The cardiovascular system is a complicated group of organs, consisting of the heart and blood vessels. Many different diseases can affect the cardiovascular system, including:

• Hypertension (high blood pressure)
• Heart disease (damage to the heart muscle or coronary arteries, the blood vessels that supply blood to the heart)
• Stroke (loss of blood supply, or abnormal bleeding, in the brain)

Conditions that affect the heart and blood vessels are often grouped together as cardiovascular disease because many people have more than one condition at the same time. Each of these diseases raises the risk of other heart and blood vessel diseases.

This article will focus on the relationship between hypertension, heart disease, and stroke so that you can better understand your own health. We’ll also discuss how to reduce your risk of developing other cardiovascular diseases.

Understanding Hypertension

High blood pressure develops when the force of blood against artery walls is consistently too high. A normal blood pressure is lower than 120/80 millimeters of mercury (mm Hg). When either the top number (systolic) or the bottom number (diastolic) is high, you may be diagnosed with hypertension.

Hypertension is often referred to as a “silent killer” because it often has no symptoms, but it can cause serious damage to your heart, blood vessels, and other organs over time. The condition can be characterized as primary (developing on its own) or secondary (due to another health problem).

According to Mayo Clinic, people at higher risk of primary hypertension include those who:

• Are older
• Are Black
• Have a family history of high blood pressure
• Are of a higher weight
• Use tobacco
• Drink more than the recommended amount of alcohol
• Consume too much salt
• Have low potassium levels
• Experience a lot of stress
• Are pregnant

Although some of these risk factors are out of your control, making lifestyle changes such as eating a low-salt diet, drinking less alcohol, exercising regularly, and managing stress can help reduce the risk of hypertension.

Hypertension and Heart Disease

Over time, people with uncontrolled hypertension can develop heart disease. There are a few explanations for this connection.

Damage to the Arteries

High blood pressure puts excessive force on the walls of your arteries, the blood vessels that send blood from your heart to your body. These usually elastic tubes can become thicker and less flexible after enduring this constant force.

This process, known as hardening of the arteries, can lead to atherosclerosis, in which fatty deposits (plaques) build up inside the artery walls. This further narrows the arteries and reduces blood flow throughout the body.

Strain on the Heart

The heart has to work harder to pump blood against increased resistance in people with hypertension. Over time, this can lead the left ventricle — the main pumping chamber of the heart — to hypertrophy (become too thick).

As the heart muscle wall thickens, it also becomes stiffer, which affects its function. Left ventricular hypertrophy can increase the risk of heart failure, when the heart can’t pump enough blood to meet the needs of the rest of the body.

Coronary Artery Disease

Hypertension increases the risk of coronary artery disease, which is the most common type of heart disease. Coronary artery disease occurs when plaques narrow or block the arteries that supply blood to the heart muscle, leading to angina (chest pain) during exertion, such as while exercising. As coronary artery disease gets worse, chest pain may occur even at rest, which is a sign of a heart attack. A heart attack, also called a myocardial infarction, happens when the heart muscle doesn’t get enou A heart attack, also called a myocardial infarction, happens when the heart muscle doesn’t get enough blood. It’s a medical emergency that needs immediate care.

Hypertension and Stroke

Not only can hypertension negatively affect heart health, but it can also cause a serious risk to your brain. Stroke occurs when blood flow to part of the brain is disrupted by either a blockage (ischemic stroke) or bleeding (hemorrhagic stroke). Hypertension can increase stroke risk in a few ways.

Damage to Blood Vessels

High blood pressure damages the delicate yet critically important vessels in the brain, speeding up plaque formation and raising the risk of blockages in the brain arteries. The blood vessels also become more susceptible to rupturing or bleeding. Even a few minutes without blood flow to the brain can lead to lasting damage or be life-threatening.

Increased Clot Formation

Hypertension can cause more blood clots to form and block arteries in the brain, leading to an ischemic stroke.

How Common Is Cardiovascular Disease?

Hypertension, heart disease, and stroke are among the leading causes of death around the world, especially in the United States, and learning the details of these diseases can be scary. You may wonder just how likely you are to face the medical situations described above.

According to the American Heart Association, cardiovascular disease is the leading cause of death in the United States, causing almost 1 million deaths in 2023 alone. These three conditions led to high proportions of deaths:

• Coronary artery disease — 40.3 percent
• Stroke — 17.5 percent
• High blood pressure — 13.4 percent

Prevention and Treatment

Luckily, many of the prevention measures for the different heart diseases are the same. Managing high blood pressure is the key to reducing the risk of heart disease and stroke. Some essential prevention and treatment strategies include lifestyle changes and medical options.

Lifestyle Modifications

Your heart health begins with your lifestyle. Whether you want to prevent hypertension or you’ve been living with heart disease for years, adopting a heart-healthy lifestyle can significantly lower blood pressure and the risk of complications. You can help protect your heart by trying to:

• Follow a healthy diet — Focus on eating more fruits, vegetables, whole grains, and lean proteins while limiting salt and saturated fats.
• Stay physically active — Aim for at least 150 minutes of moderate-intensity aerobic exercise a week, such as brisk walking, swimming, biking, or running.
• Limit alcohol — If you drink, keep it to moderate levels.
• Quit smoking — If you smoke, stopping can help protect your blood vessels and lower your risk of heart disease and stroke.

Medications

Regular checkups can help your healthcare provider determine if you’re a candidate for medications to control your blood pressure. The many types of treatments include diuretics, beta-blockers, ACE inhibitors, angiotensin II receptor blockers, and calcium channel blockers. Your symptoms and health history will help determine which options are right for you.

Regular Monitoring

Regular blood pressure checks are essential for early detection and management of hypertension. Some insurance companies will send you a free blood pressure cuff. If not, you can find automatic cuffs at your local pharmacy.

Resources for monitoring blood pressure, including blood pressure trackers and fact sheets, can be found at the American Heart Association website.

Speak With Your Doctor

If you have questions about hypertension, heart disease, or stroke, speak with your primary care doctor or cardiologist. Regular follow-up appointments in combination with home blood pressure readings can help you and your medical team keep a close eye on your heart health and reduce your risk of complications such as stroke. A healthy diet, active lifestyle, and correct use of medical treatment can help keep your heart healthy.

Small changes can make a big difference in your overall well-being. Stay informed, be proactive, and take charge of your heart health. Even simple steps you take today can help protect your heart for years to come.

Join the Conversation

On MyHeartDiseaseTeam, people share their experiences with heart disease, get advice, and find support from others who understand.

Have you been diagnosed with hypertension or heart disease? Have you ever had a stroke, or are you worried about your risk of stroke? Let others know in the comments below.