What is High Blood Pressure?

High blood pressure (also called hypertension) is known as the “silent killer.” This is because most of the time it doesn’t cause symptoms. In fact, many people don’t know they have it until other problems develop. In most cases, high blood pressure often requires lifelong treatment.

Understanding blood pressure

The circulatory system is made up of the heart and blood vessels that carry blood through the body. Your heart is the pump for this system. With each heartbeat (contraction), the heart sends blood out through large blood vessels called arteries. Blood pressure is a measure of how hard the moving blood pushes against the walls of the arteries.

High blood pressure can harm your health

In a healthy blood vessel, the blood moves smoothly through the vessel and puts normal pressure on the vessel walls.

High blood pressure occurs when blood pushes too hard against artery walls. This causes damage to the artery walls and then the formation of scar tissue as it heals. This makes the arteries stiff and weak. Plaque sticks to the scarred tissue narrowing and hardening the arteries. High blood pressure also causes your heart to work harder to get blood out to the body. High blood pressure raises your risk of heart attack, also known as acute myocardial infarction, or AMI, heart failure, and stroke. It can also lead to kidney disease, and blindness. In general, if you have high blood pressure, keeping your blood pressure below 130/80 mmHg may help prevent these problems. Your healthcare provider may prescribe medicine to help control blood pressure if lifestyle changes are not enough.

It's important to know your blood pressure numbers. Blood pressure measurements are given as 2 numbers. Systolic blood pressure is the upper number. This is the pressure when the heart contracts. Diastolic blood pressure is the lower number. This is the pressure when the heart relaxes between beats.

Blood pressure is categorized as normal, elevated, or stage 1 or stage 2 high blood pressure:

• Normal blood pressure is systolic of less than 120 and diastolic of less than 80 (120/80)

• Elevated blood pressure is systolic of 120 to 129 and diastolic less than 80

• Stage 1 high blood pressure is systolic is 130 to 139 or diastolic between 80 to 89

• Stage 2 high blood pressure is when systolic is 140 or higher or the diastolic is 90 or higher

High blood pressure is diagnosed when multiple, separate readings show blood pressure above 130/80 mmHg. Talk with your healthcare provider if you have questions or concerns about your blood pressure readings.

Measuring blood pressure

An example of a blood pressure measurement is 120/70 (120 over 70). The top number is the pressure of blood against the artery walls during a heartbeat (systolic). The bottom number is the pressure of blood against artery walls between heartbeats (diastolic). Talk with your healthcare provider to find out what your blood pressure goals should be. 

Controlling blood pressure

If your blood pressure is too high, work with your doctor on a plan for lowering it. Below are steps you can take that will help lower your blood pressure.

• Choose heart-healthy foods. Eating healthier meals helps you control your blood pressure. Ask your doctor about the DASH eating plan. This plan helps reduce blood pressure by limiting the amount of sodium (salt) you have in your diet. DASH also encourages eating plenty of fruits and vegetables, low-fat or non-fat dairy, whole-grains, and foods high in fiber, and low in fat. This also provides an enhanced amount of potassium which can also help lower blood pressure.

• Reduce sodium. Reducing sodium in your diet reduces fluid retention. Fluid retention caused by too much salt increases blood volume and blood pressure. The American Heart Association’s (AHA) "ideal" sodium intake recommendation is 1,500 milligrams per day.  However, since American's eat so much salt, the AHA says a positive change can occur by cutting back to even 2,400 milligrams of sodium a day.

• Maintain a healthy weight. Being overweight makes you more likely to have high blood pressure. Losing excess weight helps lower blood pressure.

• Exercise regularly. Daily exercise helps your heart and blood vessels work better and stay healthier. It can help lower your blood pressure.

• Stop smoking. Smoking increases blood pressure and damages blood vessels.

• Limit alcohol. Drinking too much alcohol can raise blood pressure. Men should have no more than 2 drinks a day. Women should have no more than 1. (A drink is equal to 1 beer, or a small glass of wine, or a shot of liquor.)

• Control stress. Stress makes your heart work harder and beat faster. Controlling stress helps you control your blood pressure.

Controlling High Blood Pressure

High blood pressure (hypertension) is often called the silent killer. This is because many people who have it don’t know it. High blood pressure is defined as 140/90 mm Hg or higher. Know your blood pressure and remember to check it regularly. Doing so can save your life. Here are some things you can do to help control your blood pressure.

Choose heart-healthy foods

• Select low-salt, low-fat foods. Limit sodium intake to 2,400 mg per day or the amount suggested by your healthcare provider.

• Limit canned, dried, cured, packaged, and fast foods. These can contain a lot of salt.

• Eat 8 to 10 servings of fruits and vegetables every day.

• Choose lean meats, fish, or chicken.

• Eat whole-grain pasta, brown rice, and beans.

• Eat 2 to 3 servings of low-fat or fat-free dairy products.

• Ask your doctor about the DASH eating plan. This plan helps reduce blood pressure.

• When you go to a restaurant, ask that your meal be prepared with no added salt.

Maintain a healthy weight

• Ask your healthcare provider how many calories to eat a day. Then stick to that number.

• Ask your healthcare provider what weight range is healthiest for you. If you are overweight, a weight loss of only 3% to 5% of your body weight can help lower blood pressure. Generally, a good weight loss goal is to lose 10% of your body weight in a year.

• Limit snacks and sweets.

• Get regular exercise.

Get up and get active

• Choose activities you enjoy. Find ones you can do with friends or family. This includes bicycling, dancing, walking, and jogging.

• Park farther away from building entrances.

• Use stairs instead of the elevator.

• When you can, walk or bike instead of driving.

• Rake leaves, garden, or do household repairs.

• Be active at a moderate to vigorous level of physical activity for at least 40 minutes for a minimum of 3 to 4 days a week. 

Manage stress

• Make time to relax and enjoy life. Find time to laugh.

• Communicate your concerns with your loved ones and your healthcare provider.

• Visit with family and friends, and keep up with hobbies.

Limit alcohol and quit smoking

• Men should have no more than 2 drinks per day.

• Women should have no more than 1 drink per day.

• Talk with your healthcare provider about quitting smoking. Smoking significantly increases your risk for heart disease and stroke. Ask your healthcare provider about community smoking cessation programs and other options.

High Blood Pressure and Peripheral Arterial Disease (PAD)

Blood pressure measures the force of blood against your artery walls. High blood pressure (hypertension) can harm your arteries. It also puts you at risk for peripheral arterial disease (PAD). PAD is a disease of arteries in the legs. If you have PAD, it’s likely that arteries in other parts of your body are diseased, too. That puts you at high risk for heart attack and other heart diseases. Read on to learn how high blood pressure can lead to PAD and affect your health.

How can high blood pressure lead to peripheral arterial disease?

Having high blood pressure makes it easier for plaque to form. Plaque is a waxy material made up of cholesterol and other things. It can build up in your artery walls. As plaque builds up, your arteries can become narrowed. This limits blood flow. If high blood pressure isn’t controlled, you are more likely to have PAD and other heart problems. But high blood pressure can be controlled with exercise, weight loss, dietary changes, and medicine.

What happens if blood pressure isn’t controlled?

You double your risk of dying from heart disease or stroke each time your blood pressure rises:

• 20 mmHg in the top number

• 10 mmHg in the bottom number

If you have diabetes, high blood pressure increases your risk for diabetes complications.

What happens if blood pressure is controlled?

Lowering your blood pressure and keeping it low can reduce your risk for:

• Stroke

• Heart attack 

• Dying from heart disease 

• Diabetes complications

High Blood Pressure and Kidney Disease

If you have high blood pressure and it is not controlled, it can damage the walls of the blood vessels in your body including those in the kidneys. If that happens, the tiny filtration units, or nephrons, become damaged and less able to filter your blood and waste products in the blood. Lowering high blood pressure can reduce the amount of damage to your kidneys and help slow any progression of kidney disease. High blood pressure is one of the top two causes of kidney failure in Western countries.

Check your blood pressure often

Checking your blood pressure is a simple test that you can do at home. Most pharmacies have in-store monitors and home blood pressure monitors. For best results, keep the hints below in mind.

• Always take your blood pressure at the same time of the day. Morning may be best.

• Sit so that you feel relaxed, and do not talk.

• Use the cuff on your bare arm.

• Place the cuff so it fits snugly on your upper arm. Some monitors are placed on the wrist.

• Follow all the instructions that come with your kit.

• Keep a record of all your blood pressure readings.

• Take your record and kit with you to healthcare provider visits. Ask your healthcare provider to check your blood pressure using your kit, and compare your readings with your providers.

Take medicine as directed

Blood pressure medicines often play a large role in treatment. Your medicine will work best if it’s taken as directed. Be sure to do these things:

• Take your medicine at the same time each day.

• Find out if it should be taken with food.

• Call your healthcare provider if you think the medicine is making you dizzy or sick to your stomach.

• Do not skip doses.

• Do not stop taking your medicine unless your healthcare provider tells you to. Doing so may be harmful.

• Get regular urine and blood tests at least annually to watch for kidney disease or monitor existing kidney disease.

Addressing other risk factors for kidney disease

Many other factors can also contribute to kidney disease. Smoking, diabetes, dietary habits, lack of exercise, obesity, and other factors can contribute.

Understanding the Link Between High Blood Pressure and Stroke

Each day that your blood pressure is too high, your chances of having a stroke are increased. Normal blood pressure is considered to be less than 120 over less than 80 millimeters of mercury (mmHg) or 120/80 mmHg. A stroke is a loss of brain function caused by a lack of blood to the brain. Stroke can result from the damage that ongoing high blood pressure causes in your vessels. If the affected vessel stops supplying blood to the brain, a stroke results.

High blood pressure damages blood vessels