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Roughly 47% of all adults in the U.S. have high blood pressure (hypertension) and are at risk for related health complications like stroke and heart disease. Knowing what high blood pressure is is the first step toward seeking treatment if you’re at risk. The second step is learning how to lower your numbers if your medical provider told you that you have hypertension.

What does it mean when your blood pressure is high?

If your doctor says that your blood pressure is high, that means that your blood pushes against the walls of your arteries with more force than what is normal.

Blood pressure fluctuates throughout the day, so it’s possible to have high blood pressure at night if you consumed a lot of caffeine during the day. Or, you could experience high blood pressure in the morning at the office because of a stressful meeting.

Normally, when people talk about high blood pressure they are describing a medical condition where blood pressure levels are consistently elevated. Doctors may call this hypertension, the medical term for high blood pressure.

What do bp numbers mean?

Blood pressure readings consist of two numbers:

  • Systolic blood pressure: Commonly called the first or top number, this shows how much pressure blood pushes with when your heart beats.
  • Diastolic blood pressure: Commonly called the second or bottom number, this shows how much pressure blood pushes between heartbeats.

Although many people now use electronic high blood pressure monitor devices, blood pressure is still measured in millimeters of mercury (mmHg).

What is considered high blood pressure?

The American College of Cardiology and the American Heart Association define normal blood pressure as:

  • Systolic blood pressure below 120 mmHg
  • Diastolic blood pressure below 80 mmHg

Normally, doctors diagnose someone with high blood pressure if they consistently have high blood pressure readings.

What causes high blood pressure?

There are many potential causes of high blood pressure, and in many cases, it’s not possible to determine a single cause. Also, some differences exist between the causes of high blood pressure in women and men.

Genetics play a significant role in the condition. If other members of your immediate family have hypertension, you’re more likely to develop it.

Older adults are more likely to develop hypertension. Black people often develop high blood pressure at younger ages than others and are more likely to suffer from complications of high blood pressure.

What causes high systolic blood pressure?

High systolic blood pressure generally occurs when blood can’t pass through arteries freely. Often, this happens when the arteries stiffen due to age and other factors or due to plaque buildup.

Having only high systolic blood pressure is called isolated systolic hypertension.

What causes high diastolic blood pressure?

High diastolic blood pressure can be caused by:

  • A high sodium diet
  • Obesity
  • Lack of physical activity
  • Excessive alcohol consumption
  • Stress and anxiety

Having only high diastolic blood pressure is called isolated diastolic hypertension. It is less common for people to develop isolated diastolic hypertension than hypertension and isolated systolic hypertension.

Can certain medications increase your blood pressure?

Some prescription and over-the-counter medications that can raise blood pressure levels include:

  • Acetaminophen
  • Antidepressants like bupropion and desipramine
  • Corticosteroids
  • Estrogen used in birth control pills and hormone replacement therapy
  • Immunosuppressants like cyclosporine
  • Nasal decongestants like pseudoephedrine found in over-the-counter cough and cold medications
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen
  • Phentermine
  • Testosterone

Some herbal supplements also have the potential to raise blood pressure, including:

  • Arnica
  • Black licorice
  • Ephedra
  • Ginseng
  • Guarana
  • Yohimbine

Caffeine and alcohol may also increase blood pressure levels.

Medical conditions that can affect blood pressure

Underlying medical conditions cause or worsen hypertension in some people. Medical conditions associated with high blood pressure include:

  • Congenital heart and blood vessel defects
  • Cushing syndrome
  • Kidney disease
  • Obesity
  • Obstructive sleep apnea
  • Thyroid problems
  • Tumors in endocrine glands

When high blood pressure is due to a medication condition, doctors refer to it as secondary hypertension.

Stages of high blood pressure

Doctors describe the severity of hypertension by categorizing it into stages:

Stage 1 high blood pressure

Stage 1 hypertension is:

  • Systolic pressure between 130 and 139 mmHg

or

  • Diastolic pressure between 80 and 89

Stage 2 high blood pressure

Stage 2 hypertension is:

  • Systolic pressure of 140 mmHg or more

or

  • Diastolic pressure of 90 mmHg or more

Symptoms of high blood pressure

Many people wonder what does high blood pressure feel like? The truth is that hypertension usually doesn’t cause any symptoms. As a result, many people have high blood pressure and don’t know it.

Symptoms of high blood pressure usually occur only when the problem becomes severe and may include:

  • Chest pain
  • Intense headache
  • Confusion
  • Blurred vision
  • Anxiety
  • Shortness of breath
  • Seizures

Blood pressure and heart rate

Blood pressure and heart rate are two vital signs that doctors use to assess your current state and your overall health. Heart rate is the measure of how many times your heart beats in one minute. Although the numbers are not linked, doctors often consider heart rate and blood pressure together when evaluating patients.

High blood pressure and high heart rate

People may experience high blood pressure and a high heart rate due to hypertension, panic attacks, extreme stress and the use of certain substances such as illicit drugs or caffeine.

High blood pressure and low heart rate

People with high blood pressure may have a low heart rate due to the baroreceptor reflex. In an effort to lower blood pressure levels, this reflex can sometimes cause drops in heart rate.

Normal blood pressure and high pulse

Having normal blood pressure and a high pulse can occur due to an abnormal heart rhythm. Many other things may contribute to this phenomenon, including medications, medical conditions and even fevers due to illnesses.

Low blood pressure and high pulse

Low blood pressure and a high pulse can occur briefly when you move from a sitting to a standing position. It can also occur due to abnormal heart rhythms.

Complications of high blood pressure

When left untreated, high blood pressure can contribute to or cause serious health problems. Potential complications of high blood pressure include:

  • Heart attack
  • Stroke
  • Aneurysm
  • Heart failure
  • Kidney dysfunction
  • Vision loss
  • Memory problems
  • Difficulty concentrating
  • Dementia

Fortunately, the risk for high blood pressure complications falls dramatically with treatment, especially when you receive a diagnosis while still in Stage 1 hypertension.

How is high blood pressure treated?

Medication

Depending on your age, your blood pressure reading data and your overall health, your doctor may put you on one or more of the many blood pressure medications that are approved for treating hypertension. The most commonly prescribed types are:

  • Diuretics that remove sodium and water from the body to help blood pass through arteries more easily. Examples of diuretics include triamterene, spironolactone, chlorthalidone and hydrochlorothiazide.
  • Angiotensin-converting enzyme (ACE) inhibitors that relax blood vessels by preventing certain natural body chemicals from being formed. Examples of ACE inhibitors include lisinopril, benazepril and captopril.
  • Angiotensin II receptor blockers (ARBs) that relax blood vessels by blocking the activities of natural body chemicals. Examples of ARBs include candesartan and losartan.
  • Calcium channel blockers that relax blood vessels and slow heart rate. Examples include amlodipine and diltiazem.

Lifestyle changes

Doctors may recommend lifestyle changes with or without medication to treat hypertension. You will likely be encouraged to exercise to lower blood pressure and to follow a diet for high blood pressure.

In addition, your doctor may give you ideas on how to lower your stress to reduce blood pressure. You may also need to quit smoking, give up caffeine and cut down on your intake of alcohol.

At-home monitoring

To assess the success of your treatment plan, your doctor will likely encourage you to check your numbers at home with a high blood pressure monitor. This can usually be done once daily or several times per week, though occasionally your doctor may request more frequent measurements.  

When should you go to the emergency room for high blood pressure?

If you experience sudden high blood pressure above 180/120, you should let your doctor know as soon as possible. Should you also experience any of the following symptoms, go to the emergency room:

  • Chest pain
  • Shortness of breath
  • Numbness or weakness
  • Change in vision
  • Difficulty speaking
  • Severe headache.

Pregnant women should notify their doctors anytime their blood pressure reading is above 140/90.

How Forward can help you control your blood pressure

Because high blood pressure can have so many potential causes, managing the condition usually requires a combination of medication and lifestyle interventions. As your primary care provider, Forward delivers one-to-one, personalized care and ongoing support and biometric monitoring for individuals with hypertension. We will work with you to establish personal health goals, including lowering your blood pressure, and partner with you to help you achieve them.

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