When doctors take a person's blood pressure, they measure the force that blood exerts on the walls of the arteries as it flows through them.
If blood pressure is too high for too long, it can cause serious damage to the blood vessels.
This damage can result in a range of complications, some of which can be life threatening. They include heart failure, vision loss, stroke, kidney disease, and other health problems.
There are ways of managing high blood pressure, or hypertension. High blood pressure often does not cause symptoms, but regular screening can help a person know if they need to take preventive action.
In the United States, around 75 million people, or 29% of the population, have high blood pressure, according to the Centers for Disease Control and Prevention (CDC).
In this article, we look at the causes of high blood pressure and how to treat it. We also explain the blood pressure measurements that health authorities consider to be healthy and too high.
What is high blood pressure?
The heart is a muscle that pumps blood around the body. As it travels, the blood delivers oxygen to the body's vital organs.
Sometimes, a problem in the body makes it harder for the heart to pump the blood. This could happen, for example, if an artery becomes too narrow.
Persistent high blood pressure can put a strain on the walls of the arteries. This can lead to a variety of health problems, some of which can be life threatening.
High blood pressure chart
The chart below shows measures for normal and high blood pressure, according to the American Heart Association (AHA).
Doctors measure blood pressure in millimeters of mercury (mm Hg).
Systolic pressure measures the pressure in the arteries as the heart contracts and is the top number on a blood pressure reading. Diastolic, which is the lower number, represents the blood pressure when the heart is resting between beats.
Anybody who experiences these symptoms should see their doctor immediately.
Symptoms in women
Hormonal factors mean that the risk of high blood pressure may be different in males and females.
Factors that can increase the risk of high blood pressure in females include:
During pregnancy, high blood pressure can be a sign of preeclampsia, a potentially dangerous condition that can affect the woman and her unborn baby.
Symptoms of preeclampsia include:
Newborns and very young babies can sometimes have high blood pressure due to an underlying health condition, such as kidney or heart disease.
Symptoms may include:
a failure to thrive
seizures
irritability
lethargy
respiratory distress
Other symptoms will depend on the condition that is causing the high blood pressure.
Causes
High blood pressure can occur when certain changes happen in the body or if a person is born with specific genetic features that cause a health condition.
It can affect people with:
congenital conditions, such as Cushing's syndrome, acromegaly, or pheochromocytoma
Sometimes, there is no apparent cause. In this case, a doctor will diagnose primary hypertension.
Consuming a high fat diet, carrying excess weight, drinking a lot of alcohol, smoking tobacco, and the use of some medications also increase the risk.
How to lower blood pressure
Treatment will depend on several factors, including:
how high the blood pressure is
the risk of cardiovascular disease or a stroke
The doctor will recommend different treatments as blood pressure increases. For slightly high blood pressure, they may suggest making lifestyle changes and monitoring the blood pressure.
If blood pressure is high, they will recommend medication. The options may change over time, according to how severe the hypertension is and whether complications arise, such as kidney disease. Some people may need a combination of several different medications.
Medications
Conventional drugs for treating high blood pressure include: 1) Angiotensin converting enzyme inhibitors
Angiotensin converting enzyme (ACE) inhibitors block the actions of some hormones that regulate blood pressure, such as angiotensin II. Angiotensin II causes the arteries to constrict and increases blood volume, resulting in increased blood pressure.
ACE inhibitors can reduce the blood supply to the kidneys, making them less effective. As a result, it is necessary for people taking ACE inhibitors to have regular blood tests.
People should not use ACE inhibitors if they:
are pregnant
have a condition that affects the blood supply to the kidneys
ACE inhibitors may cause the following side effects, which usually resolve after a few days:
dizziness
fatigue
weakness
headaches
a persistent dry cough
If the side effects are persistent or too unpleasant to manage, a doctor may prescribe an angiotensin II receptor antagonist instead.
These alternative medications often cause fewer side effects, but they may include dizziness, headaches, and increased potassium levels in the blood.
2) Calcium channel blockers Calcium channel blockers (CCBs) aim to decrease calcium levels in the blood vessels. This will relax the vascular smooth muscle, causing the muscle to contract less forcefully, the arteries to widen, and blood pressure to go down.
CCBs may not always be suitable for people with a history of heart disease, liver disease, or circulation issues. A doctor can advise on taking CCBs and which type of CCB is safe to use.
The following side effects may occur, but they usually resolve after a few days:
redness of the skin, generally on the cheeks or neck
People taking thiazide diuretics should have regular blood and urine tests to monitor their blood sugar and potassium levels.
4) Beta-blockers Beta-blockers were once popular for treating hypertension, but doctors only tend to prescribe them now when other treatments have not been successful.
Beta-blockers slow the heart rate and reduce the force of the heartbeat, causing a drop in blood pressure.
Beta-blockers are often the standard medication for a person with very high blood pressure, known as a hypertensive crisis.
5) Renin inhibitors
Aliskiren (Tekturna, Rasilez) reduces the production of renin, an enzyme that the kidneys produce.
Renin helps produce a hormone that narrows blood vessels and raises blood pressure. Reducing this hormone causes the blood vessels to widen and blood pressure to fall.
This drug is relatively new, and healthcare professionals are still determining its optimal use and dosage.
Possible side effects include:
diarrhea
dizziness
flu-like symptoms
fatigue
a cough
It is essential to read the packaging of any medication to check for interactions with other drugs.
Find out more detail here about blood pressure medications.
Diet
Managing the diet can be an effective way of both preventing and treating high blood pressure. Plant-based foods
A healthful, balanced diet includes plenty of fruits and vegetables, vegetable and omega oils, and good quality, unrefined carbohydrates, such as whole grains. People who include animal products in their diet should trim all the fat off and avoid processed meats.
Lowering salt intake
Experts recommend reducing salt consumption and increasing potassium intake to manage or prevent high blood pressure. Limiting salt intake to less than 5–6 grams per day could help improve cardiovascular health and reduce systolic blood pressure by 5.6 mm Hg in people with hypertension.
Healthful fats
In moderation, plant sources of fats, such as avocados, nuts, olive oil, and omega oils, can be healthful. People should limit their intake of saturated fats and trans fats, common in animal-sourced and processed foods.
The DASH diet
Health experts recommend the DASH diet for people with high blood pressure. The DASH diet focuses on an eating plan that emphasizes whole grains, fruits, vegetables, nuts, seeds, beans, and low-fat dairy products.
Food groups
Number of weekly servings for those eating 1,600–3,100 calories a day
Number of weekly servings for those on a 2,000-calorie diet
Grains and grain products
6–12
7–8
Fruits
3–6
3–5
Vegetables
4–6
4–5
Mostly low-fat or non-fat dairy foods
2–4
2–3
Lean meat, fish, or poultry
1.5–2.5
2
Nuts, seeds, and legumes
3–6
4–5
Fats and candy
2–4
Limited
Which foods are good for reducing blood pressure? Find out here.
Alcohol
Some studies indicate that consuming some alcohol may help lower blood pressure. However, others report the opposite, noting that even drinking a moderate amount might increase blood pressure levels.
People who regularly drink more than moderate amounts of alcohol will almost always experience elevated blood pressure levels.
Caffeine Studies into the relationship between caffeine and blood pressure have produced conflicting results. A report published in 2017 concluded that a moderate intake of coffee appears to be safe for people with high blood pressure.
Home remedies
The AHA recommend a range of lifestyle adjustments that can help reduce blood pressure, such as:
The AHA note that most healthy people should do at least 150 minutes of moderate intensity physical exercise a week. This could be 30 minutes — or three lots of 10 minutes a day — on 5 days of the week.
This amount of exercise is also appropriate for people with high blood pressure.
However, a person who has not exercised for a while or who has a new diagnosis should talk to their doctor before starting a new physical activity program to ensure the choices they make are suitable for them.
Losing weight
Studies have revealed that losing as little as 5–10 pounds in weight can help reduce blood pressure.
Weight loss will also improve the effectiveness of blood pressure medications.
Ways of achieving and maintaining a healthy weight include:
getting regular exercise
following a diet that emphasizes plant-based foods and limits the intake of fat and added sugars
For more advice on maintaining weight loss, click here.
Sleep
Increasing sleep alone cannot treat hypertension, but too little sleep and poor sleep quality may make it worse.
A 2015 analysis of data from a Korean national health survey found that people who had less than 5 hours of sleep per night were more likely to have hypertension.
In this article, you can find more tips on how to manage high blood pressure.
Natural remedies
According to the National Center for Complementary and Integrative Health (NCCIH), the following may help lower blood pressure:
