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High Blood Pressure(Blood Pressure, High; Essential Hypertension; Idiopathic Hypertension; Primary Hypertension)
Definition

High blood pressure is abnormally high blood pressure with no known cause. Blood pressure measurements are read as two numbers:

  • Systolic pressure: higher number, normal reading is 120 millimeters of mercury (mmHg) or less
  • Diastolic pressure: lower number, normal reading is 80 mmHg or less

High blood pressure is defined as systolic pressure greater than 140 mmHg and/or diastolic pressure greater than 90 mmHg. You are considered prehypertensive if your systolic blood pressure is between 120-139 mmHg, or your diastolic pressure is between 80- 89 mmHg. Your doctor will recommend monitoring and lifestyle changes.

High blood pressure puts stress on the heart, lungs, brain, kidneys, and blood vessels. Over time, this condition can damage these organs and tissues.

Organs Impacted by High Blood Pressure

High blood pressure and organs

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Causes

The cause of essential hypertension is not known.

Risk Factors

These factors increase your chance of developing high blood pressure. Tell your doctor if you have any of these risk factors:

  • Sex:
    • Male
    • Postmenopausal female
  • Race: Black
  • Age: middle-aged and older
  • Overweight
  • Heavy drinking of alcohol
  • Smoking
  • Use of oral contraceptives (birth control pills)
  • Sedentary lifestyle
  • Family history
  • Kidney disease
  • Diabetes
  • High-fat, high-salt diet
  • Stress
Symptoms

High blood pressure usually does not cause symptoms. But, the condition can still damage your organs and tissues.

Occasionally, if blood pressure reaches extreme levels, you may have the following:

  • Headache
  • Blurry or double vision
  • Abdominal pain
  • Chest pain
  • Shortness of breath
  • Dizziness
Diagnosis

High blood pressure is often diagnosed during a doctor's visit. Blood pressure is measured using an arm cuff and a special device. If your reading is high, you will come back for repeat checks. If you have three visits with readings over 140/90 mmHG, you will be diagnosed with high blood pressure.

Your doctor will order tests to make sure your high blood pressure is not caused by another condition. You will also be tested to see if the high blood pressure has caused any problems.

Tests include:

  • Blood tests
  • Urine tests
  • Chest x-rays —a test that uses radiation to take a picture of structures inside the body
  • Electrocardiogram (ECG, EKG) —a test that records the heart's activity by measuring electrical currents through the heart muscle
Treatment
Lifestyle Changes
  • Maintain a healthy weight .
  • Begin a safe exercise program with the advice of your doctor.
  • If you smoke, quit .
  • Eat a healthful diet , one that is low fat, low salt, and rich in fiber , fruits, and vegetables. Your doctor may recommend the DASH diet , which is designed to reduce blood pressure.
  • Drink alcohol in moderation (no more than two drinks per day for men, one drink per day for women).
  • Manage stress .
Medications

These include:

  • Diuretics
  • Beta blockers
  • Angiotensin converting enzyme inhibitors (ACE inhibitors)
  • Calcium channel blockers
  • Angiotensin receptor blockers
  • Aldosterone blockers
  • Alpha blockers
  • Alpha-beta blockers
  • Nervous system inhibitors
  • Vasodilators

Note: Untreated high blood pressure can lead to:

If you are diagnosed with high blood pressure, follow your doctor's instructions .

Prevention

To help reduce your risk of getting high blood pressure, take the following steps:

  • Eat a well-balanced diet. The DASH diet —rich in fruits, vegetables and low-fat dairy foods, and low in saturated fat, total fat, and cholesterol—may help keep your blood pressure in the healthy range.
  • Exercise regularly.
  • Maintain a healthy weight. (Your body mass index should be below 25.)
  • If you smoke, quit .
  • Drink alcohol in moderation. Moderate is two or fewer drinks per day for men and one or fewer drinks per day for women and older adults.

RESOURCES:

American Heart Association
http://www.americanheart.org

National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov

CANADIAN RESOURCES

Canadian Cardiovascular Society
http://www.ccs.ca

Heart and Stroke Foundation of Canada
http://www.heartandstroke.com

References:

Chobanian AV. Clinical practice. Isolated systolic hypertension in the elderly. N Engl J Med . 2007;357:789-796.

Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. The JNC 7 report. JAMA . 2003;289:2560-2572.

Conn HF, Rakel RE. Conn's Current Therapy 2001 . 53rd ed. Philadelphia, PA: WB Saunders Company; 2001.

High blood pressure. American Heart Association website. Available at: http://www.americanheart.org/hearthub/hc-high-blood-pressure.htm . Accessed July 6, 2008.

Hypertension diagnosis and treatment (guideline). Institute for Clinical Systems Improvement website. Available at: http://www.icsi.org/guidelines_and_more/guidelines__order_sets___protocols/cardiovascular/hypertension_4/hypertension_diagnosis_and_treatment__11.html . Published 2010. Accessed May 10, 2012.

Hypertension: making the diagnosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated April 30, 2012. Accessed May 10, 2012.

Schroeder K. The DASH diet. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated May 2008. Accessed July 6, 2008.

Smith N. How to measure blood pressure (in a clinical setting). EBSCO PERC website. Available at: http://www.ebscohost.com/healthLibrary . Updated October 2007. Accessed July 6, 2008.

Smoots E. Do you have prehypertension? EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary . Updated March 2008. Accessed July 6, 2008.

What is high blood pressure? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/Hbp/HBP_WhatIs.html . Updated April 2008. Accessed July 6, 2008.

9/2/2009 DynaMed Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Forman J, Stampfer M, Curhan G. Diet and lifestyle risk factors associated with incident hypertension in women. JAMA . 2009;302(4):401-411.



Last reviewed September 2013 by Michael J. Fucci, DO

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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