single drug. In fact, two or more blood pressure drugs often work better than one. Sometimes finding the most effective medication — or combination of drugs — is a matter of trial and error.
Lifestyle changes to treat high blood pressure
Resistant hypertension: When your blood pressure is difficult to control
Having resistant hypertension doesn't mean your blood pressure will never get lower. In fact, if you and your doctor can identify what's behind your persistently high blood pressure, there's a good chance you can meet your goal with the help of treatment that's more effective.
Your doctor or hypertension specialist can evaluate whether the medications and doses you're taking for your high blood pressure are appropriate. You may have to fine-tune your medications to come up with the most effective combination and doses.
In addition, you and your doctor can review medications you're taking for other conditions. Some medications, foods or supplements can worsen high blood pressure or prevent your high blood pressure medications from working effectively. Be open and honest with your doctor about all the medications or supplements you take.
If you don't take your high blood pressure medications exactly as directed, your blood pressure can pay the price. If you skip doses because you can't afford the medication, because you have side effects or because you simply forget to take your medications, talk to your doctor about solutions. Don't change your treatment without your doctor's guidance.
Lifestyle and home remedies
Lifestyle changes can help you control and prevent high blood pressure — even if you're taking blood pressure medication. Here's what you can do:
Although diet and exercise are the best tactics to lower your blood pressure, some supplements also may help decrease it. These include:
While it's best to include these supplements in your diet as foods, you can also take supplement pills or capsules. Talk to your doctor before adding any of these supplements to your blood pressure treatment. Some supplements can interact with medications, causing harmful side effects, such as an increased bleeding risk that could be fatal.
You can also practice relaxation techniques, such as yoga or deep breathing, to help you relax and reduce your stress level. These practices can temporarily reduce your blood pressure.
Coping and support
High blood pressure isn't a problem that you can treat and then ignore. It's a condition you need to manage for the rest of your life. To keep your blood pressure under control:
Sticking to lifestyle changes can be difficult — especially if you don't see or feel any symptoms of high blood pressure. If you need motivation, remember the risks associated with uncontrolled high blood pressure. It may help to enlist the support of your family and friends as well.
Last Updated: 2011-03-22
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