Essential Hypertension
(Blood Pressure, High; High Blood Pressure; Idiopathic Hypertension; Primary Hypertension)
by Editorial Staff And Contributors
Definition TOP
Blood pressure is the force that blood puts on the blood vessel walls. Blood pressure measurements include 2 numbers:
- Systolic pressure: top number, normal reading is 120 millimeters of mercury (mmHg) or less
- Diastolic pressure: bottom number, normal reading is 80 mmHg or less
There is a range of what high blood pressure is. Your doctor will talk to you about what your pressure should be. An example of blood pressure ranges from the American Heart Association (AHA) include:
-
Blood pressure is considered elevated, but not yet hypertension (abnormally high blood pressure) when the:
- Systolic pressure is 120-129 mmHg and the
- Diastolic pressure is 80 mmHg
-
Stage 1 hypertension:
- Systolic pressure is 130-139 mmHg and/or
- Diastolic pressure is 80-89 mmHg
-
Stage 2 hypertension:
- Systolic pressure is greater than or equal to 140 mmHg and/or
- Diastolic pressure is greater than or equal to 90 mmHg
High blood pressure puts stress on the heart, lungs, brain, kidneys, and blood vessels. Over time, it can cause severe damage and illness.
Organs Impacted by High Blood PressureCopyright © Nucleus Medical Media, Inc. |
Causes TOP
The body has a number of steps to help keep blood pressure in a healthy range. It is not clear what changes happen that lead to hypertension. Factors that may play a role include:
- Genetics
- Low physical activity levels
- Dietary choices
- Overweight or obesity
Risk Factors TOP
High blood pressure develops over time. It is most common in older adults, especially postmenopausal women.
Factors that may increase the risk of high blood pressure include:
- Overweight
- Excess alcohol use
- Smoking
- Use of oral contraceptives (birth control pills)
- Sedentary lifestyle
- Family history
- Kidney disease
- Diabetes
- High-fat, high-salt diet
- Stress
Symptoms TOP
High blood pressure usually does not cause symptoms.
If blood pressure reaches extreme levels, symptoms may include:
- Headache
- Blurry or double vision
- Abdominal pain
- Chest pain
- Shortness of breath
- Lightheadedness
Diagnosis TOP
High blood pressure is often found during a doctor's visit. Blood pressure is measured using an arm cuff and a special device. If the reading is high, you will come back for repeat checks. High blood pressure will be confirmed after more than 2 readings over more than 2 visits.
A doctor's office can make some people anxious. This can cause higher than normal blood pressure. You may be asked to measure your blood pressure at home or in another location.
Treatment TOP
Treatment will focus on reducing blood pressure. Improving the blood pressure will help to decrease the stress on important organs. It can also decrease the risk of:
- Heart disease
- Heart attack
- Stroke
- Kidney damage
Treatment may need to be adjusted over time. Options may include:
Lifestyle Changes
Lifestyle changes may be helpful in reducing blood pressure. It is often the first approach. Recommended steps include:
- Reach and keep a healthy weight.
- Exercise on a regular basis. Start an exercise program if you don't already exercise.
- If you smoke, talk to your doctor about ways to quit.
-
Eat a
healthful diet. The
DASH diet
is one known to decrease blood pressure. Heart healthy diets should be:
- Low in fat, salt, and processed foods
- Rich in fiber, fruits, and vegetables
- If you drink alcohol, do so in moderation. Moderate is 2 or fewer drinks per day for men and 1 or fewer drinks per day for women and older adults.
- Reduce stress levels. Try relaxation techniques like meditation or breathing exercises.
Medicine
Medicine may be needed. It may be needed if lifestyle changes were not effective enough. Some medicine options include:
- Diuretics —decreases the amount of fluid in the blood
- Beta blockers —decreases the force and rate of heart beat
-
Medications that help keep blood vessels from tightening and narrowing such as:
- Angiotensin converting enzyme inhibitors (ACE inhibitors)
- Angiotensin receptor blockers
- Calcium channel blockers
- Alpha blockers
- Vasodilators
- Aldosterone blockers—increases amount of salt that is lost out of urine
Prevention TOP
To help reduce the risk of high blood pressure:
- Eat a well-balanced diet. It should be rich in fruits, vegetables and low-fat dairy foods. It should also be low in saturated fat, total fat, and cholesterol.
- Be physically active often. Aim for at least 3-4 days per week. Some activity everyday is best.
- Maintain a healthy weight.
- If you smoke, talk to your doctor about ways to quit.
- If you drink alcohol, do so in moderation. Moderate is 2 or fewer drinks per day for men and 1 or fewer drinks per day for women and older adults.
RESOURCES:
American Heart Association
http://www.heart.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.ca
REFERENCES:
Chobanian AV. Clinical practice. Isolated systolic hypertension in the elderly. N Engl J Med. 2007;357:789-796.
High blood pressure or hypertension. American Heart Association website. Available at:
...(Click grey area to select URL)
Accessed October 2, 2018.
Hypertension. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115345/Hypertension . Updated September 12, 2018. Accessed October 2, 2018.
What is high blood pressure? National Heart, Lung, and Blood Institute website. Available at:
...(Click grey area to select URL)
Updated September 10, 2015. Accessed October 2, 2018.
Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2018 May 15;71(19):e127
9/2/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115345/Hypertension : Forman J, Stampfer M, Curhan G. Diet and lifestyle risk factors associated with incident hypertension in women. JAMA. 2009;302(4):401-411.
1/5/2018 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115345/Hypertension : Whelton PK, Carey RM, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2017 Nov 13. [Epub ahead of print].
Last reviewed September 2018 by
EBSCO Medical Review Board
James P. Cornell, MD
Last Updated: 10/2/2018