What is hypertension? 

Hypertension, commonly referred to as high blood pressure, occurs when a person has chronically high blood pressure compared to normal values. Blood pressure measures the force your blood causes when pushing into the wall of the arteries as it circulates. One’s blood pressure naturally fluctuates throughout the day, but consistently high pressure values constitute hypertension. 

High blood pressure values occur during periods of stress, strenuous physical activities, and other occasions that can make hypertension a larger problem. However, hypertension itself does not have many identified symptoms, making a diagnosis from a healthcare professional necessary for proper treatment and monitoring. Roughly half of adults in the United States have hypertension, making the condition very common and a key aspect of health. Left untreated, hypertension carries serious medical risks and complications that can put a person at risk of strokes, heart attacks, and other dangerous conditions.

How do you measure hypertension?

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You measure hypertension using a ratio of two values collected during a blood pressure test. The test equipment often involves a cuff that wraps around your upper arm which compresses either by manual compressions with a pump or automatically by a machine. While the cuff is compressing, your doctor can manually use a stethoscope to listen for and count the pulse rate. These two values, blood pressure during heart beats and blood pressure between heart beats, combine to produce your blood pressure. 

The first number of systolic blood pressure (SBP), measuring pressure during heart beats, is placed over the second number of your diastolic blood pressure (DBP), measuring pressure between heart beats. The following values are common interpretations of blood pressure readings. 

Normal: SBP less than 120/ DBP less than 80 

High Blood Pressure (absent other heart risk): SBP 140 or higher/DBP 90 or higher

High Blood Pressure (present other heart risk): SBP 130 or higher/ DBP 80 or higher 

Dangerous Blood Pressure: SBP 180 or higher/ DBP 120 or higher

What causes hypertension?

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Generally, the cause of high blood pressure is when the heart has a hard time pumping more blood through more narrow arteries. The precise cause of hypertension depends on the type of hypertension a person has. There are two main types of high blood pressure: primary and secondary hypertension. 

Primary Hypertension 

Most people who have hypertension have primary hypertension. It is more difficult to pinpoint the exact cause of primary hypertension because there is often no one aspect to explain the high blood pressure. This type of hypertension develops over time due to a buildup of plaque in the arteries. The following factors can contribute to the onset of primary hypertension: 

  • Consuming large amounts of alcohol 
  • Living a sedentary lifestyle with a lack of physical activity 
  • Eating a diet high in sodium 
  • Smoking 

Secondary Hypertension

Secondary hypertension is caused by an underlying health condition. This type of hypertension occurs more suddenly and can result in higher blood pressure ratings than primary hypertension. The most common conditions that result in second hypertension include:

  • Thyroid issues
  • Kidney disease
  • Some medications, like NSAIDS, oral contraceptives, and immunosuppressants 
  • Sleep apnea
  • Illegal drugs 
  • Congenital heart defects
  • Adrenal gland problems 

There are also some situations which may cause a person to measure hypertension values. For example, white coat hypertension occurs for people who have high blood pressure when they visit a doctor’s office that returns to normal when they are at home.

What are the symptoms of hypertension?

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In many cases, hypertension does not present any symptoms or signs that confirm a hypertension diagnosis. The main, and often only, way to know if you have hypertension is to get tested at a doctor’s office. Even at dangerous levels, you may still be unaware of your blood pressure levels. 

In a few cases, a person may experience symptoms correlated to high blood pressure that can cause a person to test their levels. These symptoms are shortness of breath, nosebleeds, and headaches. However, experiencing symptoms is not the norm for this condition.

Are there any risk factors or groups for hypertension?

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There are many risk factors that can put a person at a higher likelihood of developing hypertension.

Family history: High blood pressure can run in families and can be passed down through genes. If your parent or sibling has the condition, you are at a higher risk of having hypertension. 

Age: While both children and adults can have high blood pressure, your chance of developing hypertension increases as you age. The risk is highest for people aged 65 or older. 

Race: Black non-Hispanic people are at a higher risk of high blood pressure. Often, Black individuals develop hypertension at a younger age than other races. 

Lifestyle: Sedentary lifestyles place people at a higher risk of hypertension than people who exercise. A lack of exercise can also make a person gain weight, which puts more pressure on the circulatory system. 

Diet: Diets high in sodium and low in potassium contribute to a person’s risk for hypertension. Salt encourages the body to retain more liquid, increasing overall blood pressure. Potassium works to balance sodium levels in the body, so not getting enough potassium prevents the body from maintaining normal levels. 

Medical conditions: Medical conditions like obesity, kidney disease, diabetes, and sleep apnea can all increase a person’s risk for hypertension. 

Pregnancy: High blood pressure during pregnancy is becoming more common. Pregnant people should be aware of their risk for high blood pressure and monitor their levels. 

Alcohol: Drinking more than two alcoholic drinks in a day puts you at a higher risk. 

Smoking: Tobacco is damaging to blood vessels and can lead a person to hypertension. 

Stress: Stress often results in shorter term high blood pressure, but consistent stress puts you at a higher likelihood of hypertension.

How is hypertension diagnosed?

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Your health care provider can diagnose hypertension with a review of your health history and taking accurate measures of your blood pressure. The review of your health history helps your doctor understand your risk for the condition as well as possible causes for high blood pressure. Depending on your blood pressure levels, your doctor may perform follow up exams to determine the cause for the hypertension if they believe an underlying condition may be resulting in high blood pressure. 

After an initial diagnosis, your doctor may ask you to keep track of your blood pressure levels by self-testing at home or at a pharmacy. Having a log of your levels on different days and different times of day can help track your levels and response to your treatment plan.

How is hypertension treated?

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Healthcare professionals typically treat hypertension with a combination of lifestyle adjustments and medication. The right treatment plan can take some trial and error to see which treatment your body responds to as well as keeping in mind other conditions you need treatment for. 

For some people, a combination of different medications is needed to treat their case of hypertension. Be sure to communicate with your doctor on the right dosage and goal blood pressure for you. Common medications to treat high blood pressure include:

  • Diuretics (water pills)
  • ACE (angiotensin-converting enzyme) inhibitors
  • ARBs (angiotensin II receptor blockers)
  • Calcium channel blockers

Lifestyle changes can also treat high blood pressure and improve your levels. The following lifestyle adjustments are just some of the possible treatments you may consider. 

  • Quitting smoking
  • Reducing alcohol 
  • Getting quality sleep (7-9 hours)
  • Following a heart-healthy diet 
  • Exercising regularly

Should you see a doctor for hypertension?

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Since hypertension can only be diagnosed by seeing your healthcare provider, you should see a doctor for high blood pressure. Early detection of your risk for or presence of high blood pressure can greatly help in the prompt management and treatment of the condition. Hypertension can create other serious health issues without notice or symptoms. Attending your doctor for regular checkups is an important part of monitoring this condition and reducing the risk of further complications. 

In between visits to your doctor, you can take advantage of blood pressure check machines at your local pharmacy or purchase an at-home test kit. Follow your treatment plan determined with your doctor and consult your doctor before making any changes to your medication. If you begin to experience any difficulty breathing, chest pains, or other symptoms of heart issues, seek medical attention immediately.

What are the complications and outlook for people living with hypertension?

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Hypertension is generally treatable, leading to a good outlook for people with the condition. People diagnosed with high blood pressure are at an increased risk of certain complications relating to the heart, mainly heart attack, stroke, heart disease, and kidney disease. Implementing an effective treatment plan and lifestyle adjustments lowers this risk. 

High blood pressure diagnoses are very common, and people with the condition have many techniques they can use to interact better with their environment and take care of their body. For example, practicing stress relief and breathing techniques can help you relax during times of stress and eating a heart-healthy diet can improve your blood pressure and overall quality of life.