Overview
What is hypertension? A Mayo Clinic expert explains.
Learn more about hypertension from nephrologist Leslie Thomas, M.D.
Hi. I'm Dr. Leslie Thomas, a nephrologist at Mayo Clinic. In this video, we'll cover the basics of hypertension. What is it? Who gets it? The symptoms, diagnosis, and treatment. Whether you're looking for answers for yourself or someone you love, we're here to give you the best information available. Hypertension means high blood pressure. A blood pressure measurement includes two numbers. Those numbers are the systolic blood pressure and the diastolic blood pressure. Because of the pumping action of the heart, the pressure within the arteries cycles between a higher pressure and a lower pressure. The higher pressure occurs during the contraction of the heart's left ventricle. The higher pressure is known as the systolic blood pressure. The lower pressure occurs during the relaxation of the heart's left ventricle. This lower pressure is referred to as the diastolic blood pressure.
Who gets it?
Hypertension is a very common condition affecting up to 40% of adults. It is one of the most common conditions for which medications are prescribed. Most people with hypertension have primary hypertension. How primary hypertension develops is not entirely understood. However, it has felt to result from many inherited and environmental factors that interact in complex ways within the body. Risks for the development of primary hypertension include family history, advancing age, obesity, high sodium diet, alcohol consumption and physical inactivity. In cases of hypertension in which a specific cause is identified, the term secondary hypertension is used. Many potential causes of secondary hypertension exist. These causes include certain prescription or over-the-counter medications, kidney disease, certain endocrine disorders, or a significant narrowing of the aorta or a kidney artery.
What are the symptoms?
Rarely, an individual with very high blood pressure may have symptoms. These symptoms might include shortness of breath, blurry vision or headache.
How is it diagnosed?
Hypertension can be diagnosed by performing careful and repeated measures of the blood pressure. Blood pressure categories include normal blood pressure, defined as a systolic pressure less than 120, and a diastolic pressure less than 80. Elevated blood pressure is defined as a systolic pressure 120 to 129, and a diastolic pressure less than 80. Hypertension is defined as systolic pressure greater than or equal to 130, or a diastolic pressure greater than or equal to 80.
How is it treated?
Treatment of hypertension involves lifestyle modification alone or in combination with antihypertensive medication therapy. For individuals with certain common conditions, including cardiovascular disease, chronic kidney disease, and diabetes mellitus. Certain medications may be more advantageous to use compared to other medications. Deciding upon the best blood pressure to target, when to start antihypertensive medication therapy, and which specific medication or a combination of medications to utilize is highly individualized and informed by many factors.
What now?
You and your care team can work together to create the best treatment plan for you. No matter what methods you decide on. There are plenty of reasons to be optimistic about managing your hypertension. If you'd like to learn even more about hypertension, watch our other related videos or visit mayoclinic.org. We wish you well.
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.
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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.
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.
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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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By Mayo Clinic Staff
Sept. 15, 2022
FAQs
What are the 3 main causes of hypertension? ›
eat too much salt and do not eat enough fruit and vegetables. do not do enough exercise. drink too much alcohol or coffee (or other caffeine-based drinks) smoke.
What are 5 symptoms of hypertension? ›- Blurry or double vision.
- Lightheadedness/Fainting.
- Fatigue.
- Headache.
- Heart palpitations.
- Nosebleeds.
- Shortness of breath.
- Nausea and/or vomiting.
- Being overweight or obese. The more you weigh the more blood flow you need to supply oxygen and nutrients to your tissues. ...
- Too much salt (sodium) in your diet. ...
- Too little potassium in your diet. ...
- Not being physically active. ...
- Drinking too much alcohol.
When symptoms do occur, they can include early morning headaches, nosebleeds, irregular heart rhythms, vision changes, and buzzing in the ears. Severe hypertension can cause fatigue, nausea, vomiting, confusion, anxiety, chest pain, and muscle tremors.
What is the biggest cause of hypertension? ›Having overweight or obesity
People who have overweight or obesity tend to have higher blood pressure than those who do not. In fact, excess weight may be responsible for up to 75% of all cases of hypertension.
- Take a warm bath or shower. Stay in your shower or bath for at least 15 minutes and enjoy the warm water. ...
- Do a breathing exercise. Take a deep breath from your core, hold your breath for about two seconds, then slowly exhale. ...
- Relax!
Unfortunately, high blood pressure can happen without feeling any abnormal symptoms. Moderate or severe headaches, anxiety, shortness of breath, nosebleeds, palpitations, or feeling of pulsations in the neck are some signs of high blood pressure.
How does a person with hypertension behave? ›If you have hypertension, you're more likely to experience mood issues, such as anxiety and depression than those with normal blood pressure. Hypertension is a manageable condition. There are ways to control your blood pressure with lifestyle changes and/or medication.
Can you feel if you have hypertension? ›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.
Can hypertension be cured? ›While there is no cure for high blood pressure, it is important for patients to take steps that matter, such as making effective lifestyle changes and taking BP-lowering medications as prescribed by their physicians.
Can lack of sleep cause high blood pressure? ›
Insomnia is linked to high blood pressure and heart disease. Over time, poor sleep can also lead to unhealthy habits that can hurt your heart, including higher stress levels, less motivation to be physically active, and unhealthy food choices.
Can anxiety cause high blood pressure? ›Anxiety doesn't cause long-term high blood pressure (hypertension). But episodes of anxiety can cause dramatic, temporary spikes in blood pressure.
Does hypertension have warning signs? ›If your blood pressure is extremely high, there may be certain symptoms to look out for, including: Severe headaches. Nosebleed. Fatigue or confusion.
Can hypertension go away on its own? ›There is no cure for high blood pressure. But treatment can lower blood pressure that is too high. If it is mild, high blood pressure may sometimes be brought under control by making changes to a healthier lifestyle.
What happens if hypertension is left untreated? ›Left undetected or uncontrolled, high blood pressure can lead to: Heart attack — High blood pressure damages arteries that can become blocked and prevent blood flow to the heart muscle. Stroke — High blood pressure can cause blood vessels that supply blood and oxygen to the brain to become blocked or burst.
What diet is good to lower blood pressure? ›The DASH diet is a healthy-eating plan designed to help treat or prevent high blood pressure (hypertension). The DASH diet includes foods that are rich in potassium, calcium and magnesium. These nutrients help control blood pressure. The diet limits foods that are high in sodium, saturated fat and added sugars.
Can stress cause high blood pressure? ›Stress can cause a steep rise in blood pressure. But when stress goes away, blood pressure returns to what it was before the stress. However, short spikes in blood pressure can cause heart attacks or strokes and may also damage blood vessels, the heart and the kidneys over time.
Does high blood pressure make you tired? ›High blood pressure causes tiredness as a result of elevated pressure on vital organs such as the brain, heart and kidneys. Often though, medication plays a larger role in contributing to fatigue than the actual condition does. Tiredness is often a common side effect of many medications used to lower blood pressure.
Can drinking water lower blood pressure? ›Something as simple as keeping yourself hydrated by drinking six to eight glasses of water every day improves blood pressure. Water makes up 73% of the human heart,¹ so no other liquid is better at controlling blood pressure.
Can aspirin lower blood pressure? ›Does aspirin lower blood pressure? Overall, aspirin hasn't been found to consistently lower blood pressure. But some research shows that low-dose aspirin (81 mg per day) may lower blood pressure when it's taken before bedtime.
Do bananas lower blood pressure? ›
Bananas. Bananas contain potassium, which can help manage hypertension. One medium-sized banana contains around 422 milligrams (mg) of potassium. According to the American Heart Association (AHA) , potassium reduces the effects of sodium and alleviates tension in the walls of the blood vessels.
What causes a sudden spike in blood pressure? ›Adrenal issues
Your adrenal system is responsible for hormone production. Adrenal fatigue occurs when your hormone production is low. Your blood pressure may fall as a result. An overactive adrenal system can cause sudden spikes in blood pressure and hypertension.
- Ten minutes of brisk or moderate walking three times a day. ...
- Thirty minutes a day of biking or stationary cycling, or three 10-minute blocks of cycling. ...
- Hiking. ...
- Desk treadmilling or pedal pushing. ...
- Weight training. ...
- Swimming.
The development of hypertension is related to both genetic and lifestyle factors. Genetic factors include age, gender, body shape, and family history, and lifestyle factors include excessive drinking, smoking, poor eating habits, and reduced physical activity3,4,5,6,7).
How do doctors diagnose hypertension? ›Your health care provider will use a blood pressure test to see if you have higher-than-normal blood pressure readings. The reading is made up of two numbers, the systolic number and the diastolic number. These numbers are measures of pressure in mm HG (millimeters of mercury).
How long can you have hypertension without knowing? ›What You Need to Know. Twenty percent of patients with hypertension are resistant. Resistant hypertension may have no symptoms at all for months or years, but then can cause heart attack, stroke, and vision and kidney damage.
How long does it take for high blood pressure to cause damage? ›High blood pressure can cause many complications. High blood pressure (hypertension) can quietly damage the body for years before symptoms develop. Uncontrolled high blood pressure can lead to disability, a poor quality of life, or even a deadly heart attack or stroke.
How long can you live with high blood pressure? ›With that being said, research³ does show that although you can live a long life, it may be five to seven years shorter than those without high blood pressure. Some potential causes⁴ of this shorter life expectancy include smoking and obesity.
What are the Top 5 reasons for high blood pressure? ›- Smoking.
- Being overweight or obese.
- Lack of physical activity.
- Too much salt in the diet.
- Too much alcohol consumption (more than 1 to 2 drinks per day)
- Stress.
- Older age.
- Genetics.
High blood pressure (hypertension) can be dangerous if it's not treated. It can put you at risk for stroke, heart failure, kidney failure and other medical problems. Changing what you eat, exercising more and taking your medicine can help you keep your blood pressure where it should be.
What is stroke level blood pressure? ›
Call 911 or emergency medical services if your blood pressure is 180/120 mm Hg or greater and you have chest pain, shortness of breath, or symptoms of stroke. Stroke symptoms include numbness or tingling, trouble speaking, or changes in vision.
What is the most common complication of hypertension? ›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.
Is it OK to sleep with high blood pressure? ›Excessive reduction of blood pressure during sleep may also be detrimental. Patients with well-controlled hypertension showed a significantly increased risk of stroke when nighttime systolic pressure took extreme dips.
What is the best position to sleep in with high blood pressure? ›Sleeping on the left side is the best sleeping position for hypertension because it relieves blood pressure on blood vessels that return blood to the heart.
What causes blood pressure to not go down? ›Possible causes of resistant hypertension
The accumulation of artery-clogging plaque in blood vessels that nourish the kidneys, a condition called renal artery stenosis. Sleep problems, such as the breath-holding type of snoring known as obstructive sleep apnea.
Unfortunately, high blood pressure can happen without feeling any abnormal symptoms. Moderate or severe headaches, anxiety, shortness of breath, nosebleeds, palpitations, or feeling of pulsations in the neck are some signs of high blood pressure.
What is the difference between high blood pressure and hypertension? ›Blood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Hypertension is the term used to describe high blood pressure. Untreated high blood pressure can lead to many medical problems.