- First, let’s define high blood pressure
- How your blood pressure and circulatory system work
- The damage starts in your arteries and heart
- High blood pressure is a “silent killer”
- How to Prevent High Blood Pressure
- 6 Facts About High Blood Pressure
- Blood pressure affects your health at every level
- 1. Blood pressure is linked to other medical issues.
- 2. Lowering systolic blood pressure more may cut health risks.
- 3. You shouldn’t ignore white coat hypertension.
- People with high blood pressure and those at a high risk for developing hypertension, including adults over 50 and black men and women, should have no more than 1,500 milligrams of sodium daily (less than 3/4 tsp.) of salt.
- 5. Good sleep can prevent and manage high blood pressure.
- 6. Excessive salt raises blood pressure.
- Common causes of high blood pressure spikes
- High Blood Pressure (Hypertension)
- Causes – High blood pressure (hypertension)
- Known causes of high blood pressure
- What causes high blood pressure and how to know if you have hypertension
- What causes high blood pressure
- How to know if you have high blood pressure
- Related stories about heart health:
- Nine ways to raise blood pressure
- 10 Factors That Can Affect Blood Pressure Readings
Hypertension and Nutrition
- How does nutrition affect blood pressure?
- What should I eat to control high blood pressure?
- What are some of the foods I should eat?
- What foods should I eat less of?
- What’s the difference between sodium and salt?
- How does salt increase blood pressure?
- How much sodium is too much?
- How can I reduce my sodium intake?
- What foods are high in sodium?
- What else should I do to change my diet?
- Comparison of Sodium in Foods
- What to know about high blood pressure
First, let’s define high blood pressure
High blood pressure (HBP or hypertension) is when your blood pressure, the force of your blood pushing against the walls of your blood vessels, is consistently too high.
How your blood pressure and circulatory system work
In order to survive and function properly, your tissues and organs need the oxygenated blood that your circulatory system carries throughout the body. When the heart beats, it creates pressure that pushes blood through a network of tube-shaped blood vessels, which include arteries, veins and capillaries. This pressure — blood pressure — is the result of two forces: The first force (systolic pressure) occurs as blood pumps out of the heart and into the arteries that are part of the circulatory system. The second force (diastolic pressure) is created as the heart rests between heart beats. (These two forces are each represented by numbers in a blood pressure reading.)
See how high blood pressure can damage your arteries and heart.
The damage starts in your arteries and heart
The primary way that high blood pressure causes harm is by increasing the workload of the heart and blood vessels — making them work harder and less efficiently.
Over time, the force and friction of high blood pressure damages the delicate tissues inside the arteries. In turn, LDL (bad) cholesterol forms plaque along tiny tears in the artery walls, signifying the start of atherosclerosis.
The more the plaque and damage increases, the narrower (smaller) the insides of the arteries become — raising blood pressure and starting a vicious circle that further harms your arteries, heart and the rest of your body. This can ultimately lead to other conditions ranging from arrhythmia to heart attack and stroke.
- See how high blood pressure can damage the inside of your arteries.
- See how atherosclerosis takes place.
- See how your heart can become enlarged.
- See an infographic of the consequences of high blood pressure. (PDF)
High blood pressure is a “silent killer”
You may not feel that anything is wrong, but high blood pressure could be quietly causing damage that can threaten your health. The best prevention is knowing your numbers and making changes that matter in order to prevent and manage high blood pressure.
- Get the high blood pressure fact sheet: English (PDF) | Spanish (PDF)
- Check out all the high blood pressure tools and resources.
How to Prevent High Blood Pressure
About 1 in 3 adults in the U.S. has high blood pressure, or hypertension, but many don’t realize it. High blood pressure usually has no warning signs, yet it can lead to life-threatening conditions like heart attack or stroke. The good news is that you can often prevent or treat high blood pressure. Early diagnosis and simple, healthy changes can keep high blood pressure from seriously damaging your health.
Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood. This is called systolic pressure. When your heart is at rest, between beats, your blood pressure falls. This is called diastolic pressure.
Your blood pressure reading uses these two numbers. Usually the systolic number comes before or above the diastolic number.
How do I know if my blood pressure is high?
High blood pressure usually has no symptoms. So the only way to find out if you have high blood pressure is to get regular blood pressure checks from your health care provider. Your provider will use a gauge, a stethoscope or electronic sensor, and a blood pressure cuff. For most adults, blood pressure readings will be in one of four categories:
Normal blood pressure means
- Your systolic pressure is less than 120 AND
- Your diastolic pressure is less than 80
- Your systolic pressure is between 120-139 OR
- Your diastolic pressure is between 80-89
Stage 1 high blood pressure means
- Your systolic pressure is between 140-159 OR
- Your diastolic pressure is between 90-99
Stage 2 high blood pressure means
- Your systolic pressure is 160 or higher OR
- Your diastolic pressure is 100 or higher
For children and teens, the health care provider compares the blood pressure reading to what is normal for other kids who are the same age, height, and gender.
People with diabetes or chronic kidney disease should keep their blood pressure below 130/80.
Why do I need to worry about prehypertension and high blood pressure?
Prehypertension means you’re likely to end up with high blood pressure, unless you take steps to prevent it.
When your blood pressure stays high over time, it causes the heart to pump harder and work overtime, possibly leading to serious health problems such as heart attack, stroke, heart failure, and kidney failure.
What are the different types of high blood pressure?
There are two main types of high blood pressure: primary and secondary high blood pressure.
- Primary, or essential, high blood pressure is the most common type of high blood pressure. For most people who get this kind of blood pressure, it develops over time as you get older.
- Secondary high blood pressure is caused by another medical condition or use of certain medicines. It usually gets better after you treat the cause or stop taking the medicines that are causing it.
Who is at risk for high blood pressure?
Anyone can develop high blood pressure, but there are certain factors that can increase your risk:
- Age – Blood pressure tends to rise with age
- Race/Ethnicity – High blood pressure is more common in African American adults
- Weight – People who are overweight or have obesity are more likely to develop prehypertension or high blood pressure
- Gender – Before age 55, men are more likely than women to develop high blood pressure. After age 55, women are more likely than men to develop it.
- Lifestyle – Certain lifestyle habits can raise your risk for high blood pressure, such as eating too much sodium or not enough potassium, lack of exercise, drinking too much alcohol, and smoking.
- Family history – A family history of high blood pressure raises the risk of developing prehypertension or high blood pressure
How can I prevent high blood pressure?
You can help prevent high blood pressure by having a healthy lifestyle. This means
- Eating a healthy diet. To help manage your blood pressure, you should limit the amount of sodium (salt) that you eat, and increase the amount of potassium in your diet. It is also important to eat foods that are lower in fat, as well as plenty of fruits, vegetables, and whole grains. The DASH diet is an example of an eating plan that can help you to lower your blood pressure.
- Getting regular exercise. Exercise can help you maintain a healthy weight and lower your blood pressure. You should try to get moderate-intensity aerobic exercise at least 2 and a half hours per week, or vigorous-intensity aerobic exercise for 1 hour and 15 minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats harder and you use more oxygen than usual.
- Being at a healthy weight. Being overweight or having obesity increases your risk for high blood pressure. Maintaining a healthy weight can help you control high blood pressure and reduce your risk for other health problems.
- Limiting alcohol. Drinking too much alcohol can raise your blood pressure. It also adds extra calories, which may cause weight gain. Men should have no more than two drinks per day, and women only one.
- Not smoking. Cigarette smoking raises your blood pressure and puts you at higher risk for heart attack and stroke. If you do not smoke, do not start. If you do smoke, talk to your health care provider for help in finding the best way for you to quit.
- Managing stress. Learning how to relax and manage stress can improve your emotional and physical health and lower high blood pressure. Stress management techniques include exercising, listening to music, focusing on something calm or peaceful, and meditating.
If you already have high blood pressure, it is important to prevent it from getting worse or causing complications. You should get regular medical care and follow your prescribed treatment plan. Your plan will include healthy lifestyle habit recommendations and possibly medicines.
NIH: National Heart, Lung, and Blood Institute
Essential hypertension is also greatly influenced by diet and lifestyle. The link between salt and high blood pressure is especially compelling. People living on the northern islands of Japan eat more salt per capita than anyone else in the world and have the highest incidence of essential hypertension. By contrast, people who add no salt to their food show virtually no traces of essential hypertension.
Most people with high blood pressure are “salt sensitive,” meaning that anything more than the minimal bodily need for salt is too much for them and increases their blood pressure. Other factors that can raise the risk of having essential hypertension include obesity; diabetes; stress; insufficient intake of potassium, calcium, and magnesium; lack of physical activity; and chronic alcohol consumption.
When a direct cause for high blood pressure can be identified, the condition is described as secondary hypertension. Among the known causes of secondary hypertension, kidney disease ranks highest. Hypertension can also be triggered by tumors or other abnormalities that cause the adrenal glands (small glands that sit atop the kidneys) to secrete excess amounts of the hormones that elevate blood pressure. Birth control pills — specifically those containing estrogen — and pregnancy can boost blood pressure, as can medications that constrict blood vessels.
6 Facts About High Blood Pressure
Blood pressure affects your health at every level
There’s a good reason why every doctor’s appointment starts with a blood pressure check. While one in three American adults has high blood pressure, about 20 percent of people are unaware that they have it because it is largely symptomless.
In fact, most people find out they have high blood pressure during a routine office visit.
Blood pressure is the force of blood pushing against the walls of arteries as the heart pumps blood. High blood pressure, also referred to as hypertension, is when that force is too high and begins harming the body. If left untreated, it willl eventually cause damage to the heart and blood vessels.
Your blood pressure is measured in two numbers: The top systolic blood pressure measures the force pushing against artery walls when the heart is contracting. The bottom diastolic blood pressure measures pressure in the arteries when the heart is resting between beats.
Normal blood pressure levels are 120 mmHg/80 mmHg or lower. At risk levels are 120-139 mmHg/80-89 mmHg. Readings of 140 mmHg/90 mmHg or higher are defined as high blood pressure.
Here are six other things you should know about high blood pressure.
High blood pressure can be the first indication of a serious underlying condition. When a patient comes in with high blood pressure, doctors will check their urine and kidney function; do an electrocardiogram to check the size of the heart; and look for lung changes.
Stress on the blood vessels makes people with hypertension more prone to heart disease, peripheral vascular disease, heart attack, stroke, kidney disease and aneurysms. Correspondingly, chronic conditions such as diabetes, kidney disease, sleep apnea and high cholesterol increase the risk for developing high blood pressure.
In some women, pregnancy can contribute to high blood pressure, leading to preeclampsia. Postpartum blood pressure typically goes back to normal levels within six weeks. However, some women who have high blood pressure during more than one pregnancy may be more likely to develop high blood pressure and other cardiovascular diseases as they age.
Some of these medical issues can also cause spikes in high blood pressure (see below).
2. Lowering systolic blood pressure more may cut health risks.
A major study found that lowering systolic blood pressure to well below the commonly recommended level also greatly lowered the number of cardiovascular events and deaths among people at least 50 years old with high blood pressure.
When study participants achieved a systolic blood pressure target of 120 mmHg — compared to the higher target of 140 mmHg recommended for most people, and 150 for people over 60 — issues such as heart attack, stroke and heart failure were reduced by almost one-third, and the risk of death by almost one-fourth.
“That’s important information, because more lives may be saved and more deaths may be prevented if we maintain lower blood pressure in certain patients,” says Lynne Braun, NP, PhD, a nurse practitioner at the Rush Heart Center for Women.
Braun cautions, however, that your personal blood pressure target depends on a variety of things, including your current blood pressure, lifestyle, risk factors, other medications you are taking and your age. “Every person has to be evaluated as an individual,” she says. “Realistically, we can’t get everybody down to 120, and trying to do so may create unintended problems.”
It can be dangerous, for instance, to keep an older person on medications that have unsafe side effects, such as diuretics (water pills), which can cause dehydration and dizziness in older adults.
And there can be other issues involved with taking multiple medications, such as cost and compliance.
Bottom line: If you have high blood pressure, talk to your doctor about what your target should be and how best to achieve it.
3. You shouldn’t ignore white coat hypertension.
Some people experience white coat hypertension, when blood pressure is elevated in the doctor’s office but not in other settings. These patients need to monitor their blood pressure at home or wear an ambulatory blood pressure monitor that takes your blood pressure every 30 minutes for 24 hours.
While white coat hypertension was formerly considered simple nervousness, recent research suggests otherwise.
A study published in the journal Hypertension found that people with white coat hypertension are at a significantly greater risk for developing sustained high blood pressure than people who have normal blood pressure. One possible explanation is that people with white coat hypertension have a harder time managing stress and anxiety.
People with high blood pressure and those at a high risk for developing hypertension, including adults over 50 and black men and women, should have no more than 1,500 milligrams of sodium daily (less than 3/4 tsp.) of salt.
Stress and hypertension have often been linked, but researchers are still looking into a direct relationship between the two. Still, the best advice to hypertensive patients: Try to relax.
When you are stressed, your body sends stress hormones — adrenaline and cortisol — into the bloodstream. These hormones create a temporary spike in blood pressure, causing your heart to beat faster and blood vessels to narrow. When the stressful situation is over, blood pressure goes back to its normal level.
Chronic stress, however, may cause your body to stay in this highly-charged state longer than natural.
While stress itself may or may not affect blood pressure, how you cope with stress does. For instance, overeating, smoking and drinking alcohol in response to stressful situations are direct causes of sustained high blood pressure. On the flip side, healthier coping mechanisms like exercising, practicing yoga and meditating can all help lower blood pressure.
5. Good sleep can prevent and manage high blood pressure.
Most people experience a dip in blood pressure during the deepest stage of sleep (also known as slow wave sleep), which is the body’s normal and healthy reaction to sleep. Not having that nighttime dip is a risk factor for heart disease and may increase daytime blood pressure.
Typically people spend 90 minutes to two hours in slow wave sleep per night. A recent study published in Hypertension found that men who got less slow wave sleep each night were a higher risk for hypertension than men who got more deep sleep.
While sleep disorders, like sleep apnea, and age can both affect the amount of deep sleep you get, there are steps you can take to ensure a good night’s sleep. Getting seven to eight hours of sleep a night, maintaining a consistent sleep schedule and being more active during the day can help improve the quality of your sleep.
6. Excessive salt raises blood pressure.
Too much sodium can cause water retention that puts increased pressure on your heart and blood vessels. People with high blood pressure and those at a high risk for developing hypertension, including adults over 50 and black men and women, should have no more than 1,500 milligrams (mg) of sodium daily (less than 3/4 teaspoon) of salt.
Even people with normal levels should eat salt in moderation. Stick to no more than 2,300 mg of sodium (about one teaspoon of salt), per day.
Most dietary sodium comes from processed foods. Rules of thumb are to choose foods with five percent or less of the daily value of sodium per serving and opt for fresh poultry, fish and lean meats, rather than canned, smoked or processed. Similarly, fresh or frozen vegetables are better than canned.
A study published in the New England Journal of Medicine found that if people cut just 1/2 teaspoon of salt per day, it could help lower the number of new cases of heart disease per year by up to 120,000.
Further, potassium — found in foods like sweet potatoes, spinach, bananas, oranges, low-fat milk and halibut — can counterbalance the pressure-increasing effects of sodium by helping to rid the body of excess sodium.
Common causes of high blood pressure spikes
Some people with high blood pressure will experience sharp rises in their blood pressure. These spikes, which typically last only a short period of time, are also known as sudden high blood pressure. These are some possible causes:
- Certain medications (such as nonsteroidal anti-inflammatory drugs) or combinations of medications
- Chronic kidney disease
- Cocaine use
- Collagen vascular disorders
- Overactive adrenal glands
- Pregnancy-related high blood pressure
- Stress or anxiety
- Thyroid issues (such as overactive or underactive thyroid gland)
If you have high blood pressure and experience the sudden onset of any of the following symptoms — which may signal a blood pressure spike or other serious condition — seek medical attention right away:
- Blurred vision
- Chest pain (angina)
- Nausea or vomiting
- Shortness of breath (dyspnea)
- Weakness or numbness in your arms, legs, face (this can be a sign of stroke)
- Anxiety, fatigue, confusion or restlessness
High Blood Pressure (Hypertension)
Hypertension, the medical term for high blood pressure, is known as “the silent killer.” More than 80 million Americans (33%) have high blood pressure, and as many as 16 million of them do not even know they have the condition. If left untreated, high blood pressure greatly increases your risk for heart attack and stroke. Hypertension is projected to increase about 8 percent between 2013 and 2030.
Your heart pumps blood through a network of arteries, veins, and capillaries. The moving blood pushes against the arterial walls, and this force is measured as blood pressure.
High blood pressure results from the tightening of very small arteries called arterioles. Arterioles regulate the blood flow through your body. As these arterioles tighten (or constrict), your heart has to work harder to pump blood through the smaller space, and the pressure inside the vessels grows.
High blood pressure can affect your health in four main ways:
- Hardening of the arteries. Pressure inside your arteries can cause the muscles that line the walls of the arteries to thicken, thus narrowing the passage. A heart attack or stroke can occur if a blood clot blocks blood flow to your heart or brain.
- Enlarged heart. High blood pressure increases the amount of work for your heart. Like any heavily exercised muscle in your body, your heart grows bigger (enlarges) to handle the extra workload. The bigger your heart is, the more it demands oxygen-rich blood but the less able it is to maintain proper blood flow. As a result, you feel weak and tired and are not able to exercise or perform physical activities. Without treatment, your heart failure will only get worse.
- Kidney damage. Prolonged high blood pressure can damage your kidneys if their blood supply is affected.
- Eye damage. If you have diabetes, high blood pressure can cause the tiny capillaries in the retina of your eye to bleed. This condition, called retinopathy, can lead to blindness.
About 90% to 95% of all high blood pressure cases are what is called primary, or essential hypertension. That means the real cause of the high blood pressure is not known, but a number of factors contribute. You are at increased risk if you –
- Have a family history of high blood pressure.
- Are African American. African Americans develop high blood pressure more often than whites, and it tends to happen earlier in life and be more severe.
- Are a man, but women are at an increased risk after age 55.
- Are older than 60. Blood vessels become more brittle with age and are not as flexible.
- Face high levels of stress. In some studies, stress, anger, hostility, and other personality traits have been shown to lead to high blood pressure.
- Are overweight or obese.
- Use tobacco products. Smoking damages your blood vessels.
- Use oral contraceptives. Women who smoke and use oral contraceptives greatly increase their risk.
- Eat a diet high in saturated fat.
- Eat a diet high in salt (sodium).
- Drink more than a moderate amount of alcohol. Experts say that moderate intake is an average of one to two drinks per day for men and one drink per day for women. One drink is defined as 1½ fluid ounces (fl oz) of 80-proof spirits, 1 fl oz of 100-proof spirits, 4 fl oz of wine, or 12 fl oz of beer.
- Are physically inactive.
- Have diabetes.
Researchers have also found a gene that appears to be linked to high blood pressure. If you have the gene, you are more likely to develop high blood pressure, so you should monitor your blood pressure and eliminate as many of the other risk factors as you can.
The remaining patients with high blood pressure have what is called secondary hypertension which means the high blood pressure is the result of another condition or illness. Many cases of secondary hypertension are caused by kidney disorders. Other conditions that can cause secondary hypertension are
- Problems with the parathyroid gland.
- Acromegaly, which is a condition where the pituitary gland makes too much growth hormone.
- Tumors in the adrenal or pituitary glands.
- Reactions to medicines for other medical problems.
Most people who have high blood pressure do not have symptoms. In some cases, people with high blood pressure may have a pounding feeling in their head or chest, a feeling of lightheadedness or dizziness, or other signs. Without symptoms, people with high blood pressure may go years without knowing they have the condition.
How is high blood pressure diagnosed?
A visit to your doctor is the only way to find out if you have high blood pressure. You should have a general medical check-up that includes a review of your family’s medical history. Your doctor will take several blood pressure readings using a device called a sphygmomanometer and run a few routine tests.
Your doctor may also use a device called an ophthalmoscope to look at the blood vessels in your eyes. Doctors can see if these vessels have thickened, narrowed, or burst, which may be a sign of high blood pressure. Your doctor will also use a stethoscope to listen to your heart and the sound of blood flowing through your arteries. In some cases, a chest x-ray and electrocardiogram may be needed.
Blood pressure readings
Blood pressure readings measure the two parts of blood pressure: systolic and diastolic pressures. Systolic pressure is the force of blood flow through an artery when the heart beats. Diastolic pressure is the force of blood flow within blood vessels when the heart rests between beats.
A blood pressure reading measures both the systolic and diastolic forces, with the systolic pressure listed first. The numbers show your pressure in units of millimeters of mercury (mm Hg)—how high the pressure inside your arteries would be able to raise a column of mercury. For example, a reading of 120/80 mm Hg means a systolic pressure of 120 mm Hg and diastolic pressure of 80 mm Hg.
Most doctors do not make a final diagnosis of high blood pressure until they measure your blood pressure several times (at least 2 blood pressure readings on 3 different days). Some doctors ask their patients to wear a portable machine that measures their blood pressure over the course of several days. This machine may help the doctor find out whether a patient has true high blood pressure or what is known as “white-coat hypertension.” White-coat hypertension is a condition in which a patient’s blood pressure rises during a visit to a doctor when anxiety and stress probably play a role.
How often should blood pressure be checked?
Adults should have their blood pressure checked at least once a year. Many grocery or drug stores have blood pressure machines that you can use for free any time you visit the stores. Keep in mind, though, that these machines may not give you a correct reading.
Blood pressure monitors for use at home can be bought at drug stores, department stores, and other places. Again, these monitors may not always give you a correct reading. You should always compare your machine’s reading with a reading from your doctor’s machine to make sure they are the same. Remember that any measurement above normal should prompt a visit to the doctor, who can then talk with you about the best course of action.
How high is high?
According to guidelines from the American Heart Association (AHA) and the American College of Cardiology (ACC), a reading below 120/80 mm Hg is classified as normal blood pressure. Those with a blood pressure reading anywhere from 120/80 up to 129/80 are classified within a category called elevated blood pressure. Hypertension is defined as a reading of 130/80 or higher.
The classification chart is based on adults, aged 18 and older, who are not taking high blood pressure medicines and who are not acutely ill. If systolic and diastolic measurements fall into different categories, the higher category should be used to classify the person’s blood pressure status.
The first course of action involves lifestyle changes, especially for people with elevated blood pressure.
- Start eating a low-fat and low-salt diet.
- Lose weight, if you need to.
- Begin a regular exercise program.
- Learn to manage stress.
- If you smoke, quit.
- Drink alcohol in moderation, if at all. Remember that moderate intake is an average of one or two drinks per day for men and one drink per day for women.
- Control obstructive sleep apnea (OSA), if you have it. Many patients who get their OSA under control see improvements in their blood pressure.
Medicines are available if these changes do not help control your blood pressure within 3 to 6 months. Diuretics help rid your body of water and sodium. ACE inhibitors block the enzyme that raises your blood pressure. Other types of medicines— beta blockers, calcium channel blockers, and other vasodilators—work in different ways, but their overall effect is to help relax and widen your blood vessels and reduce the pressure inside the vessel.
Tags: blood pressure, diastolic pressure, essential hypertension, HBP, HTN, hypertension, primary hypertension, systolic blood pressure
High blood pressure (hypertension)
High blood pressure (hypertension)
Known causes of high blood pressure
In about 1 in 20 cases, high blood pressure happens as the result of an underlying health condition or taking a certain medicine.
Health conditions that can cause high blood pressure include:
- kidney disease
- long-term kidney infections
- obstructive sleep apnoea – where the walls of the throat relax and narrow during sleep, interrupting normal breathing
- glomerulonephritis – damage to the tiny filters inside the kidneys
- narrowing of the arteries supplying the kidneys
- hormone problems – such as an underactive thyroid, an overactive thyroid, Cushing’s syndrome, acromegaly, increased levels of the hormone aldosterone (hyperaldosteronism), and phaeochromocytoma
- lupus – a condition in which the immune system attacks parts of the body, such as the skin, joints and organs
- scleroderma – a condition that causes thickened skin, and sometimes problems with organs and blood vessels
Medicines that can increase your blood pressure include:
- the contraceptive pill
- non-steroidal anti-inflammatory drugs (NSAIDs) – such as ibuprofen and naproxen
- some pharmacy cough and cold remedies
- some herbal remedies – particularly those containing liquorice
- some recreational drugs – such as cocaine and amphetamines
- some selective serotonin-noradrenaline reuptake inhibitor (SSNRI) antidepressants – such as venlafaxine
In these cases, your blood pressure may return to normal once you stop taking the medicine or drug.
What causes high blood pressure and how to know if you have hypertension
- The main causes of high blood pressure are lack of exercise, a high-sodium diet, smoking cigarettes, and obesity.
- A strong family history can increase the risk of high blood pressure, and people over 60 years old, African-Americans, and men are also more likely to have high blood pressure.
- This article was reviewed by Hina W. Chaudhry, MD, director of cardiovascular regenerative medicine at Mount Sinai School of Medicine.
- Visit Insider’s homepage for more.
High blood pressure, or hypertension, is a common condition. According to the Centers for Disease Control and Prevention, about one in three American adults have high blood pressure, and more than half don’t have it under control.
There are two types of hypertension — primary and secondary — and they each have different causes. Here’s what you need to know about the biggest risk factors.
What causes high blood pressure
High blood pressure, or hypertension, occurs when the force of the blood against your artery walls is too high, and can potentially lead to heart disease, heart attack, or stroke.
Primary hypertension tends to develop as you age and there is no one identifiable cause, says Sanjiv Patel, MD, a cardiologist with MemorialCare Heart & Vascular Institute at Orange Coast Medical Center.
Secondary hypertension, on the other hand, is caused by other factors, such as adrenal gland tumors or kidney problems, like renal artery stenosis — a condition that narrows arteries resulting in less blood flow to the kidneys.
Because secondary hypertension is the result of an underlying cause, it can be treated by addressing that cause, Patel says, while primary hypertension has no cure — but can be controlled with lifestyle changes or medication.
Lifestyle factors often cause primary hypertension, Patel says. Some of the biggest risk factors include:
- Smoking cigarettes. Smoking can cause your blood pressure to temporarily increase and damage your arteries, increasing your risk of heart disease.
- Lack of exercise. Regular physical activity strengthens your heart, helping it pump blood more effectively. Less physical activity can contribute to a higher heart rate, putting more strain on your arteries and increasing blood pressure.
- Obesity. Excess weight puts a strain on your circulatory system, and research shows it can contribute to hypertension.
- Diet — particularly consuming too much sodium. Salt causes your body to retain fluid, which can increase blood pressure. The American Heart Association recommends consuming no more than 2,300 milligrams of sodium per day.
- Stress. Stress can cause your blood pressure to temporarily spike, and can also contribute to other behaviors that increase blood pressure, like poor diet and tobacco use.
How to know if you have high blood pressure
Hypertension can cause headaches, blurred vision and shortness of breath, but you may not experience many symptoms until the condition is very severe, Patel says.
However, certain people have a higher risk of hypertension. For example, older people — especially over the age of 60 — are more likely to have high blood pressure because blood vessels gradually lose flexibility as we age.
Here are some other physical and hereditary risk factors:
- Family history. If you have a close family member who has high blood pressure before the age of 60, you are two times more likely to develop it. This doesn’t necessarily mean you will have high blood pressure, but it does increase your chances, particularly if combined with other risk factors like lack of physical activity and a poor diet, Patel says.
- Gender. Men younger than 65 years old have consistently higher levels of hypertension when compared with women of the same age group, according to several studies. Research has also shown that even in their twenties, 27% of men had high blood pressure, while only 12% of women did.
Regular blood pressure checks at your doctor’s office or at home with a home blood pressure monitor can be crucial to identifying hypertension. If you think you’re at risk of hypertension based on these factors, you should contact your doctor to discuss treatment options.
Related stories about heart health:
- What foods lower blood pressure and make up the DASH diet
- How to lower cholesterol with the right diet and exercise regimens
- A cardiologist is begging patients to avoid the high-fat keto diet because their cholesterol levels could skyrocket
- An avocado a day could lower your ‘bad’ cholesterol levels and reduce your risk of heart disease
- 7 of the most dangerous things that put you at risk of a heart attack
- A cardiologist revealed the truth behind red wine’s health benefits
Nine ways to raise blood pressure
Most people with low blood pressure do not need medications or other medical interventions to raise blood pressure. There are plenty of natural ways and lifestyle changes to raise low blood pressure, including the following lifestyle changes.
1. Eat more salt
Contrary to popular advice, low-sodium diets are not good for everyone with blood pressure problems.
People with low blood pressure should consider increasing their sodium intake moderately to help raise blood pressure.
2. Avoid alcoholic beverages
Alcohol can lower blood pressure further, so people with low blood pressure should avoid drinking excessive amounts of alcohol.
3. Discuss medications with a doctor
Low blood pressure can be a side effect of a variety of medications.
If symptoms of low blood pressure begin after starting a medication, a person should discuss the symptoms with their doctor.
4. Cross legs while sitting
Crossing the legs while sitting has been shown to increase blood pressure. For people with high blood pressure, this can be a problem.
For people with low blood pressure symptoms, crossed legs may help increase blood pressure with minimal effort.
5. Drink water
Drinking more water can help increase blood volume, which can aleviate one of the potential causes of low blood pressure. It can also help avoid dehydration.
6. Eat small meals frequently
Eating smaller, more frequent meals throughout the day may help with low blood pressure.
This is because the smaller meals help prevent a drop in a blood pressure associated with eating larger, heavier meals.
7. Wear compression stockings
Compression stockings help reduce the amount of blood that gets caught in the lower legs and feet, so shifting it elsewhere.
Compression stockings are also used to help relieve pressure and pain associated with varicose veins. They are available to purchase online.
8. Avoid sudden position changes
Sitting up or standing up rapidly can cause a feeling of lightheadedness, dizziness, or potential fainting in people with low blood pressure.
In these cases, the heart has not pumped enough blood through the body quickly enough to account for the sudden change in position or elevation.
9. Be aware of symptoms
Low blood pressure is only considered a problem if symptoms exist. If there are no symptoms present, low blood pressure should be taken as a sign of good health.
It is important for a person to know the symptoms and what to look out for if their low blood pressure starts to cause problems.
10 Factors That Can Affect Blood Pressure Readings
Have you ever visited the doctor’s office and discovered your blood pressure was higher than you expected? Most people do not realize their blood pressure is constantly changing minute by minute in response to mood, activity, body position, etc. In fact, simple changes can cause blood pressure to fluctuate between 5 and 40 mmHg. Here is a list of 10 factors that can temporarily cause significant deviations in your blood pressure measurements.
- Blood Pressure Cuff is too Small1,3,4 – It is extremely important to make sure the proper size blood pressure cuff is used on your upper arm when taking a measurement. In fact, most blood pressure measurement errors occur by not taking the time to determine if the patient’s arm circumference falls within the Range indicators on the cuff. Studies have shown that using too small of a blood pressure cuff can cause a patient’s systolic blood pressure measurement to increase 10 to 40 mmHg.
- Blood Pressure Cuff Used Over Clothing1,3,4 – When having your blood pressure measured, the cuff should always be placed directly on your arm. Studies have shown that clothing can impact a systolic blood pressure from 10 to 50 mmHg.
- Not Resting 3-5 minutes3,4- To obtain an accurate blood pressure measurement, it is important that you relax and rest quietly in a comfortable chair for 3 to 5 minutes before a reading is taken. Any activities such as exercise or eating can affect your systolic blood pressure measurement 10 to 20 mmHg.
- Arm/Back/Feet Unsupported1,3,4 – When having your blood pressure measured, you should always be seated in a comfortable chair, legs uncrossed, with your back and arm supported. If your back is not supported, your diastolic blood pressure measurement may be increased by 6 mmHg. Crossing your legs has shown to raise your systolic blood pressure by 2 to 8 mmHg. The positioning of your upper arm below your heart level will also result in higher measurements, whereas positioning your upper arm above your heart level will give you lower measurements. These differences can increase/decrease your systolic blood pressure 2mmHg for every inch above/below your heart level.
- Emotional State5,6- Stress or anxiety can cause large increases in blood pressure. If you are having your blood pressure taken while thinking about something that causes you to tense up or become stressed, your blood pressure levels could significantly increase.
- Talking1,2,3,4 – If you are talking to the nurse/doctor while having your blood pressure taken, studies have shown that your systolic blood pressure measurement may increase 10 to 15mmHg.
- Smoking1,5,6- Tobacco products (cigarettes, cigars, smokeless tobacco) all contain nicotine which will temporarily increase your blood pressure, so refrain from smoking at least 30 minutes before having a blood pressure measurement taken.
- Alcohol/Caffeine4,5,6 – Alcohol and caffeine (sodas, coffee, tea, etc) consumption causes blood pressure levels to spike so stay away from alcohol/caffeine at least 30 minutes before having a blood pressure measurement taken.
- Temperature4,5 – Blood pressure tends to increase when you are cold. Therefore, if you are at the doctor’s office and the room temperature is “chilly” to you, be aware that your blood pressure readings may be higher than expected.
- Full bladder1,3,4 – Your blood pressure is lower when your bladder is empty. As your bladder gradually fills, your blood pressure increases. Studies have shown that your systolic blood pressure measurements could increase 10 to 15mmHg when you have a full bladder.
From the list above, you can see that small changes in your body, environment, and activities all have a significant impact on your blood pressure measurements. Since there are several factors that influence blood pressure, it is important that medical professionals follow the AHA guidelines for taking blood pressure measurements to avoid misdiagnosis of hypertension and inappropriate prescription of anti-hypertension medications.
Like what you’ve read?
Subscribe today to get the latest insights from the BP Measurement Experts.
Hypertension and Nutrition
Blood pressure is the force of blood pushing against blood vessel walls. The heart pumps blood into the arteries (blood vessels) which carry the blood throughout the body. High blood pressure, also called hypertension, means the pressure in your arteries is above the normal range. In most cases, no one knows what causes high blood pressure. What you eat can affect your blood pressure.
How does nutrition affect blood pressure?
- Certain foods can increase blood pressure.
- Certain foods can lower blood pressure.
- Gaining weight can increase blood pressure.
- Losing weight can reduce blood pressure.
What should I eat to control high blood pressure?
- Eat foods lower in fat, salt, and calories.
- Use spices and herbs, vinegar, lemon or fruit juices instead of salt to flavor foods.
- Use less oil, butter, margarine, shortening, and salad dressings.
What are some of the foods I should eat?
- Skim or 1% milk, yogurt, Greek yogurt (calcium-rich foods can lower blood pressure).
- Lean meat.
- Skinless turkey and chicken.
- Low-salt, ready-to-eat cereals.
- Cooked hot cereal (not instant).
- Low-fat and low-salt cheeses.
- Fruits (fresh, frozen, or canned without added salt).
- Vegetables (fresh, frozen or canned, no added salt).
- Richly colored green, orange, and red items are high in potassium and minerals that help lower blood pressure.
- The goal is 5-9 servings of fruits and vegetables per day.
- Plain rice, pasta, and potatoes.
- Breads (English muffins, bagels, rolls, and tortillas).
- Lower salt “prepared” convenience food.
Unsalted seeds (pumpkin, squash, sunflower) and unsalted nuts are mineral-rich foods that lower blood pressure.
What foods should I eat less of?
- Butter and margarine.
- Regular salad dressings.
- Fatty meats.
- Whole milk dairy products.
- Fried foods.
- Salted snacks.
- Canned soups.
- Fast foods.
- Deli meats.
What’s the difference between sodium and salt?
Salt is mostly sodium, a mineral that occurs naturally in foods. Sodium is the substance that may cause your blood pressure to increase. Other forms of sodium are also present in food. MSG (monosodium glutamate) is another example of a sodium added to food (common in Chinese food).
How does salt increase blood pressure?
When you eat too much salt, which contains sodium, your body holds extra water to “wash” the salt from your body. In some people, this may cause blood pressure to rise. The added water puts stress on your heart and blood vessels.
How much sodium is too much?
The American Heart Association recommends limiting daily sodium intake no more than 1,500 milligrams. (A teaspoon of salt has about 2,400 milligrams of sodium.) Most people greatly exceed these sodium guidelines.
How can I reduce my sodium intake?
- Don’t use table salt.
- Read nutrition labels and choose foods lower in sodium.
- Choose foods marked “sodium-free,” “low sodium,” and “unsalted.”
- Use salt substitutes (ask your healthcare provider first).
- Don’t use lite salt as a substitute.
- Read content labels. (Contents are listed in order of greatest amount.)
- Purchase sodium-free herbs and seasoning mixes like Mrs. Dash®.
What foods are high in sodium?
What else should I do to change my diet?
- Avoid alcohol.
- Eat a variety of foods.
- Eat foods high in dietary fiber (whole grain breads, cereals, pasta, fresh fruit, and vegetables).
Comparison of Sodium in Foods
Meats, poultry, fish, and shellfish
Food: Milligrams (mg.) sodium
Fresh meat, 3 oz. cooked: Less than 90 mg
Shellfish, 3 oz: 100 to 325 mg
Tuna, canned, 3 oz: 300 mg
Lean ham, 3 oz.: 1,025 mg
Food: Milligrams sodium
*Whole milk, 1 cup: 120 mg
Skim or 1% milk, 1 cup: 125 mg
*Buttermilk (salt added), 1 cup: 260 mg
*Swiss cheese, 1 oz: 75 mg
*Cheddar cheese, 1 oz : 175 mg
Low-fat cheese, 1 oz.: 150 mg
*Cottage cheese (regular), 1/2 cup: 455 mg
Food: Milligrams sodium
Fresh or frozen vegetables, and no-salt-added canned (cooked without salt), 1/2 cup: Less than 70 mg
Vegetables canned or frozen (without sauce), 1/2 cup: 55-470 mg
Tomato juice, canned, 3/4 cup: 660 mg
Breads, cereals, rice and pasta
Food: Milligrams sodium
Bread, 1 slice: 110-175 mg
English muffin (half): 130 mg
Ready-to-eat, shredded wheat, 3/4 cup: Less than 5 mg
Cooked cereal (unsalted), 1/2 cup: Less than 5 mg
Instant cooked cereal, 1 packet: 180 mg
Canned soups, 1 cup: 600-1,300 mg
Food: Milligrams sodium
Canned and frozen main dishes, 8 oz: 500-1,570 mg
*These can also be high in saturated fat, unless low-fat or reduced fat options are purchased.
*High in saturated fat.
Share Facebook Twitter LinkedIn Email Get useful, helpful and relevant health + wellness information enews
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
What to know about high blood pressure
Treatment will depend on several factors, including:
- how high the blood pressure is
- the risk of cardiovascular disease or a stroke
The doctor will recommend different treatments as blood pressure increases. For slightly high blood pressure, they may suggest making lifestyle changes and monitoring the blood pressure.
If blood pressure is high, they will recommend medication. The options may change over time, according to how severe the hypertension is and whether complications arise, such as kidney disease. Some people may need a combination of several different medications.
Conventional drugs for treating high blood pressure include:
1) Angiotensin converting enzyme inhibitors
Angiotensin converting enzyme (ACE) inhibitors block the actions of some hormones that regulate blood pressure, such as angiotensin II. Angiotensin II causes the arteries to constrict and increases blood volume, resulting in increased blood pressure.
ACE inhibitors can reduce the blood supply to the kidneys, making them less effective. As a result, it is necessary for people taking ACE inhibitors to have regular blood tests.
People should not use ACE inhibitors if they:
- are pregnant
- have a condition that affects the blood supply to the kidneys
ACE inhibitors may cause the following side effects, which usually resolve after a few days:
- a persistent dry cough
If the side effects are persistent or too unpleasant to manage, a doctor may prescribe an angiotensin II receptor antagonist instead.
These alternative medications often cause fewer side effects, but they may include dizziness, headaches, and increased potassium levels in the blood.
2) Calcium channel blockers
Calcium channel blockers (CCBs) aim to decrease calcium levels in the blood vessels. This will relax the vascular smooth muscle, causing the muscle to contract less forcefully, the arteries to widen, and blood pressure to go down.
CCBs may not always be suitable for people with a history of heart disease, liver disease, or circulation issues. A doctor can advise on taking CCBs and which type of CCB is safe to use.
The following side effects may occur, but they usually resolve after a few days:
- redness of the skin, generally on the cheeks or neck
- swollen ankles and feet
- skin rash
- swollen abdomen, in rare cases
Learn more here about calcium channel blockers.
3) Thiazide diuretics
Thiazide diuretics help the kidneys get rid of sodium and water. This lowers blood volume and pressure.
The following side effects can occur, and some of them may persist:
- low blood potassium, which can affect heart and kidney function
- impaired glucose tolerance
- erectile dysfunction
People taking thiazide diuretics should have regular blood and urine tests to monitor their blood sugar and potassium levels.
Beta-blockers were once popular for treating hypertension, but doctors only tend to prescribe them now when other treatments have not been successful.
Beta-blockers slow the heart rate and reduce the force of the heartbeat, causing a drop in blood pressure.
Side effects may include:
- cold hands and feet
- slow heartbeat
- Less common side effects are:
- disturbed sleep
- erectile dysfunction
Beta-blockers are often the standard medication for a person with very high blood pressure, known as a hypertensive crisis.
5) Renin inhibitors
Aliskiren (Tekturna, Rasilez) reduces the production of renin, an enzyme that the kidneys produce.
Renin helps produce a hormone that narrows blood vessels and raises blood pressure. Reducing this hormone causes the blood vessels to widen and blood pressure to fall.
This drug is relatively new, and healthcare professionals are still determining its optimal use and dosage.
Possible side effects include:
- flu-like symptoms
- a cough
It is essential to read the packaging of any medication to check for interactions with other drugs.
Find out more detail here about blood pressure medications.
Managing the diet can be an effective way of both preventing and treating high blood pressure.
A healthful, balanced diet includes plenty of fruits and vegetables, vegetable and omega oils, and good quality, unrefined carbohydrates, such as whole grains. People who include animal products in their diet should trim all the fat off and avoid processed meats.
Lowering salt intake
Experts recommend reducing salt consumption and increasing potassium intake to manage or prevent high blood pressure. Limiting salt intake to less than 5–6 grams per day could help improve cardiovascular health and reduce systolic blood pressure by 5.6 mm Hg in people with hypertension.
In moderation, plant sources of fats, such as avocados, nuts, olive oil, and omega oils, can be healthful. People should limit their intake of saturated fats and trans fats, common in animal-sourced and processed foods.
The DASH diet
Health experts recommend the DASH diet for people with high blood pressure. The DASH diet focuses on an eating plan that emphasizes whole grains, fruits, vegetables, nuts, seeds, beans, and low-fat dairy products.
|Food groups||Number of weekly servings for those eating 1,600–3,100 calories a day||Number of weekly servings for those on a 2,000-calorie diet|
|Grains and grain products||6–12||7–8|
|Mostly low-fat or non-fat dairy foods||2–4||2–3|
|Lean meat, fish, or poultry||1.5–2.5||2|
|Nuts, seeds, and legumes||3–6||4–5|
|Fats and candy||2–4||Limited|
Which foods are good for reducing blood pressure? Find out here.
Some studies indicate that consuming some alcohol may help lower blood pressure. However, others report the opposite, noting that even drinking a moderate amount might increase blood pressure levels.
People who regularly drink more than moderate amounts of alcohol will almost always experience elevated blood pressure levels.
Studies into the relationship between caffeine and blood pressure have produced conflicting results. A report published in 2017 concluded that a moderate intake of coffee appears to be safe for people with high blood pressure.
The AHA recommend a range of lifestyle adjustments that can help reduce blood pressure, such as:
- managing stress
- quitting smoking
- eating healthfully
- getting exercise
- following any treatment plan the doctor prescribes
Discuss any planned lifestyle changes with a healthcare professional before introducing them.
Share on PinterestRegular exercise may help lower blood pressure.
The AHA note that most healthy people should do at least 150 minutes of moderate intensity physical exercise a week. This could be 30 minutes — or three lots of 10 minutes a day — on 5 days of the week.
This amount of exercise is also appropriate for people with high blood pressure.
However, a person who has not exercised for a while or who has a new diagnosis should talk to their doctor before starting a new physical activity program to ensure the choices they make are suitable for them.
Studies have revealed that losing as little as 5–10 pounds in weight can help reduce blood pressure.
Weight loss will also improve the effectiveness of blood pressure medications.
Ways of achieving and maintaining a healthy weight include:
- getting regular exercise
- following a diet that emphasizes plant-based foods and limits the intake of fat and added sugars
For more advice on maintaining weight loss, click here.
Increasing sleep alone cannot treat hypertension, but too little sleep and poor sleep quality may make it worse.
A 2015 analysis of data from a Korean national health survey found that people who had less than 5 hours of sleep per night were more likely to have hypertension.
In this article, you can find more tips on how to manage high blood pressure.
According to the National Center for Complementary and Integrative Health (NCCIH), the following may help lower blood pressure:
- meditation, yoga, qi gong, and tai chi
- biofeedback and transcendental meditation
- supplements such as garlic, flaxseed, green or black tea, probiotics, cocoa, and roselle (Hibiscus sabdariffa)
The NCCIH add, however, that there is not yet enough evidence to confirm that these can make a difference.
They also warn that:
Some supplements can have adverse effects. They may raise blood pressure or interact with medications.
Meditation and exercise therapies are usually safe, but some poses may not be suitable for people with high blood pressure.
Anyone who is considering an alternative therapy should speak to their doctor first.
Get some tips for lowering blood pressure naturally.