Understanding High Blood Pressure

High blood pressure (hypertension) is known as a silent killer. This is because it's a serious health problem, but doesn’t often cause symptoms. Many people don’t know they have it until it leads to other health problems.

High blood pressure is 130/80 mmHg or above. If you’re at this level for several readings over time, you’ll be diagnosed with high blood pressure. Healthy changes can help you lower your blood pressure. But once you’re diagnosed, you'll need to manage it for the rest of your life.

What is blood pressure?

Your heart and blood vessels send blood through your body. This is called your circulatory system. Your heart is the pump for this system. With each heartbeat (contraction), the heart pushes blood through large blood vessels called arteries. Blood pressure is a measure of how hard the blood pushes against the walls of the arteries as it flows.

How high blood pressure harms your health

In a healthy artery, the blood moves smoothly and puts normal pressure on its walls.

Cross section of artery with arrows showing normal blood pressure on inside walls. Cross section of artery with arrows showing high blood pressure on inside walls. Cross section of artery showing damaged lining and plaque buildup.

High blood pressure means the blood is pushing too hard against artery walls. This damages the walls. The walls form scar tissue as they heal. But the scar tissue makes the arteries stiff and weak. A fatty substance called plaque sticks to the scar tissue. This makes arteries narrower and harder.

High blood pressure:

  • Causes your heart to work harder to get blood around your body
  • Raises your risk for heart attack, heart failure, and stroke
  • Can lead to kidney disease and blindness

Measuring blood pressure

It's important to know your blood pressure numbers. A blood pressure reading is given as 2 numbers, such as 120/70. 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).

Blood pressure may be:

  • Normal: lower than 120/lower than 80 mmHg

  • Elevated (prehypertensive): 120-139/80-89 mmHg

  • High, Stage 1: 130-139/80-89 mmHg

  • High, Stage 2: 140/90 mmHg and higher

For most people with high blood pressure, keeping readings under 130/80 mmHg may help prevent health problems. Talk with your healthcare provider. Find out what your blood pressure goals should be. Tell them what questions or concerns you have about your readings.

Controlling high blood pressure

If your blood pressure is high, work with your healthcare provider to make a plan for lowering it. They may prescribe medicine to help control your blood pressure if lifestyle changes aren't enough.

Below are changes you can make to help lower your blood pressure:

  • Choose heart-healthy foods. Ask your provider about the Dietary Approaches to Stop Hypertension (DASH) eating plan. DASH limits sodium (salt). It includes a lot of fruits and vegetables, low-fat or nonfat dairy foods, whole grains, and other foods high in fiber and low in fat. This plan also includes more potassium. This can help lower blood pressure.

  • Reduce sodium. Eating less sodium reduces fluid retention. Fluid retention is when your body holds on to too much water. Having too much salt increases blood volume and blood pressure. The American Heart Association (AHA) says to have no more than 1,500 mg of sodium a day. But because people in the U.S. eat so much salt, the AHA says cutting back to even 2,300 mg a day can help.

  • Stay at 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.

  • Don't smoke. Smoking raises blood pressure. And it 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 day. A drink is equal to 1 beer, a small glass of wine, or a shot of liquor.

  • Control stress. Stress makes your heart work harder and beat faster. Managing stress in a healthy way helps you control your blood pressure.

Facts about high blood pressure

  • High blood pressure is often a lifelong problem. But it can be controlled with lifestyle changes and medicine.

  • Blood pressure medicines need to be taken every day. Stopping suddenly may cause a dangerous increase in pressure.

  • Medicine is only 1 part of controlling high blood pressure. You also need to manage your weight, get regular exercise, and change your eating habits.

  • Hypertension isn't the same as stress. Stress may be a factor in high blood pressure, but it’s only 1 factor.

  • Feeling OK doesn't mean your blood pressure is under control. And feeling bad doesn’t mean it’s out of control. The only way to know for sure is to check your pressure regularly.

Controlling High 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. It can be very dangerous. High blood pressure can raise your risk of heart attack, stroke, heart disease, and heart failure. Controlling your blood pressure can lower your risk of these problems. It's important to check your blood pressure regularly. It can save your life.

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 grouped like this:

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

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

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

  • Stage 2 high blood pressure. This is systolic of 140 or higher or diastolic of 90 or higher.

A heart-healthy lifestyle can help you control your blood pressure without medicines. Below are some things you can do to have a heart-healthy lifestyle.

Man and woman fixing a salad together.

Eat heart-healthy foods

  • Choose low-salt, low-fat foods. Limit your sodium to 2,300 mg per day or the amount advised 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 made with no added salt.

Stay at a healthy weight

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

  • Ask your 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. A good weight loss goal is to lose 10% of your body weight in a year.

  • Limit snacks and sweets.

  • Get regular exercise.

Get more active

  • Find activities you enjoy. They can be done alone or with friends or family. Try bicycling, dancing, walking, or jogging.

  • Park farther away from building entrances to walk more.

  • 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 30 minutes a day for at least 5 days a week. 

Manage stress

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

  • Talk about 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.

  • If you smoke, make a plan to stop. Talk with your healthcare provider for help. Smoking greatly raises your risk for heart disease and stroke. Ask your provider about stop-smoking programs and other support.

Blood pressure medicines

If your lifestyle changes aren’t enough, your healthcare provider may prescribe high blood pressure medicine. Take all medicines as prescribed. If you have any questions about your medicines, ask your provider before stopping or changing them.

How daily issues affect your health

Many things in your daily life impact your health. This can include transportation, money problems, housing, access to food, and child care. If you can’t get to medical appointments, you may not receive the care you need. When money is tight, it may be difficult to pay for medicines. And living far from a grocery store can make it hard to buy healthy food.

If you have concerns in any of these or other areas, talk with your healthcare team. They may know of local resources to assist you. Or they may have a staff person who can help.

High Blood Pressure and Peripheral Arterial Disease

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 that causes poor blood flow. 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.

Cross section of artery with arrows showing pressure on artery walls from inside.

High blood pressure defined

Your blood pressure is too high if it is 130/80 mmHg or higher.

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 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

High Blood Pressure and Kidney Disease

High blood pressure that isn't controlled can damage the walls of the blood vessels in your body, including those in the kidneys. If that happens, the kidneys' tiny filtration units (nephrons) become damaged. They are 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. It can help slow any progression of kidney disease. High blood pressure is the second leading cause of kidney failure in the U.S.

Man taking his blood pressure at home.

Understanding blood pressure readings

The top number (systolic pressure) is the blood pressure when your heart is beating and pumping blood. The bottom number (diastolic pressure) is the blood pressure when your heart is relaxing and refilling with blood. A normal blood pressure is less than 120/80. In chronic kidney disease (CKD), the blood pressure goal is less than 130/80.

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 quietly for at least 5 minutes before measuring so that you feel relaxed. Don't talk. Don't smoke, have caffeine drinks, or exercise for 30 minutes before measuring. Empty your bladder before sitting down.

  • Sit with your back straight and supported (on a dining chair, rather than a sofa). Don’t cross your legs. Keep your feet flat on the floor. Your arm should be supported on a flat surface (such as a table) with the upper arm at heart level. If you're using an arm cuff, the bottom of the cuff should be directly above the bend of the elbow. Ask your healthcare provider to show you.
  • Take the readings at the same time, such as morning and evening. Take the readings daily, especially after a change in treatment and during the week before your next appointment.
  • Take multiple readings 1 minute apart. Each time you measure, take 2 or 3 readings.
  • Record the results. Take your records with you to your appointments.
  • 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.

  • Take your record and kit with you to healthcare provider visits. Ask your provider to check your blood pressure using your kit. Compare your readings with your provider's reading.

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:

  • 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.

  • Don't skip doses.

  • Don't stop taking your medicine unless your 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. If you have any of these risk factors, ask your healthcare provider for resources that can help you manage these issues and improve your health.

High Blood Pressure and Stroke

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 less than 120/80 millimeters of mercury (mmHg). This means systolic of less than 120 mmHg and diastolic of less than 80 mmHg. A stroke is a loss of brain function caused by a sudden lack of blood to part of the brain. Stroke can be caused by the damage that ongoing high blood pressure causes in your vessels. If the affected vessel stops supplying blood to the brain, a stroke happens.

How high blood pressure damages blood vessels

Vessels thicken

When blood presses against a vessel wall with too much force, muscles in the wall lose their ability to stretch. This causes the wall to thicken, which narrows the vessel passage and reduces blood flow.

Cross section of carotid artery showing plaque buildup.

Clots form

When blood pressure is too high, it can damage blood vessel walls and create scar tissue. Fat and cholesterol (plaque) collect in the damaged spots. Blood cells stick to the plaque, forming a mass called a clot. A clot can block blood flow in the vessel.

Cross section of carotid artery showing plaque buildup and blood clot.

Vessels break

Sometimes, blood flows with enough force to weaken a vessel wall. If the vessel is small or damaged, the wall can break. When this happens, blood leaks into nearby tissue and kills cells. Other cells may die because blood cannot reach them.

Cross section of ruptured artery in brain causing stroke.

Know the symptoms of stroke

During a stroke, blood supply to the brain is suddenly cut off. But with fast medical help, a better recovery is more likely. Don’t wait. Call 911 if you have any of these:

  • Sudden weakness or numbness on one side of the face or body, including a leg or an arm

  • Sudden trouble seeing with one or both eyes

  • Sudden double vision

  • Sudden trouble talking, such as slurred speech

  • Sudden severe headache

  • Sudden problems using or understanding words

  • Sudden confusion

  • Sudden dizziness or loss of balance

  • Seizures for the first time 

  • Any of these symptoms that happen and then go away 

Jan. 24, 2012
Symplicity trial evaluates effectiveness of high blood pressure treatment

High blood pressure, or hypertension, is the single most common contributor to death worldwide and a major risk factor for stroke, heart attack, co

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