High blood pressure (hypertension)

Overview

Blood pressure is the force of blood pushing on the walls of your arteries. It's written as two numbers, like 120/80. The top number is the pressure when your heart beats. The bottom number is the pressure between beats.

When the pressure stays high, your heart works harder and your blood vessels slowly get damaged. This raises the risk of heart attack, stroke, heart failure, and kidney disease. That's why it's called a silent danger.

Symptoms

Most people with high blood pressure feel nothing. The only way to know is to check it.

• A high blood pressure reading
• No symptoms at all

Less common

• Headaches, usually only when it's very high
• Nosebleeds
• Dizziness

Look up a symptom: Headache

When to get medical care

Causes

Most high blood pressure has no single cause. It builds over years from genes, age, salt, extra weight, not moving enough, alcohol, and stress.

Sometimes another problem causes it, like kidney disease, sleep apnea, thyroid problems, or some medicines.

Does it spread or run in families?

• It isn't contagious. You can't catch it from someone else.
• It can run in families. Tell your doctor if a parent, brother, or sister has it.

Who is more likely to get it

• Older age
• Family history
• Being Black, where it often starts earlier and is more severe
• Extra weight and not being active
• A diet high in salt
• Drinking a lot of alcohol
• Diabetes or kidney disease

Possible complications

• Heart attack: Damaged arteries can get blocked
• Stroke: High blood pressure is a top cause
• Heart failure: The heart gets tired of pumping hard
• Chronic kidney disease: Damage to the kidneys' filters
• Dementia: From damage to small blood vessels in the brain

Diagnosis

High blood pressure is found by checking your blood pressure on two or more visits.

Questions you may be asked

• Your family history of high blood pressure or heart disease
• How much salt and alcohol you have
• Whether you smoke
• Which medicines and supplements you take

The exam

They'll measure your blood pressure, sometimes in both arms, and listen to your heart and lungs.

Tests

Other tests can look for causes and harm to your organs:

• Home or 24-hour blood pressure checks: To confirm the numbers outside the clinic.
• Blood and urine tests: To check your kidneys, blood sugar, and cholesterol.
• ECG: A quick test of your heart's electrical activity.

Treatment

The goal for most adults is a blood pressure below 130/80. Treatment starts with healthy habits, and many people also need medicine.

Self-care

• Cut back on salt and processed foods
• Eat more fruits, vegetables, and whole grains like the DASH eating plan
• Be active most days of the week
• Limit alcohol
• Quit smoking
• Check your blood pressure at home and write down the numbers

Medicines

Blood pressure medicines work in different ways. Your healthcare professional picks the best ones for you.

OwieClear doesn't give doses: follow the label or your healthcare professional. Medicine names here are examples, not a full list.

If your numbers stay high, your healthcare professional will add medicine. Many people need two or more medicines. Keep taking them even when you feel fine.

Prevention

These habits help prevent and lower high blood pressure:

• Eat less salt
• Stay at a healthy weight
• Be active
• Limit alcohol
• Don't smoke
• Get your blood pressure checked at least once a year

Which doctor treats this

• Start with your primary care provider (family doctor or internist).
• They may send you to a cardiologist (heart doctor) if it's hard to control.

Living with it

• Check your blood pressure at home and write it down.
• Eat less salt and more fruits and vegetables.
• Take your medicine every day, even when you feel fine.
• Long-term illness can affect mood. Tell your doctor if you feel down or anxious.

Support groups and helplines

• American Heart Association: Plain-language heart information and a support network for patients.

Back to school, work, or sports

• Most people can keep working or going to school.
• Ask about changes that help, like extra breaks or a flexible schedule. Workers may be covered by the ADA. Students may get a 504 plan.

Children, pregnancy, and older adults

• Pregnancy: High blood pressure in pregnancy needs close checks. A new headache, vision changes, or swelling can be signs of preeclampsia.
• Children and teens: They can get high blood pressure too, especially with extra weight. Checks start at age 3.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• This condition needs closer checkups during pregnancy. Plan ahead with your doctor.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

For caregivers

• Go to visits when you can and take notes.
• Keep a list of medicines, allergies, and doctors in one place.
• Learn the warning signs that need fast care.
• Take breaks and ask for help. Caregivers need care too.

Outlook

High blood pressure usually lasts for life, but controlling it greatly lowers the risk of heart attack, stroke, and kidney disease.

Myths and facts

Getting ready for your visit

Home readings help a lot.

What to bring

• Your home blood pressure log
• Your home monitor, to check it's accurate
• All your medicines and supplements

Questions to ask

• What should my blood pressure goal be?
• How often should I check it at home?
• What should I do if it's very high?
• Can I lower it without more medicine?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on High blood pressure (hypertension)