Blood pressure is a
measure of how hard the blood pushes against the walls of your arteries as it
moves through your body. It's normal for blood pressure to go up and down
throughout the day, but if it stays up, you have high blood pressure. Another
name for high blood pressure is hypertension.
When blood pressure
is high, it starts to damage the blood vessels, heart, and kidneys. This can
stroke, and other problems. High blood pressure is
called a "silent killer,'' because it doesn't usually cause symptoms while it
is causing this damage.
Your blood pressure consists of two
systolic and diastolic. Someone with a systolic
pressure of 120 and a diastolic pressure of 80 has a blood pressure of 120/80,
or "120 over 80." Blood pressure is measured in millimeters of mercury (mm Hg).
An ideal blood pressure for an adult is less than 120/80. High blood pressure is 140/90 or higher. You have high blood pressure if your top number is 140 or higher or your bottom number is 90 or higher, or both. Many people fall into the category called prehypertension, which is in between ideal blood pressure and high blood pressure. People with prehypertension need to make
lifestyle changes to bring the blood pressure down and help prevent or delay
high blood pressure.
About 1 out of 3 adults in the United States has high
blood pressure.footnote 1
In most cases,
doctors can't point to the exact cause. But several things are known to raise
blood pressure, including being very overweight, drinking too much alcohol,
family history of high blood pressure, eating too much
salt, and getting older.
Your blood pressure may also rise if you
are not very active, you don't eat enough potassium and calcium, or you have a
High blood pressure doesn't
usually cause symptoms. Most people don't know they have it until they go to
the doctor for some other reason.
Very high blood pressure
can cause severe headaches and vision problems. These symptoms can
also be caused by dangerously high blood pressure called
malignant high blood pressure. It may also be called a
hypertensive crisis or hypertensive emergency. Malignant high blood pressure is
a medical emergency.
find out that they have high blood pressure during a routine doctor visit. After measuring your blood pressure, your doctor may ask you to test it again when you are home.footnote 2
If you have high blood pressure, your doctor will give you a blood pressure goal. Your goal will be based on your health and your age. An example of a goal is to keep your blood pressure below 140/90.
You can help lower your blood pressure by making healthy
changes in your lifestyle. If those lifestyle changes don't work well enough, you may also
need to take pills. Either way, you will need to control your high blood
pressure throughout your life.
Treatment depends on how high
your blood pressure is, whether you have other health problems such as
diabetes, and whether any organs have already been damaged. Your doctor may also check your risk for other problems, such as heart attack and stroke.
Most people take more than one pill for high blood
pressure. Work with your doctor to find the right pill or combination of pills
that will cause the fewest side effects.
Making lifestyle changes can help you to
prevent high blood pressure. You can:
Health Tools help you make wise health decisions or take action to improve your health.
Learning about high blood pressure:
Living with high blood pressure:
Experts know that
many things are linked to high blood pressure. But experts still
don't fully understand the exact cause. Things that are linked to
high blood pressure include:
Primary, or essential, high blood pressure is the most
common type of high blood pressure. Most people who have high blood pressure
have primary high blood pressure.
Secondary high blood pressure, which is caused by
another disease or medicine, is less common.
pressure readings may not always mean that you have high blood pressure. For
some people, just being in a medical setting causes their blood pressure to
rise. This is called
People who have
high blood pressure usually don't
have any symptoms. Most people who have high blood pressure feel fine. It's during
a routine exam or a doctor visit for another problem that they find out that they
high blood pressure.
Very severe high
blood pressure (such as 180 over 110 or higher) may lead to
malignant high blood pressure. This is also called
hypertensive emergency or hypertensive crisis. Very severe high blood pressure
is a medical emergency. Symptoms of very severe high blood pressure
Healthy arteries have smooth inner walls. Your blood flows
through them without a problem. The blood vessels stay strong and
But when you have
high blood pressure, blood flows through your arteries
with too much force, even though you can't feel it. Over time, this pressure damages the walls of your arteries. They aren't smooth anymore. They get rough spots on
them where fat and calcium start to build up. This buildup is called
plaque (say "plak").
Plaque is part of atherosclerosis, sometimes called "hardening of the arteries." Over time, the plaque narrows the artery and blocks blood flow through it.
Atherosclerosis makes your arteries narrower. It also makes them
stiffer. Blood can't flow through them as easily. This lack of good blood flow
starts to damage some of the organs in your body.
This damage doesn't happen all at once. It
happens slowly over time. But you can't tell that it's happening, because you
don't feel anything. It can lead to:
Things that increase your risk (risk factors) for
high blood pressure include:
Other possible risk factors include:
Call 911 anytime you think you may need emergency care. This may mean having symptoms that suggest that your blood pressure is causing a serious heart or blood vessel problem. Your blood pressure may be over 180/110.
For example, call 911 if:
Do not wait until your blood pressure comes down on its own. Get help right away.
Call your doctor now or seek immediate care if:
Watch closely for changes in your health, and be sure to contact your doctor if:
Your blood pressure can be
For diagnosis and management of high blood pressure,
The main test for
high blood pressure is simple, fast, and painless.
These are the usual steps:
After measuring your blood pressure, your doctor may ask you to test it again when you are home.footnote 2 This is because your blood pressure can change throughout the day. And sometimes blood pressure is high only because you are seeing a doctor. This is called white-coat hypertension. To diagnose high blood pressure, your doctor needs to know if your blood pressure is high throughout the day.
So your doctor may ask you to monitor your blood pressure at home to make sure that it actually is high. You may get an ambulatory blood pressure monitor or a home blood pressure monitor. These devices measure your blood pressure several times throughout the day.
All adults should have their blood pressure checked regularly.footnote 2
Your doctor can let you know how often you should get your blood pressure checked. It may depend on what your blood pressure is and your risk for heart disease. You can get your blood pressure checked during any routine medical visit.
U.S. Preventive Services Task Force (USPSTF) makes these recommendations about how often to check your blood pressure:footnote 2
The automated devices you find in grocery stores
or drugstores may not be accurate. Having your blood
pressure checked at the doctor's office is best.
home blood pressure monitor makes it easy to keep
track of your blood pressure. It's a good idea to bring your home monitor to the doctor's office to check its accuracy.
Besides taking your blood
pressure, your doctor will do a
physical exam and medical history. Your doctor may also have
you get other tests to find out whether high blood pressure has damaged any
organs or caused other problems. These tests may include:
Your doctor may also check
your risk of
a heart attack and stroke.
If your doctor recommends a test, ask what it is for and why you need it. You can help decide if a test is right for you. Talk with your doctor to make that decision. For more information, see Heart Tests: When Do You Need Them?
high blood pressure can lead to heart attacks or
strokes. The higher your blood pressure, the greater
your risk. Lowering blood pressure lowers the risk of
damaging blood vessels and getting atherosclerosis.
High blood pressure
usually can't be cured. But it can be
controlled. The two types of treatment for high blood pressure
Your doctor will give you a blood pressure goal. An example of a goal is to keep blood pressure below 140/90. Your goal may be lower or higher based on your health and age. Your blood pressure goal can help you prevent problems caused by high blood pressure.
For some people, lifestyle changes may be enough to lower their blood pressure. Whether this is an option for you depends on how high your blood pressure is and whether you have other health problems, such as diabetes or heart disease.
Your doctor may suggest that you make
one or more of the following changes:
For tips on how to do these things, see the Living With High Blood Pressure section of this topic.
One Woman's Story:
"I could never have imagined I could get
(my blood pressure) down so low by losing weight. I feel sure it was the WAY I
lost weight, with DASH."-Izzy
Read more about Izzy and how she uses the DASH eating plan.
If lifestyle changes don't lower your blood pressure to your goal, you may need to take daily medicines as
Medicines control-but usually don't
cure-high blood pressure. So you will probably need to take them
for the rest of your life. Most people need to take two or more medicines.
Some people find it hard to take their
medicines properly. They may feel it's too much trouble-especially when they don't feel sick. Or they're worried about side effects. Some people find it hard to keep track of when and how to take their medicines.
If you have trouble taking high blood
pressure medicines for any reason, talk to your doctor.
One Man's Story:
learned that it doesn't matter how healthy you feel-if you have high blood
pressure, you're sick and you'd better do something about it."-Tyrell
Read more about Tyrell and why he started taking his medicines properly.
A heart-healthy lifestyle can help you prevent
high blood pressure. These changes are especially
important for people who have risk factors for high blood pressure that cannot
be changed, including
family history, race, or age.
Here are some things you can do:
For help with all of these, see the Living With High Blood Pressure section of this topic.
Heart-healthy lifestyle changes are important to help control
high blood pressure. These changes can help lower your risk for
coronary artery disease, heart attack, and
A heart-healthy lifestyle is always important, even if you take medicines too.
Some people can even take less
medicine after making these changes.
lifestyle changes to help lower your blood pressure and lower your risk for heart attack and stroke:
Making any kind of change in the way you live your
daily life is like being on a path. The path leads to success. Here are the
first steps on that path:
For help making lifestyle changes, see the topic Change a Habit by Setting Goals.
lesson I learned is that everything we do routinely is a habit. And habits can
be changed. I'm living proof."-Izzy
Read more about Izzy and how she changed her eating habits.
soon as I mentioned [to my wife] that I needed help, she got out a pen and some
paper and started writing out a walking schedule."-Arturo
Read more about Arturo and how he got support for his lifestyle changes.
Deciding whether to treat
high blood pressure with medicine and choosing the
best medicine may depend on:
Doctors usually prescribe a single, low-dose medicine
first. If blood pressure is not controlled, your doctor may change the dosage
or try a different medicine or combination of medicines. It is common to try
several medicines before blood pressure is successfully controlled. Many
people need more than one medicine to get the best results.
Medicine choices include:
All of these medicines are effective for lowering the
heart attack and
Work with your doctor to find the right medicine or
combination of medicines that have the fewest side effects and work well for
you. And be sure to take your medicines regularly as prescribed.
You may have regular blood tests to monitor how the medicine is working in your body. Your doctor will likely let you know when you need to have the tests.
few months I was really good about taking (my pills) every day. But they made
me a little tired, and I got tired of being tired."-Tyrell
Read more about Tyrell and why he returned to taking his medicine every day.
Complementary medicine is treatment that you use in addition to your doctor's standard care. Tell your doctor if you are using, or if you plan to use, complementary medicine to help lower your blood pressure. These treatments do not replace lifestyle changes or medicine for high blood pressure. You and your doctor can decide which therapy might be best for you.
Complementary treatments that help manage stress and improve quality of life may help lower blood pressure. These treatments include:
Most mind and body practices-such as acupuncture, meditation, and yoga-are safe when used under the care of a well-trained professional. Choose an instructor or practitioner as carefully as you would choose a doctor.
There are some dietary supplements that you may hear about to lower the risk of heart disease, heart attack, and stroke. It is not clear if some vitamins, minerals, and multivitamins can lower risk. But it is clear that some supplements, such as vitamin E and beta-carotene, do not lower risk.footnote 3
Talk with your doctor about the best ways to lower your risk of heart disease, heart attack, and stroke. Tell your doctor if you plan to use dietary supplements or vitamins. Your doctor can make sure they are safe for you.
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ByHealthwise StaffPrimary Medical ReviewerAdam Husney, MD - Family MedicineKathleen Romito, MD - Family MedicineE. Gregory Thompson, MD - Internal MedicineSpecialist Medical ReviewerMartin J. Gabica, MD - Family Medicine
Current as ofMarch 10, 2017
Current as of:
March 10, 2017
Adam Husney, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & E. Gregory Thompson, MD - Internal Medicine & Martin J. Gabica, MD - Family Medicine
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Last modified on: 8 September 2017