Hypertension, or high blood pressure, is a common problem. Over one billion people around the world, often in less wealthy countries, have hypertension. In many of these cases, those affected don’t have it under control. How can you reduce the risk of getting hypertension or effectively manage the problem? We’ll define what blood pressure is and how to measure it. From here, we’ll discuss ways to recognize high blood pressure and go over some management techniques.

What is Blood Pressure?

Blood pressure is the force exerted by circulating blood. This force creates pressure within your arteries, major blood vessels within your body. How do you know if your blood pressure is outside of the normal range? Systolic and diastolic blood pressure measurements. The first measurement, systolic blood pressure, represents the pressure in your blood vessels as your heart contracts (beats). Diastolic blood pressure measures the pressure in your blood vessels when your heart is at rest.

Although high blood pressure is more common in adults, it can affect children (particularly overweight children). You can categorize high blood pressure into two types. High blood pressure that develops gradually, usually over several years, and has no identifiable cause is known as primary (essential) hypertension. Secondary hypertension can result from an underlying condition that impacts blood pressure levels or from certain medications.

Blood Pressure Classifications

A diagnosis of high blood pressure depends on understanding how blood pressure measurements are classified. The American Heart Association recognizes five classifications: normal blood pressure, elevated blood pressure, stage 1 hypertension, stage 2 hypertension, and hypertensive crisis. 

Normal blood pressure should have a reading of less than 120 mm Hg systolic (the upper number) and less than 80 mm Hg diastolic (the lower number). A typical measurement will be written as 120/80 mm Hg. Heart-healthy lifestyle choices, such as keeping a balanced diet and getting regular activity, help keep your blood pressure in this range.

Elevated blood pressure falls between 120-129 mm Hg systolic and less than 80 mm Hg diastolic. You may need to take preventative steps to avoid high blood pressure. At this stage, lifestyle changes can be very effective at helping control blood pressures. 

High blood pressure (hypertension) stage 1 ranges from 130-139 mm Hg systolic or 80-80 mm Hg diastolic. At this point, your primary care provider will most likely recommend lifestyle changes in addition to potentially doing lab/taking additional history from you to see if there may be another medical issue going on. In certain cases, if you have a high risk for heart attack or stroke, you may be prescribed medication.

Hypertension stage 2 has blood pressure measurements of 140+ mm Hg systolic or 90+ mm Hg diastolic. Your primary care provider will likely prescribe a combination of treatment methods, including both lifestyle changes and medication.

Hypertensive crisis occurs if your blood pressure goes over 180 mm Hg systolic and (or) goes over 120 mm Hg. Emergency care may be necessary if your blood pressure reaches these levels.

Risk Factors, Symptoms, and Complications of High Blood Pressure

Risk factors can be modifiable or non-modifiable. You can alter your lifestyle to improve your diet. Eat more fruits and vegetables and reduce your intake of salt, saturated fats, and trans fats. Be as physically active as you can. Shifting your behavior in small ways towards greater activity can be more sustainable than an “all or nothing” approach. For example, take the stairs, rather than the elevator, to go up a flight or two. These changes to your diet and activity levels may help reduce your weight and lower your chances of health problems due to weight. More changes that can reduce your risk of high blood pressure include reducing the amount of alcohol you consume and limiting or stopping tobacco use. Traits such as having a family history of high blood pressure, race, having chronic conditions such as kidney disease or diabetes, or age (over 65 years) are outside of your control and unmodifiable. While easier said than done, one major change that can be incredibly helpful is decreasing your levels of stress. 

Many people don’t experience any warning signs or symptoms, so high blood pressure is considered a silent disease. Possible symptoms, especially if you have severe hypertension, include:

• Fatigue

• Nausea or vomiting

• Confusion or anxiety

• Chest pain

• Muscle tremors

• Early morning headaches

• Nosebleeds

• Irregular heart rhythm

• Changes to your vision

• Buzzing in your ears.

High blood pressure can seriously damage your heart and cause many (related) complications. Excessive pressure on your blood vessels can harden your arteries and reduce blood and oxygen flow to your heart. Issues that result from reduced blood flow can include chest pain (angina), heart attack, heart failure, an irregular heartbeat, a stroke, or kidney damage. Too much damage done to the kidneys can lead to kidney failure.

High Blood Pressure Diagnosis and Treatment

Understanding the risks associated with developing high blood pressure can help you lead a healthier life. To prevent high blood pressure, you can:

• Keep your daily salt intake under 5g

• Eat more fruits and vegetables

• Get regular physical activity

• Avoid tobacco

• Reduce alcohol intake

• Limit high saturated fats

• Eliminate trans fats   

To be diagnosed, blood pressure should be checked in both arms (note any difference in readings) and measured on different days at varying times. If you are taking your blood pressure at home and get a high reading, wait about 15 mintutes and retake it again. If it remains high, it may be time to call your primary care provider. To confirm the diagnosis, lab tests, ambulatory monitoring, or an echocardiogram may be recommended. If you have been diagnosed with high blood pressure, you can manage the condition by:

• Reducing and managing your stress

• Get your blood pressure checked regularly (at least every two years once you turn 18 and more frequently if you’re at greater risk of developing high blood pressure)

• Get the appropriate treatment for high blood pressure (this will depend on which category your blood pressure falls under)

• Manage  other medical conditions that can negatively affect your blood pressure

In many cases, lifestyle changes will reduce your blood pressure without the addition of medication. Different types of medication can be used in treatment, if necessary. Possible types of medication include diuretics, ACE inhibitors, beta-blockers, and combination medications (to name a few). 

Management is somewhat dependent on unique circumstances and preferences. Discuss unique management methods with your primary care provider.