What is High Blood Pressure (Hypertension)?
High blood pressure, or hypertension, occurs when the arteries become narrow, creating more resistance for blood flow from the heart. The narrower your arteries, the greater the resistance, and consequently, the higher your blood pressure will be. Over time, this increased pressure can lead to serious health complications, including heart disease.
Hypertension is a common condition. Since the guidelines were updated in 2017, nearly half of American adults are reported to have high blood pressure, according to the American Heart Association. Typically, hypertension develops gradually over several years and often presents without any noticeable symptoms. However, even without symptoms, high blood pressure can damage your blood vessels and organs, particularly affecting the brain, heart, eyes, and kidneys.
Early detection is crucial. Regular blood pressure readings can help you and your doctor identify any changes. If your blood pressure is elevated, your doctor may recommend monitoring it over a few weeks to determine if it remains high or returns to normal levels.
Treatment for hypertension usually involves a combination of prescription medication and healthy lifestyle changes. Without treatment, high blood pressure can lead to severe health issues, including heart attacks and strokes.
What Causes High Blood Pressure?
High blood pressure, or hypertension, can be classified into two types, each with distinct causes.
Essential (Primary) Hypertension
Essential hypertension, also known as primary hypertension, develops gradually over time and is the most common form of high blood pressure. Several factors typically contribute to its development:
- Genetics: Some individuals are genetically predisposed to hypertension due to gene mutations or inherited traits from their parents.
- Age: People over the age of 65 are at a higher risk of developing hypertension.
- Race: In the United States, Black individuals have a higher incidence of hypertension. Research indicates that systemic, cultural, and genetic factors play a role in this disparity.
- Obesity: Living with obesity can lead to multiple cardiovascular issues, including hypertension.
- High Alcohol Consumption: Studies show that even one drink per day can increase the risk of hypertension, with higher alcohol consumption further elevating this risk.
- Sedentary Lifestyle: A sedentary lifestyle is associated with several cardiovascular problems, including hypertension.
- Diabetes or Metabolic Syndrome: Individuals diagnosed with diabetes or metabolic syndrome have a higher likelihood of developing hypertension.
- High Sodium Intake: There is a strong link between daily high sodium intake (more than 5 grams per day) and hypertension.
Secondary Hypertension
Secondary hypertension often arises quickly and can be more severe than primary hypertension. Several medical conditions may lead to secondary hypertension, including:
- Kidney disease
- Obstructive sleep apnea
- Congenital heart defects
- Thyroid problems
- Adrenal gland issues
- Certain endocrine tumors
What Are the Symptoms of Hypertension?
Hypertension is often referred to as a silent condition because many people do not experience any noticeable symptoms. It may take years or even decades for the condition to progress to levels severe enough for symptoms to become apparent. Even then, some individuals might mistake these symptoms for other issues.
Regular blood pressure readings are the most reliable method to determine if you have hypertension. Most doctors routinely take a blood pressure reading during every appointment.
Symptoms of severe hypertension, such as during a hypertensive crisis, can include:
- Headaches
- Nausea
- Vomiting
- Visual disturbances
- Chest or back pain
- Difficulty breathing
What Are the Effects of High Blood Pressure on the Body?
Because hypertension is often asymptomatic, it can silently cause damage to your body for years before any symptoms become obvious. Without proper treatment, this can lead to serious, even fatal, complications.
Hypertension can damage your arteries, making them harder, narrower, and less elastic. This damage facilitates the accumulation of deposits in your arteries, restricting blood flow and affecting multiple bodily systems.
Complications of hypertension include:
- Stroke
- Heart attack
- Heart failure
- Arrhythmia
- Sudden cardiac death
- Kidney disease or failure
- Vision loss
- Sexual dysfunction
- Cognitive issues, including dementia
How Is High Blood Pressure Diagnosed?
Diagnosing hypertension is straightforward and involves taking a blood pressure reading. Most doctors’ offices measure blood pressure as part of a routine visit. If you do not receive a reading at your next appointment, you can request one.
If your blood pressure is found to be elevated, your doctor may ask for additional readings over several days or weeks. Diagnosing hypertension typically requires more than one reading to confirm that there is a consistent issue.
This is important because various factors, such as the anxiety of being in a doctor’s office (known as “white coat syndrome”), can temporarily raise blood pressure. Blood pressure levels also naturally fluctuate throughout the day.
If your blood pressure remains high, your doctor will likely conduct further tests to rule out any underlying conditions. These tests may include:
- Cholesterol screening and other blood tests
- An electrocardiogram (EKG or ECG) to measure the electrical activity of your heart
- An ultrasound of your heart or kidneys
- A home blood pressure monitor to track your blood pressure over a 24-hour period
What Are the Treatment Options for High Blood Pressure?
If you are diagnosed with primary hypertension, lifestyle changes can often help lower your blood pressure. Should these changes prove insufficient or lose effectiveness over time, your doctor may prescribe medication.
Medications for Hypertension
Many people experience a trial-and-error phase when it comes to finding the right blood pressure medication. Your doctor may need to try several different medications or combinations of medications before discovering what works best for you.
Some of the medications commonly used to treat hypertension include:
- Beta-blockers
- Diuretics, also known as water pills
- Angiotensin-converting enzyme (ACE) inhibitors
- Angiotensin II receptor blockers (ARBs)
- Calcium channel blockers
- Alpha-2 agonists
For further information, refer to: “11 Common Blood Pressure Medications”
Treating Secondary Hypertension
If your doctor identifies an underlying condition causing your hypertension, the treatment will primarily focus on that issue. For example, if a new medication you’re taking is causing your blood pressure to rise, your doctor will seek alternative medications without this side effect.
Occasionally, hypertension persists even after addressing the underlying cause. In such cases, your doctor may collaborate with you to create a plan involving lifestyle changes and prescribe medications to help reduce your blood pressure.
Treatment plans for hypertension often need adjustments over time. What initially worked may become less effective. Your doctor will continue to work with you to fine-tune your treatment approach.
Home Remedies for High Blood Pressure
Adopting a healthy lifestyle can help you manage the factors that contribute to hypertension. Experts recommend the following:
- Consuming a heart-healthy diet that emphasizes fruits, vegetables, whole grains, and lean proteins such as fish
- Increasing physical activity, aiming for 150 minutes of moderate activity each week
- Maintaining a healthy weight
- Managing stress effectively
- Quitting smoking if you smoke
- Limiting alcohol consumption
For more information, see: “7 Home Remedies for Managing High Blood Pressure”
Lifestyle Tips to Lower Your Risk of Hypertension
If you are at risk for hypertension, you can take proactive steps to lower your risk and prevent its complications. Consider the following tips:
- Eating four servings of fruit and five servings of vegetables each day
- Limiting your intake of refined sugar
- Reducing your daily sodium intake to between 1.5 and 2.3 grams
- Setting weight loss goals if you are overweight or obese
- Regularly monitoring your blood pressure