Your Guide to Understanding High Blood Pressure

High blood pressure, or hypertension, is one of the most common health conditions around — you probably know someone with it. One in three people, or 70 million Americans, have high blood pressure. There are many easy ways to manage your blood pressure. You may not understand fully why your health care provider thinks controlling your blood pressure is so important. But when you learn more about what high blood pressure means, what causes it, and how it can affect your health, their concern will make sense.

Both high blood pressure and hypertension refer to excessive force on your artery walls as your heart pumps blood throughout your body. The top number (systolic) is the pressure when your heart contracts. The bottom number (diastolic) is the pressure when your heart is relaxed. If either number is above normal, your blood pressure is high.

Over time, high blood pressure can damage your heart and blood vessels. It’s a major risk for heart attack and stroke. Fortunately, it can be managed with healthy eating and exercise habits, plus medication when necessary.

Sit down and put on an automated blood pressure cuff. Place your arm on a table so that it’s at about the same level as your heart and make sure your feet are flat on the floor Before pressing “start”, make sure you’ve rested in a seated position for at least a few minutes, and you’re breathing normally.

High blood pressure is caused by a complex mix of genetic and environmental factors. Sometimes it’s caused by a separate medical condition, such as a hormone or kidney disorder, but for most people it seems to develop on its own. Risk factors for high blood pressure include:

• Age: Our arteries harden as we get older, making it more difficult for our heart to pump blood through our body
• Lifestyle: Smoking, obesity, excessive alcohol intake, inactivity, high-sodium diet
• Family history: You’re twice as likely to have high blood pressure if one or both of your parents do
• Race or ethnicity: High blood pressure is more common, more severe, and occurs earlier in life for Black people
• Medical conditions: Having diabetes or high cholesterol seems to make you more likely to have hypertension as well

High blood pressure is often called a “silent” disease because most people don’t feel any symptoms until many years in, when it has already damaged their kidneys, heart, or nervous system. Acute symptoms of extremely high blood pressure may include: severe headache, nausea or vomiting, blurry vision, chest pain, shortness of breath, swelling in your legs, or confusion. Learn common misconceptions about high blood pressure.

Being diagnosed with high blood pressure is a process that often takes more than just one or two office visits. It’s common to get “white coat hypertension” that raises your pressure when you’re with your health care provider, so a true diagnosis comes from multiple measurements over weeks to months, either at home or with your provider.

For some people, changing exercise and eating habits is enough to normalize their blood pressure. Other people may need to add one or more medications to lower their blood pressure. If you need medications, your provider will work with you to adjust your dose until you reach your personal blood pressure target — 140/90 or 150/90, depending on your age and other health conditions. Individuals over age 50 who have particularly high cardiovascular risk may have an even lower risk of heart attack, stroke, and death by hitting a more aggressive systolic blood pressure goal of 120. Talk to your provider about the pros and cons and what’s right for you.

Because high blood pressure is a major risk factor for heart attack and stroke, it’s important to get your blood pressure under control to prevent damage to your cardiovascular system over the long term. High blood pressure can also lead to problems with your vision, kidneys, nervous system, and wound healing.

Fortunately, it’s relatively easy to control your blood pressure with heart-healthy habits and medication, if your provider thinks it’s needed.