Hypertension, commonly called high blood pressure, is when the force of blood pumping through your arteries is too strong. Your arteries are the blood vessels that carry blood from your heart throughout your body. A blood pressure reading consists of a higher number over a lower number, such as 110/72. The higher number (systolic) is the pressure inside your arteries when your heart pumps. The lower number (diastolic) is the pressure inside your arteries when your heart relaxes. Ideally you want your blood pressure below 120/80.

Hypertension forces your heart to work harder to pump blood. Your arteries may become narrow or stiff. Having untreated or uncontrolled hypertension can cause heart attack, stroke, kidney disease, and other problems.

 

RISK FACTORS

Some risk factors for high blood pressure are controllable. Others are not.

Risk factors you cannot control include:

• You may be at higher risk if you are African American.
• Risk increases with age.
• Men are at higher risk than women before age 45 years. After age 65, women are at higher risk than men.

Risk factors you can control include:

• Not getting enough exercise or physical activity.
• Being overweight.
• Getting too much fat, sugar, calories, or salt in your diet.
• Drinking too much alcohol.

SIGNS AND SYMPTOMS

Hypertension does not usually cause signs or symptoms. Extremely high blood pressure (hypertensive crisis) may cause headache, anxiety, shortness of breath, and nosebleed.

DIAGNOSIS

To check if you have hypertension, your health care provider will measure your blood pressure while you are seated, with your arm held at the level of your heart. It should be measured at least twice using the same arm. Certain conditions can cause a difference in blood pressure between your right and left arms. A blood pressure reading that is higher than normal on one occasion does not mean that you need treatment. If it is not clear whether you have high blood pressure, you may be asked to return on a different day to have your blood pressure checked again. Or, you may be asked to monitor your blood pressure at home for 1 or more weeks.

TREATMENT

Treating high blood pressure includes making lifestyle changes and possibly taking medicine. Living a healthy lifestyle can help lower high blood pressure. You may need to change some of your habits.

Lifestyle changes may include:

• Following the DASH diet. This diet is high in fruits, vegetables, and whole grains. It is low in salt, red meat, and added sugars.
• Keep your sodium intake below 2,300 mg per day.
• Getting at least 30–45 minutes of aerobic exercise at least 4 times per week.
• Losing weight if necessary.
• Not smoking.
• Limiting alcoholic beverages.
• Learning ways to reduce stress.

Your health care provider may prescribe medicine if lifestyle changes are not enough to get your blood pressure under control, and if one of the following is true:

• You are 18–59 years of age and your systolic blood pressure is above 140.
• You are 60 years of age or older, and your systolic blood pressure is above 150.
• Your diastolic blood pressure is above 90.
• You have diabetes, and your systolic blood pressure is over 140 or your diastolic blood pressure is over 90.
• You have kidney disease and your blood pressure is above 140/90.
• You have heart disease and your blood pressure is above 140/90.

Your personal target blood pressure may vary depending on your medical conditions, your age, and other factors.

HOME CARE INSTRUCTIONS

• Have your blood pressure rechecked as directed by your health care provider.  
• Take medicines only as directed by your health care provider. Follow the directions carefully. Blood pressure medicines must be taken as prescribed. The medicine does not work as well when you skip doses. Skipping doses also puts you at risk for problems.
• Do not  
• Monitor your blood pressure at home as directed by your health care provider.