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What Is Hypertension (High Blood Pressure)?

Medically reviewed by Steven Kang, M.D.
Written by Maureen McNulty
Posted on February 9, 2023

At any type of doctor visit, you’ll usually get your blood pressure checked. This information helps your doctor better understand the health of your circulatory system (your heart and blood vessels). When your blood pressure gets too high, you may be at risk of health problems.

Hypertension, or high blood pressure, is very common. Within the U.S., close to half of adults have this condition, although many don’t know it. It’s important to keep an eye on your blood pressure, especially as you get older, and take steps to manage this condition if you are diagnosed with hypertension.

What Is Hypertension?

As your heart beats, it pumps blood around your body. Blood pressure is a measure of how hard your blood is pushing against the walls of your arteries (the blood vessels that carry blood from your heart to the rest of your tissues and organs). Hypertension happens when the force inside your arteries is too high.

Hypertension can cause serious health issues if it’s left untreated. This condition increases your risk of heart disease, heart attack, and stroke, which can all be fatal. Hypertension can also damage various organs, including your brain, eyes, and kidneys. About 670,000 deaths per year in the U.S. are related to hypertension, according to the Centers for Disease Control and Prevention (CDC).

The good news is that there are treatments to help control hypertension and reduce your risk of related health issues.

Measuring Blood Pressure

When your doctor takes your blood pressure, they will give you two numbers. Both numbers describe how hard your blood presses against your blood vessels. Systolic blood pressure (the top number) measures the force when your heart beats, and diastolic blood pressure (the bottom number) measures the force when your heart is at rest.

Your blood pressure is normal if you have a systolic blood pressure that’s less than 120 millimeters of mercury (mm Hg) and a diastolic pressure of less than 80 mm Hg. This may be written as “120/80 mm Hg,” and your provider may say it as “120 over 80.”

If your systolic blood pressure is between 120 and 129 mm Hg and your diastolic blood pressure is less than 80 mm Hg, you have prehypertension (elevated blood pressure). This means that you don’t yet have high blood pressure, but you’re at a higher risk of developing hypertension if you don’t take action to prevent it.

Stage 1 hypertension develops when your systolic blood pressure is between 130 and 139 mm Hg or your diastolic blood pressure is between 80 and 89 mm Hg. Stage 2 hypertension, a more serious form of the condition, occurs when your systolic blood pressure is at least 140 mm Hg or your diastolic blood pressure is at least 90 mm Hg.

Finally, a systolic pressure above 180 and/or diastolic pressure above 120 indicates a hypertensive crisis. If this occurs, call your doctor immediately. Many people may not experience symptoms despite having such high blood pressure.

Causes of High Blood Pressure

Blood pressure is influenced by two factors — the amount of blood the heart pumps and the size of the blood vessels. Blood pressure increases when the heart pumps a larger than usual amount of blood or arteries become too narrow. Your arteries may narrow due to atherosclerosis, which occurs when fat and cholesterol build up in the arteries.

Most of the time, the exact reason for developing hypertension is not known but, rather, is a result of genetic and environmental factors. This is called primary hypertension.

Your blood pressure can increase due to other medical conditions, such as:

  • Thyroid disease
  • Kidney disease
  • Congenital heart disease
  • Obstructive sleep apnea

Hypertension can also develop as a result of some over-the-counter or prescription medications such as cough medicine, pain relievers, and birth control pills. Use of illegal drugs such as cocaine and methamphetamine also raises blood pressure. When hypertension is caused by another condition or medication, it is known as secondary hypertension.

Hypertension Risk Factors

Anyone can develop high blood pressure. However, age, race, and family history contribute to risk, according to Mayo Clinic. Under age 64, high blood pressure is more common in men, whereas after 65, women are more likely to develop the condition. Black adults have a higher risk of hypertension than white adults, and anyone with a family history of the condition also has an increased risk.

Several lifestyle factors can raise risk too. You are more likely to have hypertension if you:

  • Are overweight or obese
  • Eat a high-salt diet
  • Don’t get enough potassium
  • Aren’t physically active
  • Have high stress levels
  • Drink a lot of alcohol
  • Smoke cigarettes or vape

Symptoms of High Blood Pressure

Hypertension doesn’t usually cause symptoms. This is why many people have hypertension without realizing it. The only way to know for sure whether you have hypertension is to check your blood pressure levels.

In rare cases, severe hypertension may lead to nosebleeds, breathing problems, or headaches.

Diagnosing Hypertension

Adults should get their blood pressure measured at least once every two years. If you’re over 40, you should get a reading yearly. If you’re at a higher risk of hypertension, your doctor may recommend more frequent readings.

Your blood pressure is read using a cuff that goes around one of your arms. The cuff slowly inflates, putting pressure on your arm. The cuff should be snug and may feel a little uncomfortable, but it shouldn’t be tight enough to cause pain. The cuff will then deflate and generate a blood pressure reading.

You can get your blood pressure checked by going to your doctor’s office. Many pharmacies also offer machines that can provide readings. Alternatively, you can buy an at-home blood pressure monitor and take your blood pressure measurements.

If you have high blood pressure, your doctor may recommend other tests to analyze your heart health and look for other conditions that may have caused your hypertension.

Hypertension Treatments

There are various treatments to help you manage hypertension. Unfortunately, however, about 3 out of 4 people with hypertension don’t properly manage their condition, according to the CDC.

If you have prehypertension or stage 1 hypertension, your doctor may advise making healthy lifestyle changes to lower your blood pressure levels and stave off more serious health problems. They might recommend that you:

  • Eat a diet containing a wide range of nutrients, including lots of fiber, protein, and potassium.
  • Consume less saturated fat and sodium (salt).
  • Exercise more often, aiming for 30 minutes of physical activity five days a week.
  • Drink less alcohol.
  • Quit smoking and vaping.
  • Get at least seven hours of sleep each night.
  • Stay at a healthy weight.

To help you eat a more heart-healthy diet, you may want to consult your health care team or a dietitian for a nutrition plan. You can also try the Dietary Approaches to Stop Hypertension (DASH) plan, a diet that can help boost heart health and decrease blood pressure.

If you have been diagnosed with stage 2 hypertension or are at an increased risk of heart disease, your doctor may prescribe one or more medications to help lower your blood pressure in addition to recommending heart-healthy lifestyle changes. Medications that help lower blood pressure include diuretics (water pills), calcium channel blockers, ACE inhibitors, and angiotensin II receptor blockers.

Talk With Others Who Understand

MyHeartDiseaseTeam is the social network for people living with heart disease and their loved ones. On MyHeartDiseaseTeam, more than 56,000 members come together to ask questions, give advice, and share their stories with others who understand life with heart disease.

Do you have hypertension? How do you manage it? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Posted on February 9, 2023
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Steven Kang, M.D. is the Director of Cardiac Electrophysiology at Alta Bates Summit Medical Center and Alameda Health Systems in Oakland, California. Learn more about him here
Maureen McNulty studied molecular genetics and English at Ohio State University. Learn more about her here

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