Overview
It is estimated that close to 30% of the United States population has high blood pressure (hypertension), or about 90 million people. Blood pressure is measured as the force the pumping blood exerts on the walls of the arteries in the body.
When this pressure is higher than normal (120/80 mmHg), patients are at risk for heart attack, stroke, congestive heart failure, kidney failure, and aneurysms in the arteries and brain. Even moderate high blood pressure can lead to a shortened life expectancy. Most high blood pressure is asymptomatic, and is discovered during a routine checkup.
As blood pressure reaches dangerously high levels, some people may experience symptoms such as headache, ringing in the ears, visual changes, and irregular heartbeat. These symptoms are a medical emergency. At particularly high risk for high blood pressure are African Americans, people who are obese, smokers, diabetics, having high salt intake, and having a family history. Alcohol abuse and cocaine use can also cause hypertension.
Symptoms
High blood pressure (HBP) itself is asymptomatic, meaning it usually has no signs or symptoms. Rarely, headaches may occur.
You can have HBP for years without knowing it. During this time, the condition can damage your heart, blood vessels, kidneys, and other parts of your body.
Some people only learn that they have HBP after the damage has caused problems, such as coronary heart disease, stroke, or kidney failure.
Knowing your blood pressure numbers is important, even when you're feeling fine. If your blood pressure is normal, you can work with your health care team to keep it that way. If your blood pressure is too high, you can take steps to lower it. Lowering your blood pressure will help reduce your risk for related health problems.
Diagnosis
High blood pressure (HBP) is diagnosed using a blood pressure test. This test will be done several times to make sure the results are correct. If your numbers are high, your doctor may have you return for repeat tests to check your blood pressure over time.
If your blood pressure is 140/90 mmHg or higher over time, your doctor will likely diagnose you with HBP. If you have diabetes or chronic kidney disease, a blood pressure of 130/80 mmHg or higher is considered HBP.
The ranges for HBP in children are different, as discussed below.
A blood pressure test is easy and painless. This test is done at a doctor's office or clinic.
To prepare for the test:
- Don't drink coffee or smoke cigarettes for 30 minutes prior to the test. These actions may cause a short-term rise in your blood pressure.
- Go to the bathroom before the test. Having a full bladder can change your blood pressure reading.
- Sit for 5 minutes before the test. Movement can cause short-term rises in blood pressure.
To measure your blood pressure, your doctor or nurse will use some type of a gauge, a stethoscope (or electronic sensor), and a blood pressure cuff.
Most often, you will sit or lie down with the cuff around your arm as your doctor or nurse checks your blood pressure. If he or she doesn't tell you what your blood pressure numbers are, you should ask.
Diagnosing High Blood Pressure in Children and Teens
Doctors measure blood pressure in children and teens the same way they do in adults. Your child should have routine blood pressure checks starting at 3 years of age.
Blood pressure normally rises with age and body size. Newborn babies often have very low blood pressure numbers, while older teens have numbers similar to adults.
The ranges for normal blood pressure and HBP generally are lower for youth than for adults. To find out whether a child has HBP, a doctor will compare the child's blood pressure numbers to average numbers for his or her age, gender, and height.
For more information, go to the National Heart, Lung, and Blood Institute's "A Pocket Guide to Blood Pressure Measurement in Children."
What Does a Diagnosis of High Blood Pressure Mean?
If you're diagnosed with HBP, your doctor will prescribe treatment. You'll need to have your blood pressure tested again to see how the treatment affects it.
Once your blood pressure is under control, you'll still need treatment. "Under control" means that your blood pressure numbers are in the normal range. You also will need regular blood pressure tests. Your doctor can tell you how often you should be tested.
The sooner you find out about HBP and treat it, the better. Early treatment may help you avoid problems such as heart attack, stroke, and kidney failure.
Treatments
High blood pressure (HBP) is treated with lifestyle changes and medicines.
Most people who have HBP will need lifelong treatment. Sticking to your treatment plan is important. It can help prevent or delay problems related to HBP and help you live and stay active longer.
Goals of Treatment
The treatment goal for most adults is to get and keep blood pressure below 140/90 mmHg. For adults who have diabetes or chronic kidney disease, the goal is to get and keep blood pressure below 130/80 mmHg.
Lifestyle Changes
Healthy lifestyle habits can help you control HBP. These habits include:
- Following a healthy diet
- Being physically active
- Maintaining a healthy weight
- Quitting smoking
- Managing your stress and learning to cope with stress
If you combine healthy lifestyle habits, you can achieve even better results than taking single steps. Making lifestyle changes can be hard. Start by making one healthy lifestyle change and then adopt others.
Some people can control their blood pressure with lifestyle changes alone, but many people can't. Keep in mind that the main goal is blood pressure control.
If your doctor prescribes medicines as a part of your treatment plan, keep up your healthy lifestyle habits. They will help you better control your blood pressure.
Following a Healthy Diet
Your doctor may recommend the DASH (Dietary Approaches to Stop Hypertension) eating plan if you have HBP. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and low in fat, cholesterol, and sodium (salt).
DASH also focuses on fat-free or low-fat milk and dairy products, fish, poultry, and nuts. The DASH eating plan is reduced in red meats (including lean red meats), sweets, added sugars, and sugar-containing beverages. It's rich in nutrients, protein, and fiber.
To help control HBP, you should limit the amount of salt that you eat. This means choosing low-sodium and "no added salt" foods and seasonings at the table or when cooking. The Nutrition Facts label on food packaging shows the amount of sodium in an item. You should eat no more than about 1 teaspoon of salt a day.
You also should try to limit alcoholic drinks. Too much alcohol will raise your blood pressure. Men should have no more than two alcoholic drinks a day. Women should have no more than one alcoholic drink a day. One drink is a glass of wine, beer, or a small amount of hard liquor.
Being Physically Active
Routine physical activity can lower HBP and reduce your risk for other health problems. Talk with your doctor before you start a new exercise plan. Ask him or her how much and what kinds of physical activity are safe for you.
People gain health benefits from as little as 60 minutes of moderate-intensity aerobic activity per week. The more active you are, the more you will benefit.
For more information about physical activity, go to the U.S. Department of Health and Human Services' "2008 Physical Activity Guidelines for Americans," the Health Topics Physical Activity and Your Heart article, and the NHLBI's "Your Guide to Physical Activity and Your Heart."
Maintaining a Healthy Weight
Maintaining a healthy weight can help you control HBP and reduce your risk for other health problems.
If you're overweight or obese, aim to reduce your weight by 5 to 10 percent during your first year of treatment. This amount of weight loss can lower your risk for health problems related to HBP.
To lose weight, cut back your calorie intake and do more physical activity. Eat smaller portions and choose lower calorie foods. Don't feel that you have to finish the entrees served at restaurants. Many restaurant portions are oversized and have too many calories for the average person.
After your first year of treatment, you may have to continue to lose weight so you can lower your body mass index (BMI) to less than 25. BMI measures your weight in relation to your height and gives an estimate of your total body fat.
A BMI between 25 and 29.9 is considered overweight. A BMI of 30 or more is considered obese. A BMI of less than 25 is the goal for controlling blood pressure.
You can use the NHLBI's online BMI calculator to figure out your BMI, or your doctor can help you.
Quit Smoking
If you smoke or use tobacco, quit. Smoking can damage your blood vessels and raise your risk for HBP. Smoking also can worsen health problems related to HBP.
Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke.
If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking.
For more information about how to quit smoking, go to the Health Topics Smoking and Your Heart article and the NHLBI's "Your Guide to a Healthy Heart."
Managing Stress
Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health.
Physical activity helps some people cope with stress. Other people listen to music or focus on something calm or peaceful to reduce stress. Some people learn yoga, tai chi, or how to meditate.
Medicines
Today's blood pressure medicines can safely help most people control their blood pressure. These medicines are easy to take. The side effects, if any, tend to be minor.
If you have side effects from your medicines, talk with your doctor. He or she might adjust the doses or prescribe other medicines. You shouldn't decide on your own to stop taking your medicines.
Blood pressure medicines work in different ways to lower blood pressure. Some remove extra fluid and salt from the body to lower blood pressure. Others slow down the heartbeat or relax and widen blood vessels. Often, two or more medicines work better than one.
There are hundreds of different medications to treat hypertension, such as beta-blockers (Lopressor, Inderal), diuretics (Diamox, HydroDiuril), Calcium channel blockers (Norvasc, Procardia), and ACE inhibitors (Lotensin, Vasotec, Capoten).
Treatment for Children and Teens
If another condition is causing your child's HBP, treating it often resolves the HBP. When the cause of a child or teen's HBP isn't known, the first line of treatment is lifestyle changes (as it is for adults).
If lifestyle changes don't control blood pressure, children and teens also may need to take medicines. Most of the medicines listed above for adults have special doses for children.
Causes
Blood pressure tends to rise with age, unless you take steps to prevent or control it.
Some medical problems, such as chronic kidney disease, thyroid disease, and sleep apnea, may cause blood pressure to rise. Some medicines also may raise your blood pressure. Examples include asthma medicines (for example, corticosteroids) and cold-relief products.
In some women, blood pressure can rise if they use birth control pills, become pregnant, or take hormone therapy.
Women taking birth control pills usually have a small rise in both systolic and diastolic blood pressures. If you already have high blood pressure (HBP) and want to use birth control pills, make sure your doctor knows about your HBP. Talk with him or her about how often you should have your blood pressure checked and how to control it while taking the pill.
Taking hormones to reduce the symptoms of menopause can cause a small rise in systolic blood pressure. If you already have HBP and want to start using hormones, talk with your doctor about the risks and benefits. If you decide to take hormones, find out how to control your blood pressure and how often you should have it checked.
Children younger than 10 years old who have HBP often have another condition that's causing it (such as kidney disease). Treating the underlying condition may resolve the HBP.
The older a child is when HBP is diagnosed, the more likely he or she is to have essential hypertension. This means that doctors don't know what's causing the HBP.
Getting Help
It is always important to speak with your Doctor about HBP. Your Doctor will be able to discuss your treatment options and make recommendations on ways to deal with HBP.Your doctor may recommend you see a specialist in order to receive more in depth treatment.
For additional resources on HBP, contact the The National Heart Lung and Blood Institute.
Related Information
When blood pressure stays high over time, it can damage the body. HBP can cause:
- The heart to get larger or weaker, which may lead to heart failure. Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs.
- Aneurysms (AN-u-risms) to form in blood vessels. An aneurysm is an abnormal bulge in the wall of an artery. Common spots for aneurysms are the main artery that carries blood from the heart to the body; the arteries in the brain, legs, and intestines; and the artery leading to the spleen.
- Blood vessels in the kidney to narrow. This may cause kidney failure.
- Arteries throughout the body to narrow in some places, which limits blood flow (especially to the heart, brain, kidneys, and legs). This can cause a heart attack, stroke, kidney failure, or amputation of part of the leg.
- Blood vessels in the eyes to burst or bleed. This may lead to vision changes or blindness.
Living With
If you have high blood pressure (HBP), you'll need to treat and control it for life. This means making lifestyle changes, taking prescribed medicines, and getting ongoing medical care.
Treatment can help control blood pressure, but it will not cure HBP. If you stop treatment, your blood pressure and risk for related health problems will rise.
For a healthy future, follow your treatment plan closely. Work with your health care team for lifelong blood pressure control.
Lifestyle Changes
Making healthy lifestyle changes can help control HBP. A healthy lifestyle includes following a healthy eating plan, being physically active, maintaining a healthy weight, and not smoking. (For more information, go to "How Is High Blood Pressure Treated?")
Medicines
You should take all blood pressure medicines that your doctor prescribes. Know the names and doses of your medicines and how to take them. If you have questions about your medicines, talk with your doctor or pharmacist.
Make sure you refill your medicines before they run out. Take your medicines exactly as your doctor directs—don't skip days or cut pills in half.
If you're having side effects from your medicines, talk with your doctor. He or she may need to adjust the doses or prescribe other medicines. You shouldn't decide on your own to stop taking your medicines.
Ongoing Care
If you have HBP, have medical checkups or tests as your doctor advises. Your doctor may need to change or add medicines to your treatment plan over time. Routine checkups allow your doctor to change your treatment right away if your blood pressure goes up again.
Keeping track of your blood pressure is important. Have your blood pressure checked on the schedule your doctor advises.
You may want to learn how to check your blood pressure at home. Your doctor can help you learn how to do this. Each time you check your own blood pressure, you should write down your numbers and the date.
During checkups, you can ask your doctor or health care team any questions you have about your treatments.
High Blood Pressure and Pregnancy
Many pregnant women who have HBP have healthy babies. However, HBP can cause problems for both the mother and the fetus. HBP can harm the mother's kidneys and other organs. It also can cause the baby to be born early and with a low birth weight.
If you're thinking about having a baby and you have HBP, talk with your health care team. You can take steps to control your blood pressure before and while you're pregnant.
Some women get HBP for the first time while they're pregnant. In the most serious cases, the mother has a condition called preeclampsia (pre-eh-KLAMP-se-ah).
This condition can threaten the lives of both the mother and the unborn child. You'll need special care to reduce your risk. With such care, most women and babies have good outcomes.
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