Hypertension is the term for blood pressure that is higher than normal. If repeated checks of your blood pressure show that it is 140/90 ("140 over 90") or higher, you have hypertension.
Normal blood pressure is 120/80. In this measurement 120 mm Hg (millimeters of mercury pressure) is the systolic, or pumping, pressure. 80 mm Hg is an average diastolic, or resting, pressure. As either or both pressures rise, the heart and blood vessels work harder to pump the blood throughout the system. Over time this can cause major complications such as heart attack, hardening of the arteries, stroke, kidney failure, and congestive heart failure. How much time is required for damage to occur depends largely on how high the blood pressure is. The higher the pressure, the sooner complications will develop unless the blood pressure is treated. Additional factors that may hasten problems caused by high blood pressure include smoking, diabetes, and high cholesterol.
The condition of hypertension is often called essential or primary hypertension if there is no obvious underlying cause. More than 95% of all high blood pressure is essential hypertension. When a disease or other physical problem is the cause of high blood pressure, the condition is called secondary hypertension.
There are no clear causes of essential hypertension. However, many different factors can increase blood pressure: for example, stress, overweight, smoking, a diet high in salt, heavy use of alcohol, and in some women, the use of birth control pills. Heredity, sex, age, and race are also important factors. Exactly how these factors affect blood pressure is not yet well understood.
Hypertension usually causes no symptoms for many years. This is why it is important to have your blood pressure checked by a health care professional at least once every year.
Symptoms of severe hypertension or its complications may include headache, dizziness, rracing or irregular heartbeat, easy tiring, impotence, nosebleeds, chest pain, or shortness of breath.
Because hypertension causes no symptoms at first, it is often discovered when you are seeing your doctor for a different reason. Blood pressure is always checked at doctor visits because it is such a common problem. It can seriously affect your health if it is not treated.
If your blood pressure measurement is high, your doctor will ask you to come in again for additional measurements. If three or more blood pressure readings on different days are higher than 140/90, you have hypertension.
If you are diagnosed with high blood pressure, it is important to find whether there is an obvious cause or complications that need to be treated. Your health care provider will ask about your medical history and do a physical exam. Lab tests of samples of your urine and blood may also be done. You may need a chest x-ray or ECG.
Treatment depends on how high your blood pressure is. It also depends on your risk of heart and blood vessel disease and other complications. The goals of treatment are to lower your blood pressure to a level as near normal as possible and to reduce your risk of heart disease and stroke. It is also important for you to stay as active as possible.
If your blood pressure is mildly or even moderately high, it may be possible to bring it down to a normal level without medication. Changes in your diet, weight loss, and exercise may be the only treatment you need. Your doctor may recommend the following first steps to treat your high blood pressure:
If these lifestyle changes do not lower your blood pressure enough, your doctor may prescribe a drug that will reduce your blood pressure. There are many types of drugs for reducing blood pressure. Diuretics (sometimes called "water pills"), for example, are one type. They help your body get rid of extra water and sodium.
Years ago many blood pressure medicines caused impotence in men. Today there are many new drugs that can control blood pressure without causing impotence.
When you start taking medication, it is important to:
It may not be possible to know at first which drug or combination of drugs will work best for you. You and your doctor may need to work together for several weeks to find the best treatment for you.
You may need treatment for high blood pressure the rest of your life. However, proper treatment can control your blood pressure and prevent or delay complications. If you already have some complications, lowering your blood pressure may make the effects of the complications less severe.
Untreated high blood pressure is dangerous because the heart must work much harder to keep the blood circulating. This stress and damage to blood vessel linings and organs can lead to serious and life-threatening problems, such as heart disease, stroke, and kidney failure.
Your treatment will be much more effective if you follow these guidelines for taking good care of yourself: