What is high blood pressure?
High blood pressure is when the force of blood pushing against your artery walls is consistently too high. This damages your arteries over time and can lead to serious complications like heart attack and stroke. “Hypertension” is another word for this common condition.
Healthcare providers call high blood pressure a “silent killer” because you usually don’t have any symptoms. So, you may not be aware that anything is wrong, but the damage is still occurring within your body.
What causes hypertension?
Primary hypertension doesn’t have a single, clear cause. Usually, many factors come together to cause it. Common causes include:
- Unhealthy eating patterns (including a diet high in sodium).
- Lack of physical activity.
- High consumption of beverages containing alcohol.
- Secondary hypertension has at least one distinct cause that healthcare providers can identify. Common causes of secondary hypertension include:
- Certain medications, including immunosuppressants, NSAIDs and oral contraceptives (the pill).
- Kidney disease.
- Obstructive sleep apnea.
- Primary aldosteronism (Conn’s syndrome).
- Recreational drug use (including amphetamines and cocaine).
- Renal vascular diseases, which are conditions that affect blood flow in your kidneys’ arteries and veins. Renal artery stenosis is a common example.
- Tobacco use (including smoking, vaping and using smokeless tobacco).
Blood pressure levels
| Blood Pressure Category | Systolic and Diastolic Pressure (mm Hg) |
| Normal | Less than 120 systolic pressure AND Less than 80 diastolic pressure |
| Elevated | 120 to 129 systolic pressure AND Less than 80 diastolic pressure |
| High Blood Pressure Stage 1 | 130 to 139 systolic pressure OR 80 to 89 diastolic pressure |
| High Blood Pressure Stage 2 | 140 or higher systolic pressure OR 90 or higher diastolic pressure |
| Hypertensive Crisis | Higher than 180 systolic pressure OR Higher than 120 diastolic pressure Contact your provider immediately. |
How to treat high blood pressure?
The goal of treatment is to reduce your blood pressure so that you have a lower risk of health problems caused by high blood pressure. You and your provider should set a blood pressure goal for you.
Whenever thinking about the best treatment for high blood pressure, you and your provider must consider other factors such as:
- Your age.
- The medicines you take.
- Your risk of side effects from possible medicines.
- Other medical conditions you may have, such as a history of heart disease, stroke, kidney problems, or diabetes.
If the top blood pressure number is from 120 to 129 mm Hg, and the bottom blood pressure number is less than 80 mm Hg, you have what is called elevated blood pressure.
- Your provider will recommend lifestyle changes to bring your blood pressure down to a normal range.
- Medicines are rarely used at this stage.
If your blood pressure is 130/80 or higher, but lower than 140/90 mm Hg, you have Stage 1 high blood pressure. When thinking about the best treatment, you and your provider must consider:
- If you have no other diseases or risk factors for heart or kidney disease, your provider may recommend lifestyle changes and repeat the measurements after a few months.
- If your blood pressure remains 130/80 or above, but lower than 140/90 mm Hg, your provider may recommend medicines to treat high blood pressure.
- If you have other diseases or risk factors for heart or kidney disease, your provider may be more likely to recommend medicines at the same time as lifestyle changes.
If your blood pressure is 140/90 mm Hg or higher, you have Stage 2 high blood pressure. Your provider will most likely recommend medicines and lifestyle changes together.
Before making a final diagnosis of either elevated blood pressure or high blood pressure, your provider should ask you to have your blood pressure measured at home, at your pharmacy, or somewhere else besides their office or a hospital.
