Hypertension Overview
From WebMD.com
|
High blood pressure or hypertension increases the risk of heart disease and stroke. Hypertension risk factors include obesity, drinking too much alcohol, smoking, and family history. Beta-blockers are a common treatment for hypertension.
Overview & Facts High blood pressure, also known as hypertension, affects millions -- even children and teens. WebMD's High Blood Pressure Guide has all the information you need to understand and manage your blood pressure. Learn all about causes, symptoms, diagnosis, treatment, and prevention. Even discover natural ways to manage your blood pressure and stay well. Let's get started! |
|
What Is High Blood Pressure?
High blood pressure, also known as hypertension, is the most common cardiovascular disease,
Blood pressure refers to the force of blood pushing against artery walls as it courses through the body. Like air in a tire or water in a hose,blood fills arteries to a certain capacity. Just as too much air pressure can damage a tire or too much water pushing through a garden hose can damage the hose, high blood pressure can threaten healthy arteries and lead to life-threatening conditions such as heart disease and stroke.
Hypertension is the leading cause of stroke and a major cause of heart attack. In the U.S. alone, more than 30% of American adults have high blood pressure.
If you have high blood pressure, you'll probably find out about it during a routine checkup. Or, you may have noticed a problem while taking your own blood pressure. Be sure to see your doctor for a definite diagnosis, and take the opportunity to learn what you can do to bring your blood pressure under control.
How Is Blood Pressure Measured?
A blood pressure reading appears as two numbers. The first and higher of the two is a measure of systolic pressure, or the pressure in the arteries when the heart beats and fills them with blood. The second number measures diastolic pressure, or the pressure in the arteries when the heart rests between beats.
Normal blood pressure rises steadily from about 90/60 at birth to about 120/80 in a healthy adult. If someone were to take your blood pressure immediately after you'd delivered a speech or jogged 5 miles, the reading would undoubtedly seem high. This is not 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 when blood pressure remains consistently high, talk with your doctor about treatment. Consistently high blood pressure forces the heart to work far beyond its capacity. Along with injuring blood vessels, hypertension can damage the brain, eyes, and kidneys.
High blood pressure, also known as hypertension, is the most common cardiovascular disease,
Blood pressure refers to the force of blood pushing against artery walls as it courses through the body. Like air in a tire or water in a hose,blood fills arteries to a certain capacity. Just as too much air pressure can damage a tire or too much water pushing through a garden hose can damage the hose, high blood pressure can threaten healthy arteries and lead to life-threatening conditions such as heart disease and stroke.
Hypertension is the leading cause of stroke and a major cause of heart attack. In the U.S. alone, more than 30% of American adults have high blood pressure.
If you have high blood pressure, you'll probably find out about it during a routine checkup. Or, you may have noticed a problem while taking your own blood pressure. Be sure to see your doctor for a definite diagnosis, and take the opportunity to learn what you can do to bring your blood pressure under control.
How Is Blood Pressure Measured?
A blood pressure reading appears as two numbers. The first and higher of the two is a measure of systolic pressure, or the pressure in the arteries when the heart beats and fills them with blood. The second number measures diastolic pressure, or the pressure in the arteries when the heart rests between beats.
Normal blood pressure rises steadily from about 90/60 at birth to about 120/80 in a healthy adult. If someone were to take your blood pressure immediately after you'd delivered a speech or jogged 5 miles, the reading would undoubtedly seem high. This is not 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 when blood pressure remains consistently high, talk with your doctor about treatment. Consistently high blood pressure forces the heart to work far beyond its capacity. Along with injuring blood vessels, hypertension can damage the brain, eyes, and kidneys.
|
People with blood pressure readings of 140/90 or higher, taken on at least two occasions, are said to have high blood pressure. For those over age 60, readings of 150/90 or higher indicate high blood pressure. If the pressure remains high, your doctor will probably begin treatment. People with blood pressure readings of 180/120 or higher need treatment immediately.
Researchers have identified people with blood pressures slightly higher than 120/80 as a category at high risk for developing hypertension. This condition is called pre-hypertension and affects an estimated 50 million American men and women. Pre-hypertension is now known to increase the likelihood of damage to arteries and the heart, brain, and kidneys, so many doctors are now recommending earlier treatment, though there is no evidence that this helps in the long run. |
Even so, many people with high blood pressure don't realize they have the condition. Indeed, hypertension is often called "the silent killer" because it rarely causes symptoms, even as it inflicts serious damage to the body. Left untreated, high blood pressure can lead to vision problems, as well as to heart attack, stroke, and other potentially fatal conditions, including kidney failure.
Hypertension may also lead to heart failure, a common but disabling condition that can cause breathing problems. Critically ill patients who have very high blood pressure are said to have malignant hypertension, with a diastolic pressure usually exceeding 120 or a systolic pressure above 180. Malignant hypertension is a dangerous condition that may develop rapidly and cause organ damage quickly. It requires immediate medical attention.
Fortunately, high blood pressure can be controlled effectively. The first step is to have your blood pressure checked regularly.
Who Gets Hypertension?
High blood pressure is more likely in people who:
What Causes High Blood Pressure?
Essential Hypertension
In as many as 95% of reported high blood pressure cases in the U.S., the underlying cause cannot be determined. This type of high blood pressure is called essential hypertension.
Though essential hypertension remains somewhat mysterious, it has been linked to certain risk factors. High blood pressure tends to run in families and is more likely to affect men than women. Age and race also play a role. In the U.S., blacks are twice as likely as whites to have high blood pressure, although the gap begins to narrow around age 44. After age 65, black women have the highest incidence of high blood pressure.
Essential hypertension is also greatly influenced by diet and lifestyle. The link between salt and high blood pressure is especially compelling. People living on the northern islands of Japan eat more salt per capita than anyone else in the world and have the highest incidence of essential hypertension. By contrast, people who add no salt to their food show virtually no traces of essential hypertension.
Many people with high blood pressure are "salt sensitive," meaning that anything more than the minimal bodily need for salt is too much for them and increases their blood pressure. Other factors that have been associated with essential hypertension include obesity; diabetes; stress; insufficient intake of potassium, calcium, and magnesium; lack of physical activity; and chronic alcohol consumption.
Hypertension may also lead to heart failure, a common but disabling condition that can cause breathing problems. Critically ill patients who have very high blood pressure are said to have malignant hypertension, with a diastolic pressure usually exceeding 120 or a systolic pressure above 180. Malignant hypertension is a dangerous condition that may develop rapidly and cause organ damage quickly. It requires immediate medical attention.
Fortunately, high blood pressure can be controlled effectively. The first step is to have your blood pressure checked regularly.
Who Gets Hypertension?
High blood pressure is more likely in people who:
- Have a family history of high blood pressure, heart disease, or diabetes
- Are African-American
- Are over age 55
- Are overweight
- Are not physically active
- Drink excessively
- Smoke
- Eat foods high in refined salt
- Use certain medications such as NSAIDs (ibuprofen, aspirin, e.g.),decongestants, and illicit drugs such as cocaine
What Causes High Blood Pressure?
Essential Hypertension
In as many as 95% of reported high blood pressure cases in the U.S., the underlying cause cannot be determined. This type of high blood pressure is called essential hypertension.
Though essential hypertension remains somewhat mysterious, it has been linked to certain risk factors. High blood pressure tends to run in families and is more likely to affect men than women. Age and race also play a role. In the U.S., blacks are twice as likely as whites to have high blood pressure, although the gap begins to narrow around age 44. After age 65, black women have the highest incidence of high blood pressure.
Essential hypertension is also greatly influenced by diet and lifestyle. The link between salt and high blood pressure is especially compelling. People living on the northern islands of Japan eat more salt per capita than anyone else in the world and have the highest incidence of essential hypertension. By contrast, people who add no salt to their food show virtually no traces of essential hypertension.
Many people with high blood pressure are "salt sensitive," meaning that anything more than the minimal bodily need for salt is too much for them and increases their blood pressure. Other factors that have been associated with essential hypertension include obesity; diabetes; stress; insufficient intake of potassium, calcium, and magnesium; lack of physical activity; and chronic alcohol consumption.
|
Secondary Hypertension
When a direct cause for high blood pressure can be identified, the condition is described as secondary hypertension. Among the known causes of secondary hypertension, kidney disease ranks highest. Hypertension can also be triggered by tumors or other abnormalities that cause the adrenal glands (small glands that sit atop the kidneys) to secrete excess amounts of the hormones that elevate blood pressure. Birth control pills -- specifically those containing estrogen -- and pregnancy can boost blood pressure, as can medications that constrict blood vessels. |
|
Know Your Blood Pressure Numbers
Often wonder what the top and the bottom blood pressure numbers mean? Doctors call them systolic (the top number) and diastolic (the bottom number) blood pressure.
Knowing both your systolic and diastolic blood pressure numbers is important and could save your life.
What Does the Systolic Blood Pressure Number Mean?
When your heart beats, it contracts and pushes blood through the arteries to the rest of the body. This force creates pressure on the arteries. This is called systolic blood pressure.
A normal systolic blood pressure is below 120.
A systolic blood pressure of 120 to 139 means you have prehypertension, or borderline high blood pressure. Even people with prehypertension are at a higher risk of developing heart disease.
A systolic blood pressure number of 140 or higher is considered to be hypertension, or high blood pressure.
What Does the Diastolic Blood Pressure Number Mean?
The diastolic blood pressure number or the bottom number indicates the pressure in the arteries when the heart rests between beats.
A normal diastolic blood pressure number is less than 80.
A diastolic blood pressure between 80 and 89 indicates prehypertension.
A diastolic blood pressure number of 90 or higher is considered to be hypertension or high blood pressure.
How Is Blood Pressure Measured?
Blood pressure is measured with a simple, painless test using a blood pressure cuff -- doctors call it a sphygmomanometer. It consists of a small pressure gauge that is attached to a cuff.
The inflatable cuff is wrapped around your upper arm. Some blood pressure cuffs wrap around the forearm or wrist.
When measuring blood pressure, your doctor or nurse will use a stethoscope to listen to the blood moving through an artery.
The cuff is inflated to a pressure that’s known to be higher than your systolic blood pressure. As the cuff deflates, the first sound heard through the stethoscope is the systolic blood pressure. It sounds like a whooshing noise. When this noise goes away, that indicates the diastolic blood pressure.
The systolic blood pressure number is always said first, and then the diastolic blood pressure number is given. For example, your blood pressure may be read as "120 over 80" or written as 120/80.
Blood pressure is measured in millimeters of mercury (mm Hg).
Often wonder what the top and the bottom blood pressure numbers mean? Doctors call them systolic (the top number) and diastolic (the bottom number) blood pressure.
Knowing both your systolic and diastolic blood pressure numbers is important and could save your life.
What Does the Systolic Blood Pressure Number Mean?
When your heart beats, it contracts and pushes blood through the arteries to the rest of the body. This force creates pressure on the arteries. This is called systolic blood pressure.
A normal systolic blood pressure is below 120.
A systolic blood pressure of 120 to 139 means you have prehypertension, or borderline high blood pressure. Even people with prehypertension are at a higher risk of developing heart disease.
A systolic blood pressure number of 140 or higher is considered to be hypertension, or high blood pressure.
What Does the Diastolic Blood Pressure Number Mean?
The diastolic blood pressure number or the bottom number indicates the pressure in the arteries when the heart rests between beats.
A normal diastolic blood pressure number is less than 80.
A diastolic blood pressure between 80 and 89 indicates prehypertension.
A diastolic blood pressure number of 90 or higher is considered to be hypertension or high blood pressure.
How Is Blood Pressure Measured?
Blood pressure is measured with a simple, painless test using a blood pressure cuff -- doctors call it a sphygmomanometer. It consists of a small pressure gauge that is attached to a cuff.
The inflatable cuff is wrapped around your upper arm. Some blood pressure cuffs wrap around the forearm or wrist.
When measuring blood pressure, your doctor or nurse will use a stethoscope to listen to the blood moving through an artery.
The cuff is inflated to a pressure that’s known to be higher than your systolic blood pressure. As the cuff deflates, the first sound heard through the stethoscope is the systolic blood pressure. It sounds like a whooshing noise. When this noise goes away, that indicates the diastolic blood pressure.
The systolic blood pressure number is always said first, and then the diastolic blood pressure number is given. For example, your blood pressure may be read as "120 over 80" or written as 120/80.
Blood pressure is measured in millimeters of mercury (mm Hg).
|
How Often Should I Get My Blood Pressure Checked?
|
Can I Check my Blood Pressure at Home?
Monitoring blood pressure at home is important for many people, especially if you have high blood pressure. This helps you and your doctor track blood pressure more closely to determine if treatment is keeping it controlled.
Your doctor may also suggest that you check blood pressure at home if he/she thinks you may have "white coat hypertension." This occurs when the stress of being in a doctor’s office increases your blood pressure, but it's normal at home.
Ask your doctor to recommend an easy-to-use and reliable home blood pressure monitor. Make sure the size of the blood pressure cuff itself (the inflatable part that wraps around your upper arm) fits properly. If your arm is too large for the cuff, the blood pressure number may be elevated even if it’s really normal. Ask your doctor for a larger cuff to get an accurate reading or make sure you buy a home blood pressure monitor with a cuff that fits you.
Wrist blood pressure monitors can also be accurate when used appropriately. Follow the directions that come with the device.
No matter which type of blood pressure monitor you have, it's a good idea to take it into your doctor's office. You can compare your doctor's reading to the reading on your home monitor. This helps assure that your home blood pressure monitor is accurate.
Before you take your blood pressure, it's recommended to avoid caffeine, cigarettes, and exercise for at least 30 minutes prior to the test.
When you take your blood pressure at home, sit up straight in a chair and place both feet on the floor. Make sure your arm is supported on a table or an even surface. Place the top of the arm at the level of your heart. Ask your doctor or nurse to show you the proper way to position your arm, so you get accurate readings.
When you monitor your blood pressure at home on a regular basis, take it at the same time of day so the readings are more consistent. Then, take several readings about one minute apart. Be sure to write down these readings in a journal.
Monitoring blood pressure at home is important for many people, especially if you have high blood pressure. This helps you and your doctor track blood pressure more closely to determine if treatment is keeping it controlled.
Your doctor may also suggest that you check blood pressure at home if he/she thinks you may have "white coat hypertension." This occurs when the stress of being in a doctor’s office increases your blood pressure, but it's normal at home.
Ask your doctor to recommend an easy-to-use and reliable home blood pressure monitor. Make sure the size of the blood pressure cuff itself (the inflatable part that wraps around your upper arm) fits properly. If your arm is too large for the cuff, the blood pressure number may be elevated even if it’s really normal. Ask your doctor for a larger cuff to get an accurate reading or make sure you buy a home blood pressure monitor with a cuff that fits you.
Wrist blood pressure monitors can also be accurate when used appropriately. Follow the directions that come with the device.
No matter which type of blood pressure monitor you have, it's a good idea to take it into your doctor's office. You can compare your doctor's reading to the reading on your home monitor. This helps assure that your home blood pressure monitor is accurate.
Before you take your blood pressure, it's recommended to avoid caffeine, cigarettes, and exercise for at least 30 minutes prior to the test.
When you take your blood pressure at home, sit up straight in a chair and place both feet on the floor. Make sure your arm is supported on a table or an even surface. Place the top of the arm at the level of your heart. Ask your doctor or nurse to show you the proper way to position your arm, so you get accurate readings.
When you monitor your blood pressure at home on a regular basis, take it at the same time of day so the readings are more consistent. Then, take several readings about one minute apart. Be sure to write down these readings in a journal.
|
Take your blood pressure journal with you to your doctor's office so you can talk about any changes in your blood pressure numbers. Your doctor will decide if you need blood pressure medications.
Symptoms of High Blood Pressure One of the most dangerous aspects of hypertension is that you may not know that you have it. In fact, nearly one-third of people who have high blood pressure don't know it. The only way to know if your blood pressure is high is through regular checkups. This is especially important if you have a close relative who has high blood pressure. If your blood pressure is extremely high, there may be certain symptoms to look out for, including:
|
|
Untreated hypertension can lead to serious diseases, including stroke, heart disease, kidney failure and eye problems.
Hypertensive crisis is an umbrella term for hypertensive urgency and hypertensive emergency. These two conditions occur when blood pressure becomes very high, possibly causing organ damage.
Hypertensive Urgency
Hypertensive urgency occurs when blood pressure spikes -- blood pressure readings are 180/110 or higher -- but there is no damage to the body's organs. Blood pressure can be brought down safely within a few hours with blood pressure medication.
Hypertensive Emergency
Hypertensive emergency means blood pressure is so high that organ damage can occur. Blood pressure must be reduced immediately to prevent imminent organ damage. This is done in an intensive care unit of a hospital.
Organ damage associated with hypertensive emergency may include:
Hypertensive crisis is an umbrella term for hypertensive urgency and hypertensive emergency. These two conditions occur when blood pressure becomes very high, possibly causing organ damage.
Hypertensive Urgency
Hypertensive urgency occurs when blood pressure spikes -- blood pressure readings are 180/110 or higher -- but there is no damage to the body's organs. Blood pressure can be brought down safely within a few hours with blood pressure medication.
Hypertensive Emergency
Hypertensive emergency means blood pressure is so high that organ damage can occur. Blood pressure must be reduced immediately to prevent imminent organ damage. This is done in an intensive care unit of a hospital.
Organ damage associated with hypertensive emergency may include:
- Changes in mental status, such as confusion
- Bleeding into the brain (stroke)
- Heart failure
- Chest pain (unstable angina)
- Fluid in the lungs (pulmonary edema)
- Heart attack
- Aneurysm (aortic dissection )
- Eclampsia (occurs during pregnancy)
|
Symptoms of Hypertensive Emergency Symptoms of a hypertensive emergency include:
|
Diagnosing Hypertensive Emergency
To diagnose a hypertensive emergency, your health care providers will ask you several questions to get a better understanding of your medical history. They will also need to know all medications you are taking, including nonprescription and recreational drugs. Also, be sure to tell them if you are taking any herbal or dietary supplements.
Certain tests will be performed to monitor blood pressure and assess organ damage, including:
What's the Treatment for Hypertensive Emergency and Associated Organ Damage?In a hypertensive emergency, the first goal is to bring down the blood pressure as quickly as possible with intravenous (IV) blood pressure medications to prevent further organ damage. Whatever organ damage that has occurred is treated with therapies specific to the organ that is damaged.
When to Call Your Doctor About High Blood Pressure
Hypertension symptoms? Often there aren't any. High blood pressure is often called the "silent" disease, because it may have no noticeable symptoms.
If undetected and untreated, hypertension can cause heart disease(including congestive heart failure and heart attack), stroke, and kidney disease. That's why it is important to have regular physical examinations to make sure your blood pressure is within the normal range. This is especially important if your blood pressure has ever been high, if you have a family history of hypertension, or if you are gaining weight.
If you are being treated for high blood pressure, your doctor can answer any questions or concerns you may have during your regular visits. However, there may be situations that warrant a call to your doctor. For example:
If you have any concerns about your condition, don't hesitate to call your doctor.
To diagnose a hypertensive emergency, your health care providers will ask you several questions to get a better understanding of your medical history. They will also need to know all medications you are taking, including nonprescription and recreational drugs. Also, be sure to tell them if you are taking any herbal or dietary supplements.
Certain tests will be performed to monitor blood pressure and assess organ damage, including:
- Regular monitoring of blood pressure
- Eye exam to look for swelling and bleeding
- Blood and urine testing
What's the Treatment for Hypertensive Emergency and Associated Organ Damage?In a hypertensive emergency, the first goal is to bring down the blood pressure as quickly as possible with intravenous (IV) blood pressure medications to prevent further organ damage. Whatever organ damage that has occurred is treated with therapies specific to the organ that is damaged.
When to Call Your Doctor About High Blood Pressure
Hypertension symptoms? Often there aren't any. High blood pressure is often called the "silent" disease, because it may have no noticeable symptoms.
If undetected and untreated, hypertension can cause heart disease(including congestive heart failure and heart attack), stroke, and kidney disease. That's why it is important to have regular physical examinations to make sure your blood pressure is within the normal range. This is especially important if your blood pressure has ever been high, if you have a family history of hypertension, or if you are gaining weight.
If you are being treated for high blood pressure, your doctor can answer any questions or concerns you may have during your regular visits. However, there may be situations that warrant a call to your doctor. For example:
- If you aren't responding to the treatment your doctor prescribed and your blood pressure is still high
- If you have certain symptoms, including fatigue, nausea, shortness of breath, lightheadedness, headache, excessive sweating, problems with your vision, or confusion; these may be serious and should warrant prompt medical attention. They could be from uncontrolled high blood pressure or from medication side effects.
If you have any concerns about your condition, don't hesitate to call your doctor.
|
Hypertension
Definition By Mayo Clinic Staff High blood pressure is a common condition in which the long-term 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 both 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. Even without symptoms, damage to blood vessels and your heart continues and can be detected. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke.
High blood pressure generally 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.
Symptoms
By Mayo Clinic Staff
Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels.
A few people with high blood pressure may have headaches, shortness of breath or nosebleeds, but these signs and symptoms aren't specific and usually don't occur until high blood pressure has reached a severe or life-threatening stage.
When to see a doctor
You'll likely have your blood pressure taken as part of a routine doctor's appointment.
Ask your doctor for a blood pressure reading at least every two years starting at age 18. Blood pressure generally should be checked in both arms to determine if there is a difference. Your doctor 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 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.
Public blood pressure machines, such as those found in pharmacies, may provide helpful information about your blood pressure, but they may have some limitations. The accuracy of these machines depends on several factors, such as a correct cuff size and proper use of the machines. Ask your doctor for advice on using public blood pressure machines.
High blood pressure generally 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.
Symptoms
By Mayo Clinic Staff
Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels.
A few people with high blood pressure may have headaches, shortness of breath or nosebleeds, but these signs and symptoms aren't specific and usually don't occur until high blood pressure has reached a severe or life-threatening stage.
When to see a doctor
You'll likely have your blood pressure taken as part of a routine doctor's appointment.
Ask your doctor for a blood pressure reading at least every two years starting at age 18. Blood pressure generally should be checked in both arms to determine if there is a difference. Your doctor 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 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.
Public blood pressure machines, such as those found in pharmacies, may provide helpful information about your blood pressure, but they may have some limitations. The accuracy of these machines depends on several factors, such as a correct cuff size and proper use of the machines. Ask your doctor for advice on using public blood pressure machines.
|
Causes
By Mayo Clinic Staff There are two types of high blood pressure. Primary (essential) hypertension For most adults, there's no identifiable cause of high blood pressure. This type of high blood pressure, called primary (essential) hypertension, tends to develop gradually over many years. |
|
Risk factors
By Mayo Clinic Staff
High blood pressure has many risk factors, including:
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, obesity and lack of exercise, contribute to high blood pressure.
By Mayo Clinic Staff
High blood pressure has many risk factors, including:
- Age. The risk of high blood pressure increases as you age. Through early middle age, or about age 45, high blood pressure is more common in men. Women are more likely to develop high blood pressure after age 65.
- Race. High blood pressure is particularly common among blacks, often developing at an earlier age than it does in whites. Serious complications, such as stroke, heart attack and kidney failure, also are more common in blacks.
- Family history. High blood pressure tends to run in families.
- Being overweight or obese. The more you weigh the more blood you need to supply oxygen and nutrients to your tissues. As the volume of blood circulated through your blood vessels increases, so does the pressure on your artery walls.
- Not being physically active. People who are inactive tend to have higher heart rates. The higher your heart rate, the harder your heart must work with each contraction and the stronger the force on your arteries. Lack of physical activity also increases the risk of being overweight.
- Using tobacco. Not only does smoking or chewing tobacco immediately raise your blood pressure temporarily, but the chemicals in tobacco can damage the lining of your artery walls. This can cause your arteries to narrow, increasing your blood pressure. Secondhand smoke also can increase your blood pressure.
- Too much salt (sodium) in your diet. Too much sodium in your diet can cause your body to retain fluid, which increases blood pressure.
- Too little potassium in your diet. Potassium helps balance the amount of sodium in your cells. If you don't get enough potassium in your diet or retain enough potassium, you may accumulate too much sodium in your blood.
- Too little vitamin D in your diet. It's uncertain if having too little vitamin D in your diet can lead to high blood pressure. Vitamin D may affect an enzyme produced by your kidneys that affects your blood pressure.
- Drinking too much alcohol. Over time, heavy drinking can damage your heart. Having more than two drinks a day for men and more than one drink a day for women may affect your blood pressure.
If you drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger. One drink equals 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80-proof liquor. - Stress. High levels of stress can lead to a temporary increase in blood pressure. If you try to relax by eating more, using tobacco or drinking alcohol, you may only increase problems with high blood pressure.
- Certain chronic conditions. Certain chronic conditions also may increase your risk of high blood pressure, such as kidney disease, diabetes and sleep apnea.
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, obesity and lack of exercise, contribute to high blood pressure.
|
Complications
By Mayo Clinic Staff 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:
|
- Heart failure. To pump blood against the higher pressure in your vessels, your heart muscle thickens. Eventually, the thickened muscle may have a hard time pumping enough blood to meet your body's needs, which can lead to heart failure.
- Weakened and narrowed blood vessels in your kidneys.This can prevent these organs from functioning normally.
- Thickened, narrowed or torn blood vessels in the eyes.This can result in vision loss.
- Metabolic syndrome. This syndrome is a cluster of disorders of your body's metabolism, including increased waist circumference; high triglycerides; low high-density lipoprotein (HDL) cholesterol, the "good" cholesterol; high blood pressure; and high insulin levels. These conditions make you more likely to develop diabetes, heart disease and stroke.
- Trouble with memory or understanding. Uncontrolled high blood pressure may also affect your ability to think, remember and learn. Trouble with memory or understanding concepts is more common in people with high blood pressure.
Tests and diagnosis
By Mayo Clinic Staff
To measure your blood pressure, your doctor or a specialist will usually place an inflatable arm cuff around your arm and measure your blood pressure using 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:
- Normal blood pressure. Your blood pressure is normal if it's below 120/80 mm Hg.
- Prehypertension. Prehypertension is a systolic pressure ranging from 120 to 139 mm Hg or a diastolic pressure ranging from 80 to 89 mm Hg. Prehypertension tends to get worse over time.
- Stage 1 hypertension. Stage 1 hypertension is a systolic pressure ranging from 140 to 159 mm Hg or a diastolic pressure ranging from 90 to 99 mm Hg.
- Stage 2 hypertension. More severe hypertension, stage 2 hypertension is a systolic pressure of 160 mm Hg or higher or a diastolic pressure of 100 mm Hg or higher.
Your doctor will likely take two to three blood pressure readings each at three 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 blood pressure generally should be measured in both arms to determine if there is a difference. Your doctor may ask you to record your blood pressure at home and at work to provide additional information.
Your doctor may suggest a 24-hour blood pressure monitoring test called ambulatory blood pressure monitoring. The device used for this test measures your blood pressure at regular intervals over a 24-hour period and provides a more accurate picture of blood pressure changes over an average day and night. However, these devices aren't available in all medical centers, and they're rarely reimbursed.
If you have any type of high blood pressure, your doctor will review your medical history and conduct a physical examination.
Your doctor may also recommend routine tests, such as a urine test (urinalysis), blood tests, a cholesterol test and an electrocardiogram — a test that measures your heart's electrical activity. Your doctor may also recommend additional tests, such as an echocardiogram, to check for more signs of heart disease.
Taking your blood pressure at home
An important way to check if your blood pressure treatment is working, or to diagnose worsening high blood pressure, is to monitor your blood pressure at home. Home blood pressure monitors are widely available and inexpensive, and you don't need a prescription to buy one. Talk to your doctor about how to get started. Home blood pressure monitoring isn't a substitute for visits to your doctor, and home blood pressure monitors may have some limitations.
Treatments and drugs
By Mayo Clinic Staff
Changing your lifestyle can go a long way toward controlling high blood pressure. Your doctor may recommend you eat a healthy diet with less salt, exercise regularly, quit smoking and maintain a healthy weight. But sometimes lifestyle changes aren't enough.
In addition to diet and exercise, your doctor may recommend medication to lower your blood pressure.
Your blood pressure treatment goal depends on how healthy you are.
Blood pressure treatment goals**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.Less than150/90 mm HgIf you're a healthy adult age 60 or olderLess than140/90 mm HgIf you're a healthy adult younger than age 60Less than140/90 mm HgIf you have chronic kidney disease, diabetes or coronary artery disease or are at high risk of coronary artery diseaseIf you're age 60 or older, and use of medications produces lower systolic blood pressure (such as less than 140 mm Hg), your medications won't need to be changed unless they cause negative effects to your health or quality of life.
Also, people older than 60 commonly have isolated systolic hypertension — when diastolic pressure is normal but systolic pressure is high.
The category of medication your doctor prescribes depends on your blood pressure measurements and your other medical problems.
Medications to treat high blood pressure
- Thiazide diuretics. Diuretics, sometimes called water pills, are medications that act on your kidneys to help your body eliminate sodium and water, reducing blood volume.
Thiazide diuretics are often the first, but not the only, choice in high blood pressure medications. Thiazide diuretics include hydrochlorothiazide (Microzide), chlorthalidone and others.
If you're not taking a diuretic and your blood pressure remains high, talk to your doctor about adding one or replacing a drug you currently take with a diuretic. Diuretics or calcium channel blockers may work better for blacks and older people than do angiotensin-converting enzyme (ACE) inhibitors alone. A common side effect of diuretics is increased urination. - Beta blockers. These medications reduce the workload on your heart and open your blood vessels, causing your heart to beat slower and with less force. Beta blockers include acebutolol (Sectral), atenolol (Tenormin) and others.
When prescribed alone, beta blockers don't work as well, especially in older adults, but may be effective when combined with other blood pressure medications. - Angiotensin-converting enzyme (ACE) inhibitors. These medications — such as lisinopril (Zestril), benazepril (Lotensin), captopril (Capoten) and others — help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels. People with chronic kidney disease may benefit from having an ACE inhibitor as one of their medications.
- Angiotensin II receptor blockers (ARBs). These medications help relax blood vessels by blocking the action, not the formation, of a natural chemical that narrows blood vessels. ARBs include candesartan (Atacand), losartan (Cozaar) and others. People with chronic kidney disease may benefit from having an ARB as one of their medications.
- Calcium channel blockers. These medications — including amlodipine (Norvasc), diltiazem (Cardizem, Tiazac, others) and others — help relax the muscles of your blood vessels. Some slow your heart rate. Calcium channel blockers may work better for older people and blacks than do ACE inhibitors alone.
Grapefruit juice interacts with some calcium channel blockers, increasing blood levels of the medication and putting you at higher risk of side effects. Talk to your doctor or pharmacist if you're concerned about interactions. - Renin inhibitors. Aliskiren (Tekturna) slows down the production of renin, an enzyme produced by your kidneys that starts a chain of chemical steps that increases blood pressure.
Tekturna works by reducing the ability of renin to begin this process. Due to a risk of serious complications, including stroke, you shouldn't take aliskiren with ACE inhibitors or ARBs.
If you're having trouble reaching your blood pressure goal with combinations of the above medications, your doctor may prescribe:
- Alpha blockers. These medications reduce nerve impulses to blood vessels, reducing the effects of natural chemicals that narrow blood vessels. Alpha blockers include doxazosin (Cardura), prazosin (Minipress) and others.
- Alpha-beta blockers. In addition to reducing nerve impulses to blood vessels, alpha-beta blockers slow the heartbeat to reduce the amount of blood that must be pumped through the vessels. Alpha-beta blockers include carvedilol (Coreg) and labetalol (Trandate).
- Central-acting agents. These medications prevent your brain from signaling your nervous system to increase your heart rate and narrow your blood vessels. Examples include clonidine (Catapres, Kapvay), guanfacine (Intuniv, Tenex) and methyldopa.
- Vasodilators. These medications, including hydralazine and minoxidil, work directly on the muscles in the walls of your arteries, preventing the muscles from tightening and your arteries from narrowing.
- Aldosterone antagonists. Examples are spironolactone (Aldactone) and eplerenone (Inspra). These drugs block the effect of a natural chemical that can lead to salt and fluid retention, which can contribute to high blood pressure.