Hypertension: High Blood Pressure
Hypertension is another name for high blood pressure. It can severely impact quality of life and it increases the risk of heart disease, stroke, and death.
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.
Some people have high blood pressure caused by an underlying condition. This type of high blood pressure, called secondary hypertension, tends to appear suddenly and cause higher blood pressure than does primary hypertension. Various conditions and medications can lead to secondary hypertension, including:
- Obstructive sleep apnea
- Kidney problems
- Adrenal gland tumors
- Thyroid problems
- Certain defects in blood vessels you’re born with (congenital)
- Certain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs
- Illegal drugs, such as cocaine and amphetamines
- Alcohol abuse or chronic alcohol use
Symptoms of High Blood Pressure
- High blood pressure is generally a chronic condition and is often associated with few or no symptoms.
- When symptoms do occur, it is usually when blood pressure spikes suddenly and extremely enough to be considered a medical emergency.
- Rare symptoms include dizzy spells, headaches, and nosebleeds.
High blood pressure is often associated with few or no symptoms. Many people have it for years without knowing it.
However, just because high blood pressure is often symptomless doesn’t mean it is harmless. In fact, uncontrolled high blood pressure, or hypertension, causes damage to your arteries.High blood pressure is also a risk factor for stroke, heart attack, and other cardiovascular problems.
High blood pressure is generally a chronic condition. There are two major categories of high blood pressure (hypertension): secondary hypertension and primary hypertension.
- Secondary hypertension is high blood pressure that is the direct result of a separate health condition.
- Primary hypertension (or essential hypertension) is high blood pressure that doesn’t result from a specific cause, but instead, develops gradually over time. Many such cases are attributed to hereditary factors.
Typically, the only way to know you have it is to get your blood pressure tested.
Rare High Blood Pressure Symptoms
Rarely, people with chronic high blood pressure might have symptoms such as:
- dull headaches
- dizzy spells
- frequent nosebleeds
Emergency High Blood Pressure Symptoms
When symptoms do occur, it is usually only when blood pressure spikes suddenly and extremely enough to be considered a medical emergency. This is called a hypertensive crisis.
Hypertensive crisis (usually due to secondary high blood pressure) is defined as a blood pressure reading of 180 or above for the systolic pressure (first number) or 110 or above for the diastolic pressure (second number). If you are checking your own blood pressure and get a reading that high, wait a few minutes and then check again to make sure the first reading was accurate. Other symptoms of a hypertensive crisis may include:
- severe headache
- severe anxiety
- shortness of breath
After waiting a few minutes, if your second blood pressure reading is still 180 or above, don’t wait to see whether your blood pressure comes down on its own. Call 911 immediately. If that isn’t an option, have someone drive you to the emergency room.
Emergency hypertensive crisis can result in severe complications, including fluid in the lungs, brain swelling or bleeding, a tear in the heart’s main artery, stroke, or seizures for pregnant women with eclampsia.
Causes of High Blood Pressure
The exact causes of high blood pressure are not known, but several factors and conditions may play a role in its development, including:
- Being overweight or obese
- Lack of physical activity
- Too much salt in the diet
- Too much alcohol consumption (more than 1 to 2 drinks per day)
- Older age
- Family history of high blood pressure
- Chronic kidney disease
- Adrenal and thyroid disorders
- Sleep apnea
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 ly to affect men than women.
Age and race also play a role. In the United States, blacks are twice as ly 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.The majority of all 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 can raise the risk of having essential hypertension include obesity; diabetes; stress; insufficient intake of potassium, calcium, and magnesium; lack of physical activity; and chronic alcohol consumption.
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.
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 ly 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.
Sometimes pregnancy contributes to high blood pressure, as well.
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.
Treatment for high blood pressure typically involves a combination of medication and lifestyle changes to help control the condition and prevent or delay related health problems. The goal is to get blood pressure below the high range.
A normal blood pressure is 120/80 or lower. When the systolic blood pressure, the top number, is between 121 and 139, and the diastolic blood pressure, the lower number, is between 81 and 89, this is a condition known as prehypertension.
Prehypertension doesn’t necessarily raise your risk for heart attack or stroke. But without attention, it will usually progress to full high blood pressure, which definitely does raise those risks.
A critical step in preventing and treating high blood pressure is a healthy lifestyle. You can lower your blood pressure with the following lifestyle changes:
- Losing weight if you are overweight or obese
- Quitting smoking
- Eating a healthy diet, including the DASH diet (eating more fruits, vegetables, and low fat dairy products, less saturated and total fat)
- Reducing the amount of sodium in your diet to less than 1,500 milligrams a day if you have high blood pressure; healthy adults should try to limit their sodium intake to no more 2,300 milligrams a day (about 1 teaspoon of salt).
- Getting regular aerobic exercise (such as brisk walking at least 30 minutes a day, several days a week)
- Limiting alcohol to two drinks a day for men, one drink a day for women
In addition to lowering blood pressure, these measures enhance the effectiveness of high blood pressure drugs.
There are several types of drugs used to treat high blood pressure, including:
- Angiotensin-converting enzyme (ACE) inhibitors
- Angiotensin II receptor blockers (ARBs)
- Calcium channel blockers
- Renin inhibitors
- Combination medications
Diuretics are often recommended as the first line of therapy for most people who have high blood pressure.
However, your doctor may start a medicine other than a diuretic as the first line of therapy if you have certain medical problems. For example, ACE inhibitors are often a choice for a people with diabetes. If one drug doesn’t work or is disagreeable, additional medications or alternative medications may be recommended.
If your blood pressure is more than 20/10 points higher than it should be, your doctor may consider starting you on two drugs or placing you on a combination drug.
High Blood Pressure (Hypertension)
Essential Hypertension « Ada
Essential hypertension is a type of high blood pressure that has no clearly identifiable cause, but is thought to be linked to genetics, poor diet, lack of exercise and obesity. It is by far the most common form of high blood pressure, affecting the majority of those who experience hypertension. It is also known as primary hypertension.
As the heart pumps blood through the circulatory system, blood presses against the artery walls. High blood pressure occurs when the walls of the arteries exert a stronger oppositional force, which requires the heart to work harder in order to move blood through the body. This results in an increase in the pressure of blood in the arteries.
There are a variety of methods for managing essential hypertension, including lifestyle changes and medication. If left untreated, the condition can lead to serious complications, including heart attack and heart failure. People concerned that they may have essential hypertension can use the free Ada app to carry out a symptom assessment.
Whereas essential hypertension is characterized by its lack of identifiable causes, secondary hypertension, another form of hypertension, is directly linked to a variety of vascular, endocrine (related to hormones), heart and kidney conditions. It is far less common than essential hypertension.
Symptoms of essential hypertension
In most cases, there will be no apparent symptoms of essential hypertension, and it will only be discovered during a regular medical examination. If essential hypertension is not diagnosed, the condition has the potential to worsen and create heart or kidney problems.
Sometimes, people with essential hypertension may experience headaches, dizziness and blurred vision, but these symptoms are unly to occur until blood pressure reaches very high levels.
Some people report that their heartbeat seems louder than usual and feels as if it is inside the ear; this may be more prominent the higher the blood pressure is.People experiencing symptoms that may be linked to hypertension can use the free Ada app for a symptom assessment.
If a person experiences vomiting or nausea, severe headaches, vision changes or nosebleeds, it may be a sign of malignant hypertension – a much more dangerous type of high blood pressure. If these symptoms appear, urgent medical attention should be sought.
Causes of essential hypertension
Essential hypertension is defined by its lack of identifiable causes. However, certain risk factors that make the condition more ly have been identified. These include:
Obesity puts extra strain on the heart, increasing the risk of high blood pressure.
Those with a family history of essential hypertension are more ly to be at risk of developing the condition themselves. Fifty genes have been identified as linked to high blood pressure.
Multiple factors related to aging have been shown to increase the lihood of essential hypertension. These include the stiffening of the arteries and the onset of certain renal microvascular diseases not yet perceived as a cause.
It is thought that long-term or chronic mental stress is linked to the development of essential hypertension.
Excessive salt (sodium) consumption, defined by the American Heart Association as eating over 2300 mg per day, can play a role in the onset of essential hypertension. Salt increases retention of water in the body, which in turn increases the volume of blood and, consequently, blood pressure.
The enzyme renin, produced by the kidneys, is part of the body’s “renin angiotensin system”, which is responsible for controlling arterial blood pressure and is closely linked to both essential hypertension and hypertension in general. People with both low and high levels of renin are at risk of the condition.
Lack of exercise
The link between leading a sedentary lifestyle and an increased chance of essential hypersensitivity is well studied. To lead a healthy lifestyle and reduce the risk of high blood pressure, it is recommended that adults engage in at least 30 minutes of moderate physical activity five days a week.
Research indicates that hypertension is often more common in people of Afro-Caribbean descent. Hypertension also tends to occur earlier in life, be more severe and be associated with a higher risk of organ damage in people from this group.
Excessive alcohol intake, defined by the U.S. Department of Health as consuming more than one drink per day for women and two drinks per day for men, is associated with hypertension.
Read more about Alcohol Intoxication »
A lack of physical activity is associated with hypertension. Exercise is one of the key methods of managing high blood pressure.
Diagnosing essential hypertension
Essential hypertension is diagnosed by taking blood pressure measurements using a blood pressure monitor, which is also called a sphygmomanometer or an aneroid device.
These tests are routinely carried out as part of a normal medical examination.
Stress, anger, physical exercise and other factors can temporarily raise a person’s blood pressure, meaning a diagnosis of essential hypertension can only be made when results are consistently high.
Multiple readings, including readings taken outside of the hospital or doctor’s office, should be taken. To do this, a doctor may ask people to measure their own blood pressure daily, at home or at a pharmacy.
Blood pressure readings are expressed as two numbers, for example: 120/80. The first number is systolic pressure, which shows the amount of force being exerted on the artery walls as the heart pumps. The second number is diastolic pressure, which shows the amount of force being exerted on the artery walls between beats of the heart.
A healthy systolic reading is 120 or lower. Between 120 and 139 is considered normal, but not optimum, and over 140 is hypertensive. A healthy diastolic reading is 80 or lower.
Between 80 and 89 is considered normal, but not optimum, and over 90 is hypertensive.
These values can be used as a general guide, but it should be noted that the thresholds for healthy and hypertensive blood pressure tend to differ between countries.
People worried about their risk of hypertension should visit a doctor for testing. The free Ada app can also be used to carry out a symptom assessment.
Essential hypertension treatment
Hypertension can be managed through a combination of lifestyle changes and medication.
Doctors may recommend a range of lifestyle adjustments that will commonly include:
- Adopting a healthy, nutritious diet, ideally vegetarian or vegan in nature
- Stress relief techniques
- Reducing alcohol and tobacco use
- Consuming less salt, cheese, bread and processed foods
If lifestyle changes do not produce satisfactory results, a doctor may prescribe medication aimed at lowering blood pressure. These may include:
- Beta blockers
- Calcium channel blockers
- Angiotensin-converting enzyme (ACE) inhibitors
- Angiotensin II receptor blockers
- Renin inhibitors
Essential hypertension prognosis
People diagnosed with essential hypertension generally stand a good chance of lowering their blood pressure through lifestyle changes, medication or a combination of the two.
Lifestyle changes will normally need to be maintained for the rest of one’s life to ensure high blood pressure does not reoccur. Depending on the person, medications may need to be taken indefinitely.
In some cases, the use of medication can be stopped after blood pressure has fallen, with these lower levels then maintained through lifestyle alterations.
If essential hypertension is left untreated, it can lead to a variety of potentially serious complications. The heart, arteries and vascular system can be damaged, leading to:
Essential hypertension in pregnancy
Essential hypertension is a factor in approximately one percent of pregnancies. To be classed as essential hypertension, the high blood pressure must be pre-existing and have no identifiable cause. Some women develop hypertension during pregnancy; this is a seperate condition called gestational high blood pressure.
Typically, the blood pressure levels of women with essential hypertension during pregnancy will remain stable or fall in the early stages of pregnancy, before accelerating in around the second or third trimester.
Essential hypertension in pregnancy may cause complications including:
- Intrauterine growth restriction (IUGR)
- Placental abruption
- Premature birth
Women with essential hypertension in pregnancy will have their blood pressure levels monitored regularly by their doctor or midwife. If levels become high, the urine will be checked for protein, and symptoms of preeclampsia will be checked for. If signs of preeclampsia are found, a specialist will be brought in for treatment.
If blood pressure levels are high but there are no signs of preeclampsia, treatment will depend on the severity of the hypertension and the risks posed to the pregnancy.
To identify potential risks, ensure proper care is given and monitor the health of the baby. Women may be admitted to hospital to undergo blood tests, ultrasounds and other tests.
In some cases, medication may be prescribed to lower blood pressure levels.
Read more about Pregnancy Complications ».
Other names for essential hypertension
- High blood pressure
- Arterial hypertension
- Primary hypertension
Essential hypertension FAQs
Q: Can essential hypertension be treated successfully?
A: Yes, in many cases, there is a good chance that blood pressure can be lowered if the appropriate treatment methods are followed. To ensure blood pressure remains at a healthy level, most people will be required to maintain lifestyle changes and, if required, take medication, possibly for the rest of their lives.
Q: What is malignant essential hypertension?
A: Malignant essential hypertension, sometimes called accelerated hypertension, is a form of hypertensive emergency.
It involves high blood pressure that develops very quickly, causing serious complications.
The malignant variety is extremely rare, affecting roughly one percent of those with high blood pressure, but if it is suspected, it should be treated as a medical emergency.
Q: What is benign essential hypertension?
A: When essential hypertension remains in its early stages for a prolonged period of time and without a specific known cause, it is known as benign essential hypertension. In this state, the condition will generally be symptomless and develop very slowly. It is still important to seek treatment after a diagnosis of benign essential hypertension.
What is non-essential hypertension?
A: Non-essential hypertension is an alternative name for secondary hypertension. Essential hypertension is characterized by a lack of clearly attributable causes, whereas secondary hypertension is directly linked to a variety of vascular, endocrine, heart and kidney conditions.
Q: Can pregnancy cause essential hypertension?
A: Essential hypertension is defined by its lack of a clearly attributable cause, meaning that pregnancy cannot be said to cause the condition.
However, pregnancy can cause a form of hypertension known as gestational hypertension.
By definition, this form of hypertension must occur after 20 weeks of pregnancy in a previously not hypertensive person and disappear after the delivery of the baby Longer lasting hypertension, detected either before pregnancy or before the 20th week of pregnancy, and which remains after delivery of the baby, is defined as chronic hypertension and can be a kind of essential hypertension. Both gestational and chronic hypertension can lead to preeclampsia, a potentially serious but treatable complication of pregnancy. For more information, take a look at this resource on preeclampsia.
Q: What is hypertensive heart disease?
A: Hypertensive heart disease is an umbrella term for various heart conditions that are caused by chronically or prolonged high blood pressure levels.
People at risk of hypertensive heart disease should talk to their doctor about methods of preventing potential complications, e.g. attending regular check-ups and taking medication regularly as required by their prescription.
This will typically also include getting plenty of exercise, eating a balanced, nutritious diet and losing weight, if the person in question is considerably overweight or obese.
Why Hypertension Is a Leading Cause of Heart Disease
Hypertension, which is chronically high blood pressure, is one of the most common medical problems. Hypertension does not usually cause any symptoms, and it is not always diagnosed in the early stages. It is a leading cause of heart attack, stroke, kidney disease, and other serious medical problems.
Because hypertension is so common and consequential, it is important for everyone to have their blood pressure checked periodically. And if you have hypertension, you can work closely with your doctor to find an effective treatment.
High pressure impacts arterial wall contraction.
Most people who have hypertension only develop symptoms when their condition progresses enough to cause damage.
In many instances, the very first sign of hypertension is a sudden heart attack or a stroke. This is why hypertension is often called “the silent killer.”
Hypertension is classified how high the blood pressure is. The stages are:
- Stage 1 hypertension: Systolic pressure 130 to 139 mmHg or diastolic pressure 80 to 89 mmHg
- Stage 2 hypertension: Systolic pressure greater than 139 mmHg or pressure diastolic greater than 89 mmHg
Prehypertension describes blood pressure that is higher than the desirable range, but not high enough to be labeled hypertension. In prehypertension, the systolic pressure is 120 to 129 mmHg and the diastolic pressure is less than 80 mmHg.
Symptoms of prehypertension and stage 1 and 2 hypertension rarely occur. If you do experience symptoms, they may include:
- Nausea, vomiting
- Shortness of breath
- Blurred vision
In addition to these types of hypertension, there is a rare, severe form called hypertensive emergency, or malignant hypertension. Malignant hypertension is diagnosed when the blood pressure is extremely high and is accompanied by evidence of acute organ damage.
This acute organ damage is caused by extremely low blood supply or rupture of blood vessels when they are suddenly exposed to very high blood pressure. The effects may include bleeding in the eyes, kidney failure, heart rhythm irregularities, heart attack, aneurysm rupture, or stroke.
- Loss of consciousness
- Chest pain
- Shortness of breath
- Vision changes
- Weakness, numbness or tingling of the face, arms or legs
Malignant hypertension is always a medical emergency and requires aggressive intensive medical care.
Illustration by Cindy Chung, Verywell.
The pressure generated by the beating heart forces the blood forward and stretches the elastic walls of the arteries. In between heartbeats, as the heart muscle relaxes, the arterial walls snap back to their original shape, moving the blood forward to the body’s tissues. With hypertension, the pressure in the arteries is high enough to eventually produce damage to the blood vessels.
The causes of hypertension are usually divided into two general categories:
- Primary hypertension of no known cause, also called essential hypertension
- Secondary hypertension that is caused by an underlying medical problem
The vast majority of people with hypertension have essential hypertension.
There are some risk factors that can make it more ly for you to develop primary hypertension.
The most ones include advancing age, male gender, obesity, and elevated cholesterol and triglycerides levels. Women are more ly to develop hypertension after menopause. Hypertension is more common and more severe in African Americans and among people who have a family history of the condition.
Measuring Blood Pressure in the Doctor's Office
Formal guidelines for measuring blood pressure state that it should be measured in a quiet, warm environment after you have been sitting restfully for at least five minutes.
You should not have had coffee or used tobacco for at least 30 minutes. At least two blood pressure measurements should be taken under these conditions at least five minutes apart.
This should be repeated until the measurements agree to within 5 mmHg.
If you are anxious or stressed when getting your reading, you may experience what's called white coat hypertension. In this case, though your measurement is high at the doctor's office, it is normal just about any other time, so you do not need to be treated.
In addition to checking your blood pressure, your doctor may take a careful medical history, do a physical examination, and run routine blood work. Further steps to test for a medical condition in addition to hypertension may be necessary if your doctor suspects secondary hypertension.
Get our printable guide for your next doctor's appointment to help you ask the right questions.
Measuring Blood Pressure at Home
Ambulatory blood pressure monitoring can be done by using at-home devices that measure your blood pressure at periodic increments throughout a 24-hour or 48-hour time period.
This provides your medical team with an average blood pressure reading that is believed to be more accurate than one taken at the doctor's office.
Accumulating evidence supports the reliability of this approach.
People who have fluctuating blood pressure readings may be labeled as having labile hypertension. This could result from the medication wearing off, from white coat hypertension, or from physiological changes that affect blood pressure. Ambulatory blood pressure monitoring can help your medical team sort out that issue as well.The treatment of hypertension always starts with smoking cessation, diet, exercise, weight management, and sodium restriction. In some cases, these sorts of lifestyle changes are enough, and medical therapy may not be necessary, especially if you have prehypertension or stage 1 hypertension.
However, medication is needed to sufficiently reduce blood pressure for most stage 1 and almost all stage 2 hypertension cases. There are a vast number of prescription medications that have been approved for the treatment of hypertension, and guidelines have been developed to help doctors quickly find an effective and well-tolerated treatment regimen for almost anyone with this concern.
Medications for hypertension fall into several categories:
- Angiotensin-converting enzyme inhibitors
- Calcium channel blockers
- Beta blockers
- Angiotensin II receptor inhibitors
- Combination therapies
If you have secondary hypertension, treatment of the cause of your high blood pressure is also necessary.
When you are first diagnosed with hypertension, you can expect a period of time when you will be seeing your doctor more often than usual.
You will need some baseline testing to look for an underlying cause for your hypertension, and you will probably need several medical visits to determine whether lifestyle adjustments or medication will be effective in helping you reach your optimal blood pressure.
A few things that may come up as you adjust to treatment include medication side effects, medication adjustments, and resistant hypertension.
Medication Side Effects
The most common side effects of anti-hypertensive medications include hypotension (low blood pressure) and dizziness.
These effects are the result of the excessive lowering of blood pressure, and they can be alleviated if your doctor adjusts your medication dose.Each drug and medication category also has its own unique side effects, which you should familiarize yourself with when you begin taking the medication (check patient information provided by your pharmacy, or ask the pharmacist herself).
If your medication is working, but not quite as well as it should, your doctor may raise the dose or switch you to another medication. Most people need such adjustments when first starting treatment for hypertension and eventually require little, if any, changes.
Some people have resistant hypertension, which means that it is very difficult to get the blood pressure under control. If this is your situation, your doctor may need to continue to search for causes of secondary hypertension, as well as switch your medication(s) to try to get better blood pressure control.
A Word From Verywell
Hypertension is a common medical condition that often has severe consequences over the long-term. You generally would not know that you have hypertension unless you have your blood pressure checked.
If you have mildly elevated levels, lifestyle adjustments may be enough to lower your blood pressure within ideal ranges. If you need medication, you may need to have some adjustments to get your dose just right, especially early on.
Blood pressure management is generally effective, and most people are able to avoid the complications of hypertension with lifestyle modifications and medical management.
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- Salazar MR, Espeche WG, Stavile RN et al. Could self-measured office blood pressure be a hypertension screening tool for limited-resources settings? J Hum Hypertens. 2018 May 1. doi: 10.1038/s41371-018-0057-y. [Epub ahead of print]
What You Need to Know About Essential Hypertension
Essential hypertension is high blood pressure that doesn’t have a known secondary cause. It’s also referred to as primary hypertension.
Blood pressure is the force of blood against your artery walls as your heart pumps blood through your body. Hypertension occurs when the force of blood is stronger than it should be normally.
Most cases of high blood pressure are classified as essential hypertension. The other kind of hypertension is secondary hypertension. Secondary hypertension is high blood pressure that has an identifiable cause, such as kidney disease.
Genetic factors are thought to play a role in essential hypertension. The following factors may increase your risk of developing essential hypertension:
- minimal physical activity
- being overweight
Most people won’t notice any symptoms of essential hypertension. They usually discover that their blood pressure is high during a regular medical checkup.
Essential hypertension can begin at any age. It most often occurs first during middle age.
Blood pressure checks are the best way to screen for the condition. It’s important to understand how to take your blood pressure and read the results.
Blood pressure readings have two numbers, usually written this way: 120/80. The first number is your systolic pressure. Systolic pressure measures the force of blood against your artery walls as your heart pumps blood to the rest of your body.
The second number measures your diastolic pressure. Diastolic pressure measures the force of your blood against your artery walls between heartbeats, as the heart muscle relaxes. Learn more about systolic and diastolic pressure.
Your blood pressure readings can fluctuate up or down throughout the day. They change after exercise, during rest, when you’re in pain, and even when you’re stressed out or angry.Occasional high blood pressure readings don’t necessarily mean you have hypertension.
You won’t receive a diagnosis of hypertension unless you have high blood pressure readings at least two to three different times.
Normal blood pressure vs. abnormal blood pressure
Normal blood pressure is less than 120/80 millimeters of mercury (mmHg).
Elevated blood pressure is higher than normal blood pressure, but not quite high enough to be hypertension. Elevated blood pressure is:
- systolic pressure of 120 to 129 mmHg
- diastolic pressure less than 80 mmHg
Stage 1 hypertension is:
- systolic pressure of 130 to 139 mmHg, or
- diastolic pressure of 80 to 89 mmHg
Stage 2 hypertension is:
- systolic pressure higher than 140 mmHg, or
- diastolic pressure higher than 90 mmHg
Your doctor will test your blood pressure using a blood pressure monitor. If your blood pressure is high, they may want you to check your blood pressure at home during regular intervals. Your doctor will teach you how to use a blood pressure monitor if they ask you to measure your blood pressure at home.
You’ll record these readings and discuss them with your doctor at a later date. The severity of your high blood pressure is determined by the average of your blood pressure readings taken at different times.
Your doctor may perform a physical exam to check for signs of heart disease. This exam may include looking at your eyes and listening to your heart, lungs, and blood flow in your neck. Small blood vessels in the back of your eye can indicate damage from high blood pressure. Damage here indicates similar damage elsewhere.
Your doctor may also order the following tests to detect heart and kidney problems:
- Cholesterol test. Also called a lipid profile, this will test your blood for your cholesterol levels.
- Echocardiogram. This test uses sound waves to make a picture of your heart.
- Electrocardiogram (EKG or ECG). An EKG records the electrical activity of your heart.
- Kidney and other organ function tests. These can include blood tests, urine tests, or ultrasounds to check how your kidneys and other organs are functioning.
There’s no cure for essential hypertension, but there are treatments.
If you have elevated blood pressure or hypertension, your doctor will recommend lifestyle changes to lower your blood pressure. Lifestyle changes your doctor may recommend include the following:
If you have kidney problems, don’t increase your potassium intake without your doctor’s permission.
If lifestyle changes don’t lower your blood pressure levels enough, your doctor may prescribe one or more antihypertensive medications. The most common blood pressure medications include:
The higher your blood pressure is, the harder your heart has to work. A stronger force of blood can damage your organs, blood vessels, and heart muscle. This can eventually cause reduced blood flow through your body, leading to:
You may need to try several different medications until you find a single medication or a combination of medications that effectively lower your blood pressure. You may need to continue your lifestyle changes or take your hypertensive medications for the rest of your life.Some people are able to use medication to lower their blood pressure and then maintain that lower pressure with a healthier lifestyle, limiting their need for blood pressure medications.
With healthy lifestyle choices and medication, there’s a good chance that you can control your blood pressure. Controlling your blood pressure reduces your risk of heart attack, stroke, and heart failure. It also reduces the risk of damage to the eyes or kidneys. If you already have damage to your heart, eyes, or kidneys, treatment helps limit further damage.