High bloodpressure

• Article
• 2021-02-03

Also known as hypertension

High blood pressure is a common disease that occurs when blood flows through your arteries at a higher than normal pressure. Your blood pressure is made up of two numbers: systolic and diastolic. Systolic pressure is the pressure when the ventricles pump blood from the heart. Diastolic pressure is the pressure between heartbeats, when the heart fills with blood. For most adults, healthy blood pressure is usually less than 120 over 80 millimeters of mercury, which is written as your systolic pressure above your diastolic pressure - 120/80 mm Hg.

You don't usually have symptoms of high blood pressure until it has caused serious health problems. That is why it is important to have your blood pressure checked regularly. Your doctor will diagnose you with high blood pressure if you have consistently high blood pressure readings.

To control or reduce high blood pressure, your doctor may recommend that you adopt a healthy lifestyle. This includes choosing heart-healthy foods, such as those in the DASH eating plan. You may also need to take medication. Controlling or lowering blood pressure can help prevent or slow down serious health problems such as chronic kidney disease, heart attack, heart failure, stroke, and possibly vascular dementia.

To learn more about high blood pressure, our role in research and clinical studies to improve health, and where to find more information, check out this health topic. During High Blood Pressure Education Month in May and throughout the year, the NHLBI offers research results that help increase our understanding of high blood pressure, materials to share in person or on social media, and resources to manage your condition. Seek research studies and get resources about high blood pressure.

Symptoms

It is important to get your blood pressure measured regularly and to know your numbers, because high blood pressure usually doesn't cause symptoms until there are serious problems.

Undiagnosed or uncontrolled high blood pressure can lead to serious health problems:

• Aneurysm
• Stroke
• Chronic kidney disease
• Eye injury external link
• Heart attack
• Heart failure
• Peripheral artery disease or carotid artery disease
• Vascular dementia

High blood pressure during pregnancy can increase the risk of later heart and blood vessel problems for both the mother and her child.

Therapy

For most people with high blood pressure, a doctor will create a treatment plan that can include heart-healthy lifestyle changes alone or with medications. A risk calculator can help your doctor estimate your risk of complications and choose the right treatment. A health care team can help you best control your blood pressure and prevent complications. This team can include your doctor, nutritionist, pharmacist, and specialists for any conditions you have, including those related to your heart.

If your high blood pressure is caused by another medical condition or drug, it may improve once the cause has been treated or removed.

Risk calculators

Your doctor can use a risk calculator to estimate your risk of a stroke or heart attack, or death from heart or blood vessel disease in the next 10 years or throughout your life. This information can help your doctor choose the best treatment to avoid complications.

For example, the atherosclerotic cardiovascular disease (ASCVD) external link risk estimator takes your cholesterol level, age, gender, race, and blood pressure into account. It also determines whether you smoke or take medications to control high blood pressure or cholesterol.

Healthy lifestyle changes

If you have high blood pressure, your doctor may recommend that you adopt a healthy lifestyle to help lower and control high blood pressure.

• Choose heart-healthy foods like those in the DASH eating plan. NHLBI-funded research has shown that DASH in combination with a low-salt eating plan can be just as effective as drugs in lowering high blood pressure. Go to Living with the DASH Eating Plan or see Tips to Reduce Salt and Sodium.
• Avoid or limit alcohol. Talk to your doctor about how much alcohol you drink. Your doctor may recommend that you limit or stop alcohol. You can find resources and support from the National Institute on Alcohol's Alcohol Treatment NavigatorAbuse and Alcoholism.
• Get regular exercise. Many health benefits come from being physically active and getting the recommended amount of physical activity every week. Studies have shown that physical activity can help lower and control high blood pressure. Even a moderate amount of physical activity can help. Before starting an exercise program, ask your doctor what level of physical activity is right for you
• Aim for a healthy weight. If you are an overweight or obese adult, losing 5% to 10% of your initial weight for about 6 months can improve your health. Even if you only lose 3% to 5% of your weight, you can improve blood pressure readings.
• Stop smoking . Visit Smoking and Your Heart and our Your Guide to a Healthy Heart. While these resources focus on heart health, they provide basic information about how to quit smoking. For free help and support in quitting smoking, call the National Cancer Institute's Smoking Quitline at 1-877-44U-QUIT (1-877-448-7848).
• Manage stress. Learning to cope with stress and problems can improve your mental and physical health. Learning relaxation techniques, talking to a counselor, and finding a support group can all help.
• Get plenty of good quality sleep. The recommended amount for adults is 7 to 9 hours of sleep per day. Develop healthy sleeping habits by going to sleep and getting up regularly, following a calming bedtime routine, and keeping your bedroom cool and dark.

Changing habits can be difficult. Try to make one change at a time to make lifelong heart-healthy changes. Add one more change if you feel comfortable with the previous one. You are more likely to control your blood pressure if you practice several of these healthy lifestyle habits together and can maintain them.

Medicines

If a healthy lifestyle alone does not control or lower high blood pressure, your doctor may prescribe blood pressure medications. These drugs work in different ways to lower blood pressure. When prescribing medicines, your doctor will also consider their effect on other conditions you may have, such as heart disease or kidney disease.

Keep changing your healthy lifestyle while taking these medicines. The combination of the drugs and the heart-healthy lifestyle changes can help control and lower your high blood pressure and prevent heart disease.

Contact your doctor if you are concerned about side effects from the medications. He or she can change the dose or prescribe a new medicine. To control high blood pressure, many people need two or more medications. This is more likely in African American adults.

Possible medicines for high blood pressure are:

• Angiotensin-converting enzyme (ACE) inhibitors to prevent your blood vessels from narrowing.
• Angiotensin II receptor blockers (ARBs) to prevent blood vessels from narrowing.
• Calcium channel blockers to prevent calcium from entering the muscle cells of your heart and blood vessels. This allows the blood vessels to relax.
• Diuretics to remove extra water and sodium (salt) from your body, which decrease the amount of water in your blood. The main diuretic for the treatment of high blood pressure is thiazide. Diuretics are often used in combination with other medicines for high blood pressure, sometimes in one combined pill.
• Beta blockers to make your heart beat more slowly and with less force. This makes your heart pump less blood through your blood vessels. Beta blockers are usually only used as a backup option or if you have other conditions.

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