Hypertension: What You Need to Know About High Blood Pressure

Learn what your blood pressure readings mean

An older man with hypertension gets his blood pressure checked.

Learn what your blood pressure readings mean

What do you think when you hear someone has high blood pressure, also known as hypertension? It’s a common misconception that people with this condition are tense, angry, high-strung or Type A personalities.

The truth is, personality type can contribute or exacerbate hypertension, but many factors contribute to developing this condition.

Anyone can develop high blood pressure though the risks increase with age. High blood pressure puts you at risk for heart disease and stroke, two of the leading causes of death in the United States.

In addition, people with high blood pressure face higher risks of complications if infected with COVID-19 and should do everything possible to avoid exposure to the new coronavirus, according to the American Heart Association (AHA).

More than 100 million US adults – nearly half all adults in the nation – have high blood pressure, according to the heart association.

“If you’re diagnosed with hypertension, it’s important to be cautious and to make sure you're checking your blood pressure regularly in addition to making a commitment to living a heart healthy lifestyle,” says Todd Hitchcock, MD, a cardiologist at Scripps Clinic Carmel Valley.

What is blood pressure?

Blood pressure is defined as the force of blood against the walls of the arteries that carry blood from the heart to all parts of the body. Blood pressure normally rises and falls during the day, but it can damage the heart and lead to health problems if it remains higher than it should be for a long period.

Symptoms of high blood pressure

High blood pressure is sometimes called the silent killer because it usually has no signs or symptoms. Which is why it’s important to check your blood pressure regularly and follow your doctor’s instructions if it is higher than normal. Not treating high blood pressure is dangerous.

How is blood pressure measured?

Blood pressure is written as two numbers: The systolic number — pressure when the heart beats — over the diastolic number — pressure when the heart rests between beats. It is measured in millimeters of mercury (mmHg). Normal blood pressure is below 120/80 mmHg.

In 2017, AHA and the American College of Cardiology updated the guidelines for high blood pressure, lowering the traditional definition to encourage earlier intervention.

High blood pressure is now defined as a reading of 130 systolic or higher (top number) or 80 diastolic or higher (bottom number). The standard had been 140 over 90.

Blood pressure ranges:

  • Normal: Less than 120/80
  • Elevated 120-129/Less than 80
  • High blood pressure (stage 1): 130-139/80-89
  • High blood pressure (stage 2): Higher than 140/90
  • Hypertensive crisis: Higher than 180/120

Modifiable risk factors

Several risk factors can increase your chances of developing high blood pressure. Some are modifiable or can be changed, including:

  • Smoking
  • Obesity
  • High cholesterol
  • Poor diet
  • Lack of exercise

Risk factors that are difficult or cannot be modified

  • Family history of high blood pressure
  • Race/ethnicity
  • Increasing age
  • Gender (males)
  • Chronic kidney disease
  • Obstructive sleep apnea

High blood pressure medications

Many US adults with high blood pressure take medications to treat their condition. These may include one or more of the following:

  • Diuretics (sometimes called water pills)
  • Angiotensin converting enzyme inhibitors (ACE-inhibitors)
  • Angiotensin II receptor blockers (ARBs)
  • Calcium channel blockers

Treatment without medication

Provided it is safe to delay drug treatment, many people can lower their numbers through lifestyle changes, such as weight loss, eating healthier — including salt reduction — high fruit and vegetable intake, being more active, quitting smoking and drinking less alcohol.

While lifestyle changes can help, you may still need medications. Which is why it’s important to work with your doctor and check your blood pressure regularly.

“With proper treatment and management, you can control your blood pressure to help you live a long and healthy life,” Dr. Hitchcock says.

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