What are the symptoms of high blood pressure. How is hypertension diagnosed. What are the risk factors for developing hypertension. How can high blood pressure be prevented. What treatments are available for managing hypertension. When should you seek medical attention for high blood pressure. How often should blood pressure be checked.

What is High Blood Pressure (Hypertension)?

High blood pressure, medically known as hypertension, is a common cardiovascular condition affecting millions worldwide. It occurs when the force of blood pushing against the walls of arteries is consistently too high. This increased pressure forces the heart to work harder to pump blood throughout the body, potentially leading to serious health complications if left untreated.

Blood pressure is measured using two numbers:

• Systolic pressure (top number): The pressure in arteries when the heart beats
• Diastolic pressure (bottom number): The pressure in arteries between heartbeats

These measurements are expressed in millimeters of mercury (mm Hg). According to current guidelines, hypertension is generally defined as a blood pressure reading of 130/80 mm Hg or higher.

Understanding Blood Pressure Categories

The American College of Cardiology and the American Heart Association have established four main categories of blood pressure:

1. Normal blood pressure: Below 120/80 mm Hg
2. Elevated blood pressure: 120-129 mm Hg systolic and below 80 mm Hg diastolic
3. Stage 1 hypertension: 130-139 mm Hg systolic or 80-89 mm Hg diastolic
4. Stage 2 hypertension: 140 mm Hg or higher systolic, or 90 mm Hg or higher diastolic

A blood pressure reading above 180/120 mm Hg is considered a hypertensive crisis, requiring immediate medical attention.

Recognizing the Silent Nature of Hypertension

One of the most dangerous aspects of high blood pressure is its often asymptomatic nature. Many individuals with hypertension experience no noticeable symptoms, even when their blood pressure reaches dangerously high levels. This characteristic has earned hypertension the nickname “the silent killer.”

While most people with high blood pressure remain symptom-free, a small percentage may experience:

• Headaches
• Shortness of breath
• Nosebleeds

However, these symptoms typically only manifest when blood pressure has reached a severe or life-threatening stage. The absence of clear warning signs underscores the importance of regular blood pressure checks, even for those who feel healthy.

Risk Factors and Causes of Hypertension

Several factors can contribute to the development of high blood pressure:

Modifiable Risk Factors

• Unhealthy diet (high in sodium, low in potassium)
• Physical inactivity
• Obesity or overweight
• Excessive alcohol consumption
• Tobacco use
• Chronic stress

Non-Modifiable Risk Factors

• Age (risk increases with age)
• Family history of hypertension
• Race (African Americans are at higher risk)
• Chronic kidney disease
• Sleep apnea

Understanding these risk factors can help individuals take proactive steps to manage their blood pressure and overall health.

The Importance of Regular Blood Pressure Screening

Given the asymptomatic nature of hypertension, regular blood pressure screenings are crucial for early detection and management. How often should you have your blood pressure checked?

• Adults 18 years and older: At least every two years
• Adults 40 years and older or those at high risk: Annually
• Children 3 years and older: As part of routine check-ups

Individuals with existing hypertension or other cardiovascular risk factors may require more frequent monitoring. Many pharmacies, health fairs, and community centers offer free blood pressure screenings, making it convenient to keep track of your numbers.

Preventing and Managing High Blood Pressure

Adopting a heart-healthy lifestyle is key to preventing and managing hypertension. Here are some effective strategies:

Dietary Modifications

• Reduce sodium intake (aim for less than 2,300 mg per day)
• Increase potassium-rich foods (bananas, leafy greens, sweet potatoes)
• Follow the DASH (Dietary Approaches to Stop Hypertension) diet
• Limit alcohol consumption

Physical Activity

Engage in regular physical activity, aiming for at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week. Activities can include brisk walking, swimming, cycling, or dancing.

Stress Management

Practice stress-reduction techniques such as meditation, deep breathing exercises, yoga, or mindfulness to help lower blood pressure and improve overall well-being.

Maintain a Healthy Weight

Losing excess weight can significantly impact blood pressure. Even a small reduction in body weight can lead to noticeable improvements in blood pressure readings.

Quit Smoking

Smoking cessation not only benefits blood pressure but also reduces the risk of various other health complications.

Treatment Options for Hypertension

When lifestyle modifications alone are insufficient to control blood pressure, medication may be necessary. Common classes of antihypertensive drugs include:

• Diuretics
• ACE inhibitors
• Angiotensin II receptor blockers (ARBs)
• Calcium channel blockers
• Beta-blockers

The choice of medication depends on various factors, including the severity of hypertension, other medical conditions, and potential side effects. It’s crucial to work closely with a healthcare provider to find the most effective treatment plan.

Complications of Untreated Hypertension

Left uncontrolled, high blood pressure can lead to severe health complications, including:

• Heart attack and heart failure
• Stroke
• Aneurysm
• Kidney damage
• Vision problems
• Cognitive decline and dementia

These potential consequences highlight the importance of early detection and proper management of hypertension.

Special Considerations in Hypertension Management

Pregnancy and Hypertension

Pregnant women require special attention when it comes to blood pressure management. Hypertension during pregnancy can lead to complications such as preeclampsia, which can be dangerous for both mother and baby. Regular prenatal check-ups and close monitoring of blood pressure are essential.

Hypertension in Older Adults

As people age, the risk of developing high blood pressure increases. However, treatment goals may differ for older adults, balancing the benefits of blood pressure control with the potential risks of medication side effects. Individualized care plans are crucial for this population.

Resistant Hypertension

Some individuals may have resistant hypertension, where blood pressure remains high despite taking multiple medications. In such cases, additional testing may be necessary to rule out underlying causes, and more aggressive treatment strategies may be employed.

Emerging Research and Future Directions

The field of hypertension research is continuously evolving, with promising developments on the horizon:

• New drug therapies targeting novel pathways in blood pressure regulation
• Advanced wearable technologies for continuous blood pressure monitoring
• Personalized medicine approaches based on genetic profiles
• Investigation into the role of gut microbiome in hypertension

These advancements may lead to more effective and tailored treatments for individuals with hypertension in the future.

The Role of Technology in Hypertension Management

Digital health tools are increasingly playing a role in hypertension management:

• Smartphone apps for tracking blood pressure readings and medication adherence
• Telemedicine platforms for remote consultations with healthcare providers
• Smart home blood pressure monitors that sync data with electronic health records
• Artificial intelligence algorithms for predicting hypertension risk and complications

These technological advancements are making it easier for individuals to take an active role in managing their blood pressure and overall cardiovascular health.

Global Impact of Hypertension

Hypertension is a global health challenge, affecting populations across all income levels and geographic regions. According to the World Health Organization:

• An estimated 1.28 billion adults aged 30-79 years worldwide have hypertension
• Two-thirds of those with hypertension live in low- and middle-income countries
• Less than half of adults with hypertension are diagnosed and treated

Addressing this global burden requires coordinated efforts in public health education, improved access to healthcare, and policy interventions to promote healthier lifestyles.

The Importance of Patient Education and Empowerment

Effective management of hypertension relies heavily on patient engagement and education. Healthcare providers play a crucial role in:

• Educating patients about the risks and consequences of high blood pressure
• Teaching proper techniques for home blood pressure monitoring
• Providing guidance on lifestyle modifications
• Addressing concerns about medication side effects and adherence

Empowering patients with knowledge and tools to manage their condition can lead to better outcomes and improved quality of life.

Hypertension in Special Populations

Children and Adolescents

While hypertension is often associated with adults, it can also affect children and adolescents. Risk factors in this population include obesity, family history, and certain medical conditions. Regular blood pressure screening should be part of pediatric check-ups, especially for children with risk factors.

Athletes and Hypertension

High-performance athletes may face unique challenges in managing hypertension. While regular exercise is generally beneficial for blood pressure control, intense training can sometimes lead to transient increases in blood pressure. Proper monitoring and management are essential to ensure both athletic performance and cardiovascular health.

Hypertension in Ethnic Minorities

Certain ethnic groups, particularly African Americans, have a higher prevalence of hypertension and may be more susceptible to its complications. Targeted interventions and culturally sensitive healthcare approaches are crucial in addressing these disparities.

The Economic Burden of Hypertension

The impact of hypertension extends beyond individual health, posing a significant economic burden on healthcare systems worldwide:

• Direct medical costs for hypertension treatment and management
• Indirect costs due to lost productivity and premature mortality
• Strain on healthcare resources, particularly in managing complications

Investing in prevention and early management of hypertension can lead to substantial cost savings in the long term.

Integrative Approaches to Hypertension Management

While conventional medical treatments remain the cornerstone of hypertension management, integrative approaches are gaining attention:

• Mind-body techniques such as meditation and biofeedback
• Acupuncture and traditional Chinese medicine
• Herbal supplements (under medical supervision)
• Dietary approaches like the Mediterranean diet

It’s important to note that these complementary approaches should be discussed with a healthcare provider and used in conjunction with, not as a replacement for, conventional treatments.

The Future of Hypertension Care

As our understanding of hypertension continues to evolve, several promising areas of research and development are emerging:

• Gene therapy approaches targeting hypertension-related genes
• Development of novel drug delivery systems for improved medication adherence
• Artificial intelligence-driven predictive models for hypertension risk assessment
• Precision medicine strategies tailored to individual genetic and environmental factors

These advancements hold the potential to revolutionize hypertension prevention, diagnosis, and treatment in the coming years.

In conclusion, high blood pressure remains a significant global health challenge, but with proper awareness, prevention strategies, and management techniques, its impact can be substantially reduced. Regular monitoring, lifestyle modifications, and appropriate medical interventions are key to maintaining healthy blood pressure levels and preventing associated complications. As research continues to advance our understanding of hypertension, we can look forward to more effective and personalized approaches to combat this silent but formidable health threat.

High blood pressure (hypertension) – Symptoms & causes

Overview

What is hypertension? A Mayo Clinic expert explains.

Learn more about hypertension from nephrologist Leslie Thomas, M.D.

High blood pressure is a common condition that affects the body’s arteries. It’s also called hypertension. If you have high blood pressure, the force of the blood pushing against the artery walls is consistently too high. The heart has to work harder to pump blood.

Blood pressure is measured in millimeters of mercury (mm Hg). In general, hypertension is a blood pressure reading of 130/80 mm Hg or higher.

The American College of Cardiology and the American Heart Association divide blood pressure into four general categories. Ideal blood pressure is categorized as normal.)

• Normal blood pressure. Blood pressure is 120/80 mm Hg or lower.
• Elevated blood pressure. The top number ranges from 120 to 129 mm Hg and the bottom number is below, not above, 80 mm Hg.
• Stage 1 hypertension. The top number ranges from 130 to 139 mm Hg or the bottom number is between 80 and 89 mm Hg.
• Stage 2 hypertension. The top number is 140 mm Hg or higher or the bottom number is 90 mm Hg or higher.

Blood pressure higher than 180/120 mm Hg is considered a hypertensive emergency or crisis. Seek emergency medical help for anyone with these blood pressure numbers.

Untreated, high blood pressure increases the risk of heart attack, stroke and other serious health problems. It’s important to have your blood pressure checked at least every two years starting at age 18. Some people need more-frequent checks.

Healthy lifestyle habits —such as not smoking, exercising and eating well — can help prevent and treat high blood pressure. Some people need medicine to treat high blood pressure.

High blood pressure is a common condition that affects the body’s arteries. It’s also called hypertension. If you have high blood pressure, the force of the blood pushing against the artery walls is consistently too high. The heart has to work harder to pump blood.

Blood pressure is measured in millimeters of mercury (mm Hg). In general, hypertension is a blood pressure reading of 130/80 millimeters of mercury (mm Hg) or higher.

The American College of Cardiology and the American Heart Association divide blood pressure into four general categories. Ideal blood pressure is categorized as normal.)

• Normal blood pressure. Blood pressure is 120/80 mm Hg or lower.
• Elevated blood pressure. The top number ranges from 120 to 129 mm Hg and the bottom number is below, not above, 80 mm Hg.
• Stage 1 hypertension. The top number ranges from 130 to 139 mm Hg or the bottom number is between 80 and 89 mm Hg.
• Stage 2 hypertension. The top number is 140 mm Hg or higher or the bottom number is 90 mm Hg or higher.

Blood pressure higher than 180/120 mm Hg is considered a hypertensive emergency or crisis. Seek emergency medical help for anyone with these blood pressure numbers.

Untreated, high blood pressure increases the risk of heart attack, stroke and other serious health problems. It’s important to have your blood pressure checked at least every two years starting at age 18. Some people need more-frequent checks.

Healthy lifestyle habits —such as not smoking, exercising and eating well — can help prevent and treat high blood pressure. Some people need medicine to treat high blood pressure.

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Symptoms

Most people with high blood pressure have no symptoms, even if blood pressure readings reach dangerously high levels. You can have high blood pressure for years without any symptoms.

A few people with high blood pressure may have:

• Headaches
• Shortness of breath
• Nosebleeds

However, these symptoms aren’t specific. They usually don’t occur until high blood pressure has reached a severe or life-threatening stage.

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When to see a doctor

Blood pressure screening is an important part of general health care. How often you should get your blood pressure checked depends on your age and overall health.

Ask your provider for a blood pressure reading at least every two years starting at age 18. If you’re age 40 or older, or you’re 18 to 39 with a high risk of high blood pressure, ask for a blood pressure check every year.

Your care provider will likely recommend more-frequent readings if have high blood pressure or other risk factors for heart disease.

Children age 3 and older may have blood pressure measured as a part of their yearly checkups.

If you don’t regularly see a care provider, you may be able to get a free blood pressure screening at a health resource fair or other locations in your community. Free blood pressure machines are also available in some stores and pharmacies. The accuracy of these machines depends on several things, such as a correct cuff size and proper use of the machines. Ask your health care provider for advice on using public blood pressure machines.

Causes

Blood pressure is determined by two things: the amount of blood the heart pumps and how hard it is for the blood to move through the arteries. The more blood the heart pumps and the narrower the arteries, the higher the blood pressure.

There are two main types of high blood pressure.

Primary hypertension, also called essential hypertension

For most adults, there’s no identifiable cause of high blood pressure. This type of high blood pressure is called primary hypertension or essential hypertension. It tends to develop gradually over many years. Plaque buildup in the arteries, called atherosclerosis, increases the risk of high blood pressure.

Secondary hypertension

This type of high blood pressure is caused by an underlying condition. It tends to appear suddenly and cause higher blood pressure than does primary hypertension. Conditions and medicines that can lead to secondary hypertension include:

• Adrenal gland tumors
• Blood vessel problems present at birth, also called congenital heart defects
• Cough and cold medicines, some pain relievers, birth control pills, and other prescription drugs
• Illegal drugs, such as cocaine and amphetamines
• Kidney disease
• Obstructive sleep apnea
• Thyroid problems

Sometimes just getting a health checkup causes blood pressure to increase. This is called white coat hypertension.

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Risk factors

High blood pressure has many risk factors, including:

• Age. The risk of high blood pressure increases with age. Until about age 64, high blood pressure is more common in men. Women are more likely to develop high blood pressure after age 65.
• Race. High blood pressure is particularly common among Black people. It develops at an earlier age in Black people than it does in white people.
• Family history. You’re more likely to develop high blood pressure if you have a parent or sibling with the condition.
• Obesity or being overweight. Excess weight causes changes in the blood vessels, the kidneys and other parts of the body. These changes often increase blood pressure. Being overweight or having obesity also raises the risk of heart disease and its risk factors, such as high cholesterol.
• Lack of exercise. Not exercising can cause weight gain. Increased weight raises the risk of high blood pressure. People who are inactive also tend to have higher heart rates.
• Tobacco use or vaping. Smoking, chewing tobacco or vaping immediately raises blood pressure for a short while. Tobacco smoking injures blood vessel walls and speeds up the process of hardening of the arteries. If you smoke, ask your care provider for strategies to help you quit.
• Too much salt. A lot of salt — also called sodium — in the body can cause the body to retain fluid. This increases blood pressure.
• Low potassium levels. Potassium helps balance the amount of salt in the body’s cells. A proper balance of potassium is important for good heart health. Low potassium levels may be due to a lack of potassium in the diet or certain health conditions, including dehydration.
• Drinking too much alcohol. Alcohol use has been linked with increased blood pressure, particularly in men.
• Stress. High levels of stress can lead to a temporary increase in blood pressure. Stress-related habits such as eating more, using tobacco or drinking alcohol can lead to further increases in blood pressure.
• Certain chronic conditions. Kidney disease, diabetes and sleep apnea are some of the conditions that can lead to high blood pressure.
• Pregnancy. Sometimes pregnancy causes high blood pressure.

High blood pressure is most common in adults. But kids can have high blood pressure too. High blood pressure in children may be caused by problems with the kidneys or heart. But for a growing number of kids, high blood pressure is due to lifestyle habits such as an unhealthy diet and lack of exercise.

Complications

The excessive pressure on the artery walls caused by high blood pressure can damage blood vessels and body organs. The higher the blood pressure and the longer it goes uncontrolled, the greater the damage.

Uncontrolled high blood pressure can lead to complications including:

• Heart attack or stroke. Hardening and thickening of the arteries due to high blood pressure or other factors can lead to a heart attack, stroke or other complications.
• Aneurysm. Increased blood pressure can cause a blood vessel to weaken and bulge, forming an aneurysm. If an aneurysm ruptures, it can be life-threatening.
• Heart failure. When you have high blood pressure, the heart has to work harder to pump blood. The strain causes the walls of the heart’s pumping chamber to thicken. This condition is called left ventricular hypertrophy. Eventually, the heart can’t pump enough blood to meet the body’s needs, causing heart failure.
• Kidney problems. High blood pressure can cause the blood vessels in the kidneys to become narrow or weak. This can lead to kidney damage.
• Eye problems. Increased blood pressure can cause thickened, narrowed or torn blood vessels in the eyes. This can result in vision loss.
• Metabolic syndrome. This syndrome is a group of disorders of the body’s metabolism. It involves the irregular breakdown of sugar, also called glucose. The syndrome includes increased waist size, high triglycerides, decreased high-density lipoprotein (HDL or “good”) cholesterol, high blood pressure and high blood sugar levels. These conditions make you more likely to develop diabetes, heart disease and stroke.
• Changes with memory or understanding. Uncontrolled high blood pressure may affect the ability to think, remember and learn.
• Dementia. Narrowed or blocked arteries can limit blood flow to the brain. This can cause a certain type of dementia called vascular dementia. A stroke that interrupts blood flow to the brain also can cause vascular dementia.

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High blood pressure (hypertension) – Diagnosis & treatment

Diagnosis

Hypertension FAQs

Leslie Thomas, M. D., a nephrologist at Mayo Clinic, answers the important questions you may have about hypertension (high blood pressure).

Hi. I’m Dr. Leslie Thomas, a nephrologist at Mayo Clinic. And I’m here to answer some of the important questions you might have about hypertension.

What is the best way to measure my blood pressure at home?

Measuring your blood pressure at home is a straightforward process. Many people have a slightly higher blood pressure in one arm versus the other. So it’s important to measure the blood pressures in the arm with the higher readings. It’s best to avoid caffeine, exercise and, if you smoke, smoking for at least 30 minutes. To prepare for the measurement, you should be relaxed with your feet on the floor and legs uncrossed, and your back supported for at least five minutes. Your arms should be supported on a flat surface. After resting for five minutes, at least two readings are taken one minute apart in the morning prior to medications and in the evening before the evening meal. Your blood pressure monitor should be checked for proper calibration every year.

What could be causing my blood pressure to be quite erratic?

This pattern of abrupt changes in blood pressure from normal to quite high is sometimes referred to as labile blood pressure. For those who develop labile blood pressure, heart problems, hormonal problems, neurological problems, or even psychological conditions might be present. Finding and treating the underlying cause of labile blood pressure can significantly improve the condition.

Should I restrict salt to reduce my blood pressure?

It’s important to note that some people with high blood pressure already consume a diet significantly restricted in sodium. And those people further restriction of dietary sodium would not necessarily be helpful or even recommended. In many people, dietary sodium intake is though relatively high. Therefore, an effective target to consider for those people is less than 1500 milligrams per day. Many though, will benefit from a target of less than a 1000 milligrams per day. Following dietary sodium restriction, it may take some time, even weeks, for the blood pressure to improve and stabilize at a lower range. So it is critically important to both be consistent with decreased sodium intake and patient when assessing for improvement.

How can I lower my blood pressure without medication?

This is a very common question. A lot of people want to avoid medication if they can, when trying to reduce their blood pressure. A few ways have been shown scientifically to reduce blood pressure. The first, and perhaps most important, is to stay physically active. Losing weight also can be important in a lot of different people. Limiting alcohol, reducing sodium intake, and increasing dietary potassium intake can all help.

What is the best medication to take for hypertension?

There’s not one best medication for the treatment of hypertension for everyone. Because an individual’s historical and present medical conditions must be considered. Additionally, every person has a unique physiology. Assessing how certain physiological forces may be present to contribute to the hypertension in an individual allows for a rational approach to medication choice. Antihypertensive medications are grouped by class. Each class of medication differs from the other classes by the way it lowers blood pressure. For instance, diuretics, no matter the type, act to reduce the body’s total content of salt and water. This leads to reduction in plasma volume within the blood vessels and consequently a lower blood pressure. Calcium channel blockers reduce the relative constriction of blood vessels. This reduced vasoconstriction also promotes a lower blood pressure. Other classes of antihypertensive medication act in their own ways. Considering your health conditions, physiology, and how each medication works, your doctor can advise the safest and most effective medication for you.

Are certain blood pressure medications harmful to my kidneys?

Following the correction of blood pressure or the institution of certain blood pressure medications, it’s pretty common to see changes in the markers for kidney function on blood tests. However, small changes in these markers, which reflects small changes in kidney filtration performance shouldn’t necessarily be interpreted as absolute evidence of kidney harm. Your doctor can interpret changes in laboratory tests following any change in medication.

How can I be the best partner to my medical team?

Keep an open dialogue with your medical team about your goals and personal preferences. Communication, trust and collaboration are key to long-term success managing your blood pressure. Never hesitate to ask your medical team any questions or concerns you have. Being informed makes all the difference. Thanks for your time and we wish you well.

To diagnose high blood pressure, your health care provider examines you and asks questions about your medical history and any symptoms. Your provider listens to your heart using a device called a stethoscope.

Your blood pressure is checked using a cuff, usually placed around your arm. It’s important that the cuff fits. If it’s too big or too small, blood pressure readings can vary. The cuff is inflated using a small hand pump or a machine.

Blood pressure measurement

A blood pressure reading measures the pressure in the arteries when the heart beats (top number, called systolic pressure) and between heartbeats (bottom number, called diastolic pressure). To measure blood pressure, an inflatable cuff is usually placed around the arm. A machine or small hand pump is used to inflate the cuff. In this image, a machine records the blood pressure reading. This is called an automated blood pressure measurement.

The first time your blood pressure is checked, it should be measured in both arms to see if there’s a difference. After that, the arm with the higher reading should be used.

Blood pressure is measured in millimeters of mercury (mm Hg). A blood pressure reading has two numbers.

• Top number, called systolic pressure. The first, or upper, number measures the pressure in the arteries when the heart beats.
• Bottom number, called diastolic pressure. The second, or lower, number measures the pressure in the arteries between heartbeats.

High blood pressure (hypertension) is diagnosed if the blood pressure reading is equal to or greater than 130/80 millimeters of mercury (mm Hg). A diagnosis of high blood pressure is usually based on the average of two or more readings taken on separate occasions.

Blood pressure is grouped according to how high it is. This is called staging. Staging helps guide treatment.

• Stage 1 hypertension. The top number is between 130 and 139 mm Hg or the bottom number is between 80 and 89 mm Hg.
• Stage 2 hypertension. The top number is 140 mm Hg or higher or the bottom number is 90 mm Hg or higher.

Sometimes the bottom blood pressure reading is normal (less than 80 mm Hg) but the top number is high. This is called isolated systolic hypertension. It’s a common type of high blood pressure in people older than 65.

Tests

If you are diagnosed with high blood pressure, your provider may recommend tests to check for a cause.

• Ambulatory monitoring. A longer blood pressure monitoring test may be done to check blood pressure at regular times over six or 24 hours. This is called ambulatory blood pressure monitoring. However, the devices used for the test aren’t available in all medical centers. Check with your insurer to see if ambulatory blood pressure monitoring is a covered service.
• Lab tests. Blood and urine tests are done to check for conditions that can cause or worsen high blood pressure. For example, tests are done to check your cholesterol and blood sugar levels. You may also have lab tests to check your kidney, liver and thyroid function.
• Electrocardiogram (ECG or EKG). This quick and painless test measures the heart’s electrical activity. It can tell how fast or how slow the heart is beating. During an electrocardiogram (ECG), sensors called electrodes are attached to the chest and sometimes to the arms or legs. Wires connect the sensors to a machine, which prints or displays results.
• Echocardiogram. This noninvasive exam uses sound waves to create detailed images of the beating heart. It shows how blood moves through the heart and heart valves.

Taking your blood pressure at home

Your health care provider may ask you to regularly check your blood pressure at home. Home monitoring is a good way to keep track of your blood pressure. It helps your care providers know if your medicine is working or if your condition is getting worse.

Home blood pressure monitors are available at local stores and pharmacies.

For the most reliable blood pressure measurement, the American Heart Association recommends using a monitor with a cuff that goes around your upper arm, when available.

Devices that measure your blood pressure at your wrist or finger aren’t recommended by the American Heart Association because they can provide less reliable results.

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Treatment

Changing your lifestyle can help control and manage high blood pressure. Your health care provider may recommend that you make lifestyle changes including:

• Eating a heart-healthy diet with less salt
• Getting regular physical activity
• Maintaining a healthy weight or losing weight
• Limiting alcohol
• Not smoking
• Getting 7 to 9 hours of sleep daily

Sometimes lifestyle changes aren’t enough to treat high blood pressure. If they don’t help, your provider may recommend medicine to lower your blood pressure.

Medications

The type of medicine used to treat hypertension depends on your overall health and how high your blood pressure is. Two or more blood pressure drugs often work better than one. It can take some time to find the medicine or combination of medicines that works best for you.

When taking blood pressure medicine, it’s important to know your goal blood pressure level. You should aim for a blood pressure treatment goal of less than 130/80 mm Hg if:

• You’re a healthy adult age 65 or older
• You’re a healthy adult younger than age 65 with a 10% or higher risk of developing cardiovascular disease in the next 10 years
• You have chronic kidney disease, diabetes or coronary artery disease

The ideal blood pressure goal can vary with age and health conditions, particularly if you’re older than age 65.

Medicines used to treat high blood pressure include:

• Water pills (diuretics). These drugs help remove sodium and water from the body. They are often the first medicines used to treat high blood pressure.

  There are different classes of diuretics, including thiazide, loop and potassium sparing. Which one your provider recommends depends on your blood pressure measurements and other health conditions, such as kidney disease or heart failure. Diuretics commonly used to treat blood pressure include chlorthalidone, hydrochlorothiazide (Microzide) and others.

  A common side effect of diuretics is increased urination. Urinating a lot can reduce potassium levels. A good balance of potassium is necessary to help the heart beat correctly. If you have low potassium (hypokalemia), your provider may recommend a potassium-sparing diuretic that contains triamterene.

• Angiotensin-converting enzyme (ACE) inhibitors. These drugs help relax blood vessels. They block the formation of a natural chemical that narrows blood vessels. Examples include lisinopril (Prinivil, Zestril), benazepril (Lotensin), captopril and others.
• Angiotensin II receptor blockers (ARBs). These drugs also relax blood vessels. They block the action, not the formation, of a natural chemical that narrows blood vessels. angiotensin II receptor blockers (ARBs) include candesartan (Atacand), losartan (Cozaar) and others.

• Calcium channel blockers. These drugs help relax the muscles of the blood vessels. Some slow your heart rate. They include amlodipine (Norvasc), diltiazem (Cardizem, Tiazac, others) and others. Calcium channel blockers may work better for older people and Black people than do angiotensin-converting enzyme (ACE) inhibitors alone.

  Don’t eat or drink grapefruit products when taking calcium channel blockers. Grapefruit increases blood levels of certain calcium channel blockers, which can be dangerous. Talk to your provider or pharmacist if you’re concerned about interactions.

Other medicines sometimes used to treat high blood pressure

If you’re having trouble reaching your blood pressure goal with combinations of the above medicines, your provider may prescribe:

• Alpha blockers. These medicines reduce nerve signals to blood vessels. They help lower the effects of natural chemicals that narrow blood vessels. Alpha blockers include doxazosin (Cardura), prazosin (Minipress) and others.
• Alpha-beta blockers. Alpha-beta blockers block nerve signals to blood vessels and slow the heartbeat. They reduce the amount of blood that must be pumped through the vessels. Alpha-beta blockers include carvedilol (Coreg) and labetalol (Trandate).

• Beta blockers. These medicines reduce the workload on the heart and widen the blood vessels. This helps the heart beat slower and with less force. Beta blockers include atenolol (Tenormin), metoprolol (Lopressor, Toprol-XL, Kapspargo sprinkle) and others.

  Beta blockers aren’t usually recommended as the only medicine prescribed. They may work best when combined with other blood pressure drugs.

• Aldosterone antagonists. These drugs may be used to treat resistant hypertension. They block the effect of a natural chemical that can lead to salt and fluid buildup in the body. Examples are spironolactone (Aldactone) and eplerenone (Inspra).

• Renin inhibitors. Aliskiren (Tekturna) slows the production of renin, an enzyme produced by the kidneys that starts a chain of chemical steps that increases blood pressure.

  Due to a risk of serious complications, including stroke, you shouldn’t take aliskiren with ACE inhibitors or ARBs.

• Vasodilators. These medicines stop the muscles in the artery walls from tightening. This prevents the arteries from narrowing. Examples include hydralazine and minoxidil.
• Central-acting agents. These medicines prevent the brain from telling the nervous system to increase the heart rate and narrow the blood vessels. Examples include clonidine (Catapres, Kapvay), guanfacine (Intuniv) and methyldopa.

Always take blood pressure medicines as prescribed. Never skip a dose or abruptly stop taking blood pressure medicines. Suddenly stopping certain ones, such as beta blockers, can cause a sharp increase in blood pressure called rebound hypertension.

If you skip doses because of cost, side effects or forgetfulness, talk to your care provider about solutions. Don’t change your treatment without your provider’s guidance.

Treating resistant hypertension

You may have resistant hypertension if:

• You take at least three different blood pressure drugs, including a diuretic. But your blood pressure remains stubbornly high.
• You’re taking four different medicines to control high blood pressure. Your care provider should check for a possible second cause of the high blood pressure.

Having resistant hypertension doesn’t mean your blood pressure will never get lower. If you and your provider can determine the cause, a more effective treatment plan can be created.

Treating resistant hypertension may involve many steps, including:

• Changing blood pressure medicines to find the best combination and dosage.
• Reviewing all your medicines, including those bought without a prescription.
• Checking blood pressure at home to see if medical appointments cause high blood pressure. This is called white coat hypertension.
• Eating healthy, managing weight and making other recommended lifestyle changes.

High blood pressure during pregnancy

If you have high blood pressure and are pregnant, discuss with your care providers how to control blood pressure during your pregnancy.

Potential future treatments

Researchers have been studying the use of heat to destroy specific nerves in the kidney that may play a role in resistant hypertension. The method is called renal denervation. Early studies showed some benefit. But more-robust studies found that it doesn’t significantly lower blood pressure in people with resistant hypertension. More research is underway to determine what role, if any, this therapy may have in treating hypertension.

More Information

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Self care

A commitment to a healthy lifestyle can help prevent and manage high blood pressure. Try these heart-healthy strategies:

• Eat healthy foods. Eat a healthy diet. Try the Dietary Approaches to Stop Hypertension (DASH) diet. Choose fruits, vegetables, whole grains, poultry, fish and low-fat dairy foods. Get plenty of potassium from natural sources, which can help lower blood pressure. Eat less saturated fat and trans fat.
• Use less salt. Processed meats, canned foods, commercial soups, frozen dinners and certain breads can be hidden sources of salt. Check food labels for the sodium content. Limit foods and beverages that are high in sodium. A sodium intake of 1,500 mg a day or less is considered ideal for most adults. But ask your provider what’s best for you.
• Limit alcohol. Even if you’re healthy, alcohol can raise your blood pressure. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women, and up to two drinks a day for men. One drink equals 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80-proof liquor.
• Don’t smoke. Tobacco injures blood vessel walls and speeds up the process of hardening of the arteries. If you smoke, ask your care provider for strategies to help you quit.
• Maintain a healthy weight. If you’re overweight or have obesity, losing weight can help control blood pressure and lower the risk of complications. Ask your health care provider what weight is best for you. In general, blood pressure drops by about 1 mm Hg with every 2. 2 pounds (1 kilogram) of weight lost. In people with high blood pressure, the drop in blood pressure may be even more significant per kilogram of weight lost.

• Get more exercise. Regular exercise keeps the body healthy. It can lower blood pressure, ease stress, manage weight and reduce the risk of chronic health conditions. Aim to get at least 150 minutes a week of moderate aerobic activity or 75 minutes a week of vigorous aerobic activity, or a combination of the two.

  If you have high blood pressure, consistent moderate- to high-intensity workouts can lower your top blood pressure reading by about 11 mm Hg and the bottom number by about 5 mm Hg.

• Practice good sleep habits. Poor sleep may increase the risk of heart disease and other chronic conditions. Adults should aim to get 7 to 9 hours of sleep daily. Kids often need more. Go to bed and wake at the same time every day, including on weekends. If you have trouble sleeping, talk to your provider about strategies that might help.
• Manage stress. Find ways to help reduce emotional stress. Getting more exercise, practicing mindfulness and connecting with others in support groups are some ways to reduce stress.
• Try slow, deep breathing. Practice taking deep, slow breaths to help relax. Some research shows that slow, paced breathing (5 to 7 deep breaths per minute) combined with mindfulness techniques can reduce blood pressure. There are devices available to promote slow, deep breathing. According to the American Heart Association, device-guided breathing may be a reasonable nondrug option for lowering blood pressure. It may be an good option if you have anxiety with high blood pressure or can’t tolerate standard treatments.

More Information

Alternative medicine

Diet and exercise are the best ways to lower blood pressure. But some supplements are promoted as heart healthy. These supplements include:

• Fiber, such as blond psyllium and wheat bran
• Minerals, such as magnesium, calcium and potassium
• Folic acid
• Supplements or products that increase nitric oxide or widen blood vessels — called vasodilators — such as cocoa, coenzyme Q10, L-arginine and garlic
• Omega-3 fatty acids, found in fatty fish, high-dose fish oil supplements and flaxseed

Researchers are also studying whether vitamin D can reduce blood pressure, but evidence is conflicting. More research is needed.

Talk to your care provider before adding any supplements to your blood pressure treatment. Some can interact with medicines, causing harmful side effects that could be life-threatening.

Deep breathing or mindfulness are alterative medicine techniques that can help you relax. These practices may temporarily reduce blood pressure.

More Information

Coping and support

High blood pressure isn’t something that you can treat and then ignore. It’s a condition that requires regular health checkups. Some things you can do to help manage the condition are:

• Take medicines as directed. If side effects or costs pose problems, ask your provider about other options. Don’t stop taking your medicines without first talking to a care provider.
• Schedule regular health checkups. It takes a team effort to treat high blood pressure successfully. Work with your provider to bring your blood pressure to a safe level and keep it there. Know your goal blood pressure level.
• Choose healthy habits. Eat healthy foods, lose excess weight and get regular physical activity. Limit alcohol. If you smoke, quit.
• Manage stress. Say no to extra tasks, release negative thoughts, and remain patient and optimistic.
• Ask for help. Sticking to lifestyle changes can be difficult, especially if you don’t see or feel any symptoms of high blood pressure. It may help to ask your friends and family to help you meet your goals.
• Join a support group. You may find that talking about any concerns with others in similar situations can help.

Preparing for your appointment

If you think you may have high blood pressure, make an appointment with your health care provider for a blood pressure test. You might want to wear a short-sleeved shirt to your appointment so it’s easier to place the blood pressure cuff around your arm.

No special preparations are necessary for a blood pressure test. To get an accurate reading, avoid caffeine, exercise and tobacco for at least 30 minutes before the test.

Because some medicines can raise blood pressure, bring a list of all medicines, vitamins and other supplements you take and their doses to your medical appointment. Don’t stop taking any medicines without your provider’s advice.

Appointments can be brief. Because there’s often a lot to discuss, it’s a good idea to be prepared for your appointment. Here’s some information to help you get ready.

What you can do

• Write down any symptoms that you’re having. High blood pressure rarely has symptoms, but it’s a risk factor for heart disease. Let your care provider know if you have symptoms such as chest pains or shortness of breath. Doing so can help your provider decide how aggressively to treat your high blood pressure.
• Write down important medical information, including a family history of high blood pressure, high cholesterol, heart disease, stroke, kidney disease or diabetes, and any major stresses or recent life changes.
• Make a list of all medicines, vitamins or supplements that you’re taking. Include dosages.
• Take a family member or friend along, if possible. Sometimes it can be difficult to remember all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Be prepared to discuss your diet and exercise habits. If you don’t already follow a diet or exercise routine, be ready to talk to your care provider about any challenges you might face in getting started.
• Write down questions to ask your provider.

Preparing a list of questions can help you and your provider make the most of your time together. List your questions from most important to least important in case time runs out. For high blood pressure, some basic questions to ask your provider include:

• What kinds of tests will I need?
• What is my blood pressure goal?
• Do I need any medicines?
• Is there a generic alternative to the medicine you’re prescribing for me?
• What foods should I eat or avoid?
• What’s an appropriate level of physical activity?
• How often do I need to schedule appointments to check my blood pressure?
• Should I monitor my blood pressure at home?
• I have other health conditions. How can I best manage them together?
• Are there brochures or other printed material that I can have? What websites do you recommend?

Don’t hesitate to ask any other questions that you might have.

What to expect from your doctor

Your health care provider is likely to ask you questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your provider may ask:

• Do you have a family history of high cholesterol, high blood pressure or heart disease?
• What are your diet and exercise habits like?
• Do you drink alcohol? How many drinks do you have in a week?
• Do you smoke?
• When did you last have your blood pressure checked? What was the result?

What you can do in the meantime

It’s never too early to make healthy lifestyle changes, such as quitting smoking, eating healthy foods and getting more exercise. These are the main ways to protect yourself against high blood pressure and its complications, including heart attack and stroke.

High blood pressure – signs and complications.

The main signs of increased and high blood pressure:

• very frequent migraines;
• prostration;
• frequent, intense tinnitus;
• redness of the face;
• heavy sweating;
• depression;
• flies or circles before the eyes;
• persistent headaches;
• swelling of the extremities (more often in the morning).

In the case of persistent high blood pressure – from 140/100, 150/100 and above, it is imperative to find out the cause.
In this case, it will most likely be some kind of disease or pathology, the treatment of which should include not only drugs for high blood pressure, but also the treatment of the underlying disease that causes high blood pressure.
To identify the causes of high blood pressure, you must consult a doctor who will refer you to the necessary tests and examinations. You should not delay your visit to the doctor.
Complications and consequences of high blood pressure can be:

• Heart failure;
• Stroke;
• Myocardial infarction;
• Nephrosclerosis;
• Internal bleeding;
• Retinopathy;
• Impaired vision;
• Ischemic heart disease (CHD).

The DonMed clinic has modern and high-precision equipment. You can pass all necessary examinations , as well as get advice from qualified specialists: therapist with 33 years of work experience , as well as cardiologist, nephrologist , undergo the necessary examinations for elevated blood pressure – ECG, Holter, ultrasound of the heart , vessels of the head and neck, adrenal glands, SCT of the adrenal glands, MRI of the cervical region, take tests .

MRI, CT in Lyubertsy (Horizon Clinic)

The DonMed MC team applies high quality standards in medicine now in Lyubertsy (MOSCOW) , the Horizon Clinic.

MRI in the Horizon clinic is performed with modern equipment – Philips Achieva 3 Tesla

Go to the website of MC Horizon

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symptoms and risk factors for hypertension

How to recognize the symptoms of high blood pressure, what is the difference between the upper and lower indicators, what factors provoke hypertension and when high numbers on the tonometer are considered normal – we tell in this article.

Upper and lower

blood pressure

The tonometer shows two numerical values, one of which is slightly higher than the other. For example, 110/70 or 120/80. These numbers, SYS (systole, first value) and DIA (diastole, second value), indicate the work of the heart muscle in different states.

Systolic (upper) pressure – pressure on the walls of blood vessels during contraction of the heart muscle (systole). High top indicator with a normal lower is considered a manifestation of heart disease.

Diastolic (lower) pressure – pressure on the walls of blood vessels during relaxation of the heart muscle (diastole). High lower indicator with normal upper – a sign of atherosclerosis or kidney disease.

Mechanical blood pressure monitor more accurate than electronic

In a healthy person , blood pressure decreases during sleep and increases during physical activity. Its norms gradually change with age. Adequate indicators in adolescence – 110/70, in adults – 120/80, in the elderly – no higher than 140/90.

Normal blood pressure

Symptoms of high blood pressure

If you feel unwell, and there is no blood pressure monitor at hand, pay attention to the symptoms listed below . They may indicate problems with the pressure.

Signs of high blood pressure

• Dizziness.
• Weakness.
• Heart pain.
• Headache.
• Numbness of hands and feet.
• Nausea.
• Noise in the ears.
• Cardiac arrhythmias.
• Redness of the face.
• Puffiness.

If you have measured the pressure, and it turned out to be elevated, it is recommended to repeat the measurement for at least a week. Do it at the same time and record the readings. If the pressure constantly exceeds the age norm by 15 units or more (for example, it does not fall below 135/85 at a rate of 120/80), this is a reason to consult a doctor. Regardless of age, do not allow indicators 140/90 and above.

If measures are not taken in time, there is a risk of a hypertensive crisis – a critical increase in blood pressure that threatens life.

When pressure increase

is considered normal

High blood pressure is not necessarily a sign of illness. Its short-term increase is also possible for physiological reasons :

• 1

  Childhood and adolescence. In children, the cardiovascular system develops more slowly than the musculoskeletal system, and in adolescence, the body experiences hormonal changes. It is accompanied by mood swings for no apparent reason, which leads to jumps blood pressure. Adolescents may have higher rates at rest than during exercise.

• 2

  Physical activity. Running, lifting weights, and other types of physical activity increase the oxygen demand of the involved muscle groups. This need is provided by an intensive blood flow due to increased heart rate and increased heart rate. Due to the forced work of the cardiovascular system, an increase in pressure during and after physical exertion is possible.

• 3

  Stress. Situations in which a person experiences anger or fear lead to the release of adrenaline into the blood. The result is tachycardia and high blood pressure.

Normally, in all three cases , the pressure rises for a short time. This is not a cause for concern, but a cause for observation to rule out the development of hypertension .

Risk factors for developing

hypertension

Unhealthy diet. Frequent overeating and excessive consumption of foods high in cholesterol leads to an increased risk of atherosclerosis, narrowing of the lumen of blood vessels, obesity and increased stress on the heart. The result of these diseases is high blood pressure. reasons for the development of hypertension also include salty foods, strong tea and coffee (one cup of this drink briefly increases blood pressure by 10-15 units).

Erythrocytes in the lumen of a blood vessel free from cholesterol plaques

Bad habits. Alcoholic beverages increase blood pressure, so regular alcohol consumption provokes the development of hypertension. Due to reflex constriction and vasospasm – just one cigarette briefly increases blood pressure by 10-20 units.