What is it?
High blood pressure (hypertension) is a very common condition in which the force of the blood pressing against the walls of the arteries is too high. If hypertension continues for many years without treatment, it can cause serious health complications such as heart attacks, strokes, and damage to the kidneys and other vital organs.
What causes hypertension?
Most cases of hypertension appear to be a consequence of the normal aging process. The exact cause is not well understood, but clearly genetics play a significant role since people are more likely to develop hypertension if their parents or siblings have it. Hypertension is also much more likely to occur in people who are obese, who smoke, who don’t get regular exercise, or who have unhealthy diets (especially diets high in sodium). Rarely, hypertension is due to problems in other organs, such as the kidneys or adrenal glands.
What are the symptoms?
High blood pressure almost never produces any noticeable signs or symptoms, even when it becomes ominously high. Thus you should not attempt to determine whether your blood pressure is high based on how you feel. In extreme cases, very high blood pressure can cause headaches and vision problems, but this is rare.
How is hypertension diagnosed?
Your health care provider will measure your blood pressure as part of your routine physical exam, but you can easily measure your blood pressure yourself at home, often with even greater accuracy (link to article on measuring your own blood pressure). Since blood pressure measurements can vary depending on the time of day, your activity level, your diet and even your level of stress, your doctor will try to obtain several measurements at different times, and average them before making a diagnosis. Your own home measurements can be especially useful for this purpose. In some cases, your provider might perform additional tests to look for other conditions that can cause (or be caused by) hypertension.
Every blood pressure measurement consists of two numbers. The first number – your systolic pressure – represents the peak in pressure generated by each beat of your heart. The second, lower number—the diastolic pressure—represents the pressure between heart beats, when your heart muscle briefly relaxes. Both numbers are equally important. Here’s how we interpret them:
- Normal blood pressure — systolic pressure of less than 120 and diastolic pressure of less than 80
- Prehypertension (at risk for hypertension) — systolic pressure of 120 – 139 OR diastolic pressure of 80-89
- Hypertension — systolic pressure of 140 or higher OR diastolic pressure of 90 or higher
What’s the treatment?
Treatment of high blood pressure almost always begins with lifestyle modification. Each of the following can produce significant reduction in blood pressure, so if you’ve got hypertension (or want to avoid developing it), you should think about doing all of these things:
- Get regular aerobic exercise! Just 20 minutes of heart-pounding exercise three times a week can make a huge difference in your resting blood pressure.
- Avoid extra dietary sodium, and eat foods that are rich in potassium instead. Most restaurant food and processed food contain huge amounts of extra sodium, so try to pick low-sodium alternatives. Your best bet? Cook for yourself when possible, and eat plenty of fruits and vegetables—which contain plenty of potassium and zero sodium.
- Drink alcohol in moderation. A glass of wine at night is probably fine, but drinking more than that on a daily basis can lead to large increases in blood pressure.
- Don’t smoke.
- Reduce stress. Chronic stress leads to high blood pressure, so reduce your stress level by exercising regularly, sleeping at least 7 hours nightly, and balancing yourself with relaxing activities like meditation.
- Maintain a healthy weight. If you’re following the above suggestions, keeping your weight within a healthy range should come naturally.
Sometimes lifestyle modification alone doesn’t do the trick, and your health care provider might need to prescribe medication to keep your blood pressure in a safe range. Hypertension does not go away on its own and cannot be “cured” with medication—only controlled.
When hypertension has an identifiable cause, treatment should focus on correcting the underlying illness, if possible.