high blood pressure

What is blood pressure?

Blood pressure is the amount of force that your blood puts on your artery walls as it moves through your body. Here\'s how it works: Arteries are blood vessels that carry blood your heart to the rest of your body. When your heart beats, it pushes your blood through your arteries. As the blood moves, it puts pressure on your artery walls. This is your blood pressure.

What is high blood pressure?

High blood pressure (also called hypertension) occurs when your blood moves through your arteries at a higher pressure than normal. Many different things can cause high blood pressure. If your blood pressure gets too high or stays high for a long time, it can cause health problems.

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Symptoms

What are the symptoms of high blood pressure?

Most people who have high blood pressure do not have any symptoms. This is why it\'s sometimes called "the silent killer" and why it\'s so important to have your blood pressure checked regularly.

Causes & Risk Factors

What causes high blood pressure?

Several different things can cause high blood pressure. Your doctor can help you find out what might be causing yours. In general, there are 2 types of high blood pressure:

• Primary hypertension, also called essential hypertension,is when there is no known cause for your high blood pressure. This type of blood pressure usually takes many years to develop and probably is a result of your lifestyle, environment, and how your body changes as you age.
• Secondary hypertensionis when a health problem or medicine is causing your high blood pressure. Things that can cause secondary hypertension include:

— Certain medicines, such as birth control pills, NSAIDs (a type of pain reliever), and corticosteroids

— Excessive alcohol intake

— Excessive licorice intake

— Kidney problems

— Obesity

— Sleep apnea

— Thyroid or adrenal gland problems

What are the risk factors for high blood pressure?

The following are some common factors that can lead to high blood pressure:

• A diet high in salt, fat, and/or cholesterol
• Chronic conditions such as kidney and hormone problems, diabetes, and high cholesterol
• Family history: You are more likely to have high blood pressure if your parents or other close relatives also have it
• Lack of physical activity
• Older age: The older you are, the more likely you are to have high blood pressure
• Overweight and obesity
• Race: Non-Hispanic black people are more likely to have high blood pressure than people of other races
• Some birth control medicines
• Stress
• Tobacco use or drinking too much alcohol

Diagnosis & Tests

How is high blood pressure diagnosed?

The only way to know whether your blood pressure is too high is to check it with a blood pressure monitor. The higher your blood pressure is, the more often you need to check it.

Your doctor will measure your blood pressure at more than one visit to see if you have high blood pressure. When you first start treatment to lower your blood pressure, your doctor may want you to come to the office regularly. Your blood pressure will be checked at the office.

You may also be asked to check your blood pressure at home and keep track of your numbers for your doctor. High-quality, automated arm blood pressure cuffs for home use can be purchased for about $40 to $60. Your doctor may want you to check your blood pressure several times a day. Another option is to have you use an ambulatory blood pressure monitor  .

How often should I have my blood pressure checked?

After age 18, have your blood pressure checked at least once every 2 years. Do it more often if you have had high blood pressure in the past. Your doctor may even ask you to monitor your blood pressure at home.

What do the numbers mean?

Blood pressure is really two measurements, separated by a slash when written, such as 120/80. You may also hear someone say a blood pressure is "120 over 80."

The first number is the systolic blood pressure. This is the peak blood pressure when your heart is squeezing blood out. The second number is the diastolic blood pressure. It\'s the pressure when your heart is filling with blood­ — relaxing between beats.

A normal blood pressure is less than 120/80. High blood pressure is 140/90 or higher. If your blood pressure is between 120/80 and 140/90, you have what is called "prehypertension," which means that if you don\'t take important steps, your elevated blood pressure can turn into high blood pressure.

Hypotension, or low blood pressure, happens when your systolic pressure is consistently below 90, or 25 points below your normal reading.

	Systolic (first/top number)	Diastolic (second/bottom number)
Normal	Less than 120	Less than 80
Prehypertension	120–139	80–89
High blood pressure: Stage 1	140–159	90–99
High blood pressure: Stage 2	160 or higher	100 or over

If you have diabetes or kidney disease, what is considered high blood pressure may be lower than for other people. Talk to your doctor about what is considered high blood pressure for you.

Treatment

How is it treated?

You and your doctor will work together to find the best way to lower your blood pressure. Treatment usually begins with changes you can make to your lifestyle to help lower your blood pressure and reduce your risk of heart disease. If these changes don\'t work, you may also need to take medicine.

Even if you need to take medicine, making some changes in your lifestyle can help reduce the amount of medicine you must take.

Lifestyle changes

• Don\'t smoke cigarettes or use any tobacco products.
• Lose weight if you\'re overweight.
• Exercise regularly.
• Eat a healthy diet that includes lots of fruits and vegetables and is low in fat.
• Limit your sodium, alcohol, and caffeine intake.
• Try relaxation techniques or biofeedback.

See"Lifestyle Changes to Help Lower Your Blood Pressure"  for more information.

What about medicine?

Many different types of medicine can be used to treat high blood pressure (see"High Blood Pressure Medicines"   ). These are called antihypertensive medicines.

The goal of treatment is to reduce your blood pressure to normal levels with medicine that\'s easy to take and has few, if any, side effects. This goal can almost always be met.

If your blood pressure can only be controlled with medicine, you\'ll need to take the medicine for the rest of your life. It is common to need more than one medicine to help control your blood pressure. Don\'t stop taking the medicine without talking with your family doctor, or you may increase your risk of having a stroke or heart attack.

Complications

Why do I have to control my blood pressure?

High blood pressure can damage many parts of the body. If you have high blood pressure, you have a higher risk for stroke, heart disease, heart attack, and kidney failure. Controlling your blood pressure can reduce these risks.

Questions to Ask Your Doctor

• Am I at risk for hypertension?
• What is my blood pressure? What do the numbers mean?
• What is my target blood pressure?
• What lifestyle changes do I need to make to help lower my blood pressure?
• Is there a chance that I\'ll need antihypertensive medicine?
• What are the risks and benefits of taking this medicine?
• Could alternative therapies such as meditation, yoga or acupuncture help lower my blood pressure?