Narrow blood vessels, also known as arteries, create more resistance for blood flow. The more narrow your arteries are, the more resistance there is to blood flow, and consequently, the higher your blood pressure will be. In the long run, the increased pressure can lead to health problems such as heart disease.
Hypertension is quite common. This condition could now be diagnosed in nearly half of all American adults, according to the change in guidelines in 2017.
Hypertension typically develops over the course of several years. Usually, you don’t notice any symptoms. Even if you don’t experience any symptoms, high blood pressure can still damage your blood vessels and organs, especially the brain, heart, eyes, and kidneys.
Early detection is important. You and your doctor can spot any changes in your blood pressure by taking readings on a regular basis. If your blood pressure is higher than normal, your doctor may want you to keep track of it over a few weeks to see if it stays high or goes back down to normal levels.
There are two ways to treat hypertension: with medication and by making healthy lifestyle changes. If the condition is left untreated, it could lead to more serious health complications such as heart attack and stroke.
How to understand high blood pressure readings
Two numbers create a blood pressure reading. The top number in a blood pressure reading is called the systolic pressure. This number represents the pressure in your arteries when your heart is beating and pumping out blood. Between heartbeats, diastolic pressure is the reading of the pressure in your arteries.
Five categories define blood pressure readings for adults:
- Healthy: A healthy blood pressure reading is less than 120/80 millimeters of mercury (mm Hg).
- Elevated: The systolic number is between 120 and 129 mm Hg, and the diastolic number is less than 80 mm Hg. Doctors usually don’t treat elevated blood pressure with medication. Instead, your doctor may encourage lifestyle changes to help lower your numbers.
- Stage 1 hypertension: The systolic number is between 130 and 139 mm Hg, or the diastolic number is between 80 and 89 mm Hg.
- Stage 2 hypertension: The systolic number is 140 mm Hg or higher, or the diastolic number is 90 mm Hg or higher.
- Hypertensive crisis: The systolic number is over 180 mm Hg, or the diastolic number is over 120 mm Hg. Blood pressure in this range requires urgent medical attention. If any symptoms like chest pain, headache, shortness of breath, or visual changes occur when blood pressure is this high, medical care in the emergency room is needed.
A blood pressure reading is taken by wrapping a pressure cuff around your arm and inflating it to temporarily stop the flow of blood. For an accurate reading, you need to have a cuff that fits. An ill-fitting cuff may deliver inaccurate readings
Blood pressure readings are different for children and teenagers. If you are asked by a doctor to monitor your child’s blood pressure, find out what the healthy ranges are for your child.
Common Hypertension Symptoms
The vast majority of people living with hypertension do not experience any symptoms. A healthcare provider can usually diagnose high blood pressure with a simple blood pressure measurement using a blood pressure cuff.
If you experience any symptoms, they may be due to a temporary change in your blood pressure or the timing of your medication doses.
Symptoms of hypertension can generally happen at any time, and may not last long, as well as recur. They include:
- Recurrent headaches: Headaches are fairly common, with or without hypertension. Some people with hypertension notice changes or worsening of headaches when medications are skipped or when the blood pressure becomes higher than usual. Headaches associated with hypertension can be mild, moderate, or severe, and can be of a throbbing nature.
- Dizziness: People with hypertension may notice dizziness in relation to medication doses and blood pressure fluctuations.
- Shortness of breath: Hypertension can cause shortness of breath as a result of the effect on the heart and lung function. Shortness of breath is more noticeable with physical exertion or exercise.
- Nosebleed: You may be more prone to nosebleeds if you have high blood pressure although, in general, nosebleeds are not a classic sign of high blood pressure.
Rare Hypertension Symptoms
Acute hypertension is more likely to cause symptoms than chronic hypertension. Even though high blood pressure may not have symptoms, it is important to know that it can still be harmful.
High blood pressure is defined as a systolic pressure of >180 mmHg or a diastolic pressure of >120 mmHg. People with severe high blood pressure can develop symptoms quickly, including:
- Blurry vision or other vision disturbances: Blurred vision and vision changes are warning signs that you could be at risk of a serious health problem, such as a stroke or a heart attack.
- Headaches: Headaches associated with very high blood pressure tend to be throbbing in nature and can develop rapidly.
- Dizziness: The dizziness of very high blood pressure is described as vertigo (a sensation that the room is spinning).
- Nausea, vomiting, or loss of appetite: Nausea associated with severe hypertension can develop suddenly and may be associated with dizziness.
Hypertensive Urgency
A type of high blood pressure that doesn’t have any serious symptoms is called hypertensive urgency. Hypertensive urgency is a situation where there is high blood pressure, but no organ failure or other immediately critical conditions. However, if the blood pressure isn’t quickly brought under control, these conditions could quickly develop.
What causes high blood pressure?
There are two types of hypertension. Each type has a different cause.
Essential (primary) hypertension
Essential hypertension is also called primary hypertension. This kind of hypertension develops over time. Most people have this type of high blood pressure.
A combination of factors typically play a role in the development of essential hypertension:
- Genes: Some people are genetically predisposed to hypertension. This may be from gene mutations or genetic abnormalities inherited from your parents.
- Age: Individuals over 65 years old are more at risk for hypertension.
- Race: Black non-Hispanic individuals have a higher incidence of hypertension.
- Living with obesity: Living with obesity can lead to a few cardiac issues, including hypertension.
- High alcohol consumption: Women who habitually have more than one drink per day, and men who have more than two drinks per day, may be at an increased risk for hypertension.
- Living a very sedentary lifestyle: lowered levels of fitness have been connected to hypertension.
- Living with diabetes and/or metabolic syndrome: Individuals diagnosed with either diabetes or metabolic syndrome are at a higher risk of developing hypertension.
- high sodium intake: There’s a small association between daily high sodium intake (more than 1.5g a day) and hypertension.
Secondary hypertension
Secondary hypertension typically occurs suddenly and can be more severe than primary hypertension. Several conditions that may cause secondary hypertension include:
- kidney disease
- obstructive sleep apnea
- congenital heart defects
- problems with your thyroid
- side effects of medications
- use of illegal drugs
- chronic consumption of alcohol
- adrenal gland problems
- certain endocrine tumors
Diagnosing high blood pressure
Blood pressure readings are used to diagnose hypertension. A routine visit to the doctor usually includes a blood pressure check. If you don’t get your blood pressure checked at your next appointment, ask for it.
If your doctor finds that your blood pressure is consistently high, they may ask you to come in for more readings over the course of a few days or weeks. A hypertension diagnosis is not given after just one reading.
This means that your doctor needs to see that there is a problem that has lasted for a while and is not likely to go away soon. The environment you are in can raise your blood pressure, for example the stress you may feel when you are at the doctor’s office. Also, blood pressure levels change throughout the day.
If your blood pressure does not improve, your doctor will probably do more tests to find out the cause. These tests can include:
- cholesterol screening and other blood tests
- test of your heart’s electrical activity with an electrocardiogram (EKG, sometimes referred to as an ECG)
- ultrasound of your heart or kidneys
- home blood pressure monitor to monitor your blood pressure over a 24-hour period at home
You doctor can use these tests to figure out if there are any other problems causing your high blood pressure. They may also look at any damage that high blood pressure has caused to your organs.
Your doctor may treat your high blood pressure during this time. Early treatment may reduce your risk of lasting damage.
Treatment options for high blood pressure
There are a number of factors that your doctor will take into account in order to determine the best course of treatment for you. There are a number of factors that can affect how hypertension is treated. This includes what type of hypertension you have and what underlying causes have been identified.
Primary hypertension treatment options
If you are diagnosed with primary hypertension by your doctor, making some lifestyle changes may help to lower your blood pressure. If you are not seeing results from lifestyle changes alone, your doctor may prescribe medication.
Secondary hypertension treatment options
If your doctor finds an underlying cause for your high blood pressure, the treatment will be focused on that other condition. Your doctor will prescribe different medication if the one you are taking causes an increase in blood pressure.
Even when the underlying cause of hypertension is treated, sometimes it doesn’t go away. Your doctor may help you develop lifestyle changes to reduce your blood pressure, as well as prescribe medications to assist with this.
Treatment plans for hypertension often evolve. What is effective at first may not be as useful later on. Your doctor will keep working with you to improve your treatment.
Medications
Most people try different blood pressure medications before finding the one that works best for them. Different medications may need to be tried by your doctor until an effective one or combination is found.
Some of the medications used to treat hypertension include:
- Beta-blockers: Beta-blockers make your heart beat slower and with less force. This reduces the amount of blood pumped through your arteries with each beat, which lowers blood pressure. It also blocks certain hormones in your body that can raise your blood pressure.
- Diuretics: High sodium levels and excess fluid in your body can increase blood pressure. Diuretics, also called water pills, help your kidneys remove excess sodium from your body. As the sodium leaves, extra fluid in your bloodstream moves into your urine, which helps lower your blood pressure.
- ACE inhibitors: Angiotensin is a chemical that causes blood vessels and artery walls to tighten and narrow. ACE (angiotensin-converting enzyme) inhibitors prevent the body from producing as much of this chemical. This helps blood vessels relax and reduces blood pressure.
- Angiotensin II receptor blockers (ARBs): While ACE inhibitors aim to stop the creation of angiotensin, ARBs block angiotensin from binding with receptors. Without the chemical, blood vessels won’t tighten. That helps relax vessels and lower blood pressure.
- Calcium channel blockers: These medications block some of the calcium from entering the cardiac muscles of your heart. This leads to less forceful heartbeats and lower blood pressure. These medications also work in the blood vessels, causing them to relax and further lowering blood pressure.
- Alpha-2 agonists: This type of medication changes the nerve impulses that cause blood vessels to tighten. This helps blood vessels to relax, which reduces blood pressure.
Home remedies for high blood pressure
Developing a heart-healthy diet
A diet that is good for your heart is important in helping to lower your blood pressure. Maintaining hypertension at a controlled level is also key to reducing the risk of complications. These complications include heart disease, stroke, and heart attack.
A heart-healthy diet emphasizes:
- fruits
- vegetables
- whole grains
- lean proteins like fish
Increasing physical activity
Exercise isn’t just good for helping you lose weight if your doctor has recommended it. It can also help lower your blood pressure naturally and strengthen your cardiovascular system.
The goal is to get 150 minutes of moderate physical activity every week. That’s about 30 minutes, 5 times per week.
Reaching an optimal weight
If you’re overweight, you can help lower your blood pressure by eating a healthier diet and exercising more.
Managing stress
Exercise is a great way to manage stress. Other activities can also be helpful. These include:
- meditation
- deep breathing
- massage
- muscle relaxation
- yoga or tai chi
Getting adequate sleep may also help reduce stress levels.
Quitting smoking and limiting alcohol
If you are a smoker and have high blood pressure, your doctor will probably tell you to stop smoking. The chemicals in tobacco smoke can damage the body’s tissues and harden blood vessel walls, which can lead to a variety of health problems, including heart disease.
If you drink too much alcohol often or you are addicted to alcohol, get help to drink less or to stop drinking entirely. Drinking alcohol in excess can raise blood pressure.
Lifestyle tips to lower your risk of hypertension
Add fruits and vegetables to your diet
Working your way up slowly, try to eat more servings of heart-healthy plants. It is recommended that you eat more than seven servings of fruits and vegetables each day. For the next two weeks, try to add an extra serving to your daily intake. Within two weeks, try to add an extra serving. The goal is to consume 10 servings of fruits and vegetables per day.
Reduce sodium intake
If you are at risk for developing heart disease or have high blood pressure, your doctor may tell you to keep your daily sodium intake at 1,500-2,300 milligrams per day.
A good way to reduce sodium is to cook more fresh foods and limit the amount of fast food or prepackaged food you eat, which can often be high in sodium.
Set weight loss goals
If your doctor has told you that you need to lose weight, discuss with them what a realistic weight loss goal would be for you. For individuals looking to lose weight, the CDC recommends a goal of one or two pounds a week. You can improve your health by eating better and exercising more.
If you want to improve your fitness and learn how to make better choices for your body and lifestyle, you can get help from a trainer or fitness app, or even a dietician.