Hypertension is the term used to describe high blood pressure. Essential hypertension means that the cause of high blood pressure is not known.
Blood pressure measures the force against the walls of your arteries as your heart pumps blood through your body.
Blood pressure readings are usually given as two numbers -- for example, 120 over 80 (written as 120/80 mmHg). One or both of these numbers can be too high.
The top number is called the systolic blood pressure, and the bottom number is called the diastolic blood pressure.
If you have pre-hypertension, you are more likely to develop high blood pressure.
If you have heart or kidney problems, or if you had a stroke, your doctor may want your blood pressure to be even lower than that of people who do not have these conditions.
Many factors can affect blood pressure, including:
You are more likely to be told your blood pressure is too high as you get older. This is because your blood vessels become stiffer as you age. When that happens, your blood pressure goes up. High blood pressure increases your chance of having a stroke, heart attack, heart failure, kidney disease, and early death.
You have a higher risk of high blood pressure if you:
Most of the time, no cause is identified. This is called essential hypertension.
High blood pressure that is caused by another medical condition or medication is called secondary hypertension. See also: Hypertension
Most of the time, there are no symptoms. In most people, high blood pressure is found when they visit their health care provider and have it measured.
Because there are no symptoms, people can develop heart disease and kidney problems without knowing they have high blood pressure.
If you have a severe headache, nausea or vomiting, confusion, changes in vision, or nosebleeds you may have a severe and dangerous form of high blood pressure called malignant hypertension.
Your health care provider will check your blood pressure several times. It is normal for your blood pressure to be different at different times of the day.
Blood pressure readings that you take at home may be a better measure of your current blood pressure than those taken at your doctor's office. Make sure you get a good quality, well-fitting home device. It will probably have a cuff with a stethoscope or a digital readout. Practice with your health care provider or nurse to make sure you are taking your blood pressure correctly.
See also: Blood pressure monitors for home
Your doctor will perform a physical exam to look for signs of heart disease, damage to the eyes, and other changes in your body.
Tests may be done to look for:
The goal of treatment is to reduce blood pressure so that you have a lower risk of complications. You and your health care provider should set a blood pressure goal for you.
Your health care provider may also recommend that you exercise, lose weight, and follow a healthier diet. If you have pre-hypertension, your health care provider will recommend the same lifestyle changes to bring your blood pressure down to a normal range.
You can do many things to help control your blood pressure, including:
Your health care provider can help you find programs for losing weight, stopping smoking, and exercising. You can also get a referral from your doctor to a dietitian, who can help you plan a diet that is healthy for you.
Many different medicines can be used to treat high blood pressure. See: High blood pressure medicines.
Often, a single blood pressure drug may not be enough to control your blood pressure. You may need to take two or more drugs. It is very important that you take the medications you were prescribed. If you have side effects, your health care provider can substitute a different medication.
Most of the time, high blood pressure can be controlled with medicine and lifestyle changes.
If your blood pressure is not well controlled, you are at risk for:
If you have essential hypertension, you will have regular appointments with your doctor.
Even if you have not been diagnosed with high blood pressure, it is important to have your blood pressure checked during your yearly check-up, especially if someone in your family has or had high blood pressure.
Call your health care provider right away if home monitoring shows that your blood pressure is still high.
Adults over 18 should have their blood pressure checked regularly.
Lifestyle changes may help control your blood pressure.
Follow your health care provider's recommendations to treat your essential hypertension.
Hypertension - essential
Goldstein LB, Bushnell CD, Adams RJ, Appel LJ, Braun LT, Chaturvedi S, et al. Guidelines for the primary prevention of stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42:517-584.
Kaplan NM. Systemic Hypertension: Treatment. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 46.
Victor RG. Systemic hypertension: Mechanisms and diagnosis. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 45.
Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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