What high blood pressure means for your health
What is high blood pressure?
High blood pressure, also called hypertension, occurs when the force of blood against your artery walls is consistently too strong. This makes your heart work harder to circulate blood, and over time, it can damage your arteries, heart, and other organs. Because hypertension often develops without noticeable symptoms, it’s sometimes referred to as a “silent condition.” Left untreated, it increases the risk of heart attack, stroke, kidney problems, and other serious complications.
Blood pressure is measured in millimeters of mercury (mmHg) and recorded as two numbers:
Systolic pressure (top number) – the force when the heart beats.
Diastolic pressure (bottom number) – the force when the heart rests between beats.
The blood pressure may be considered high if the systolic is 130 mmHg or higher, or the diastolic is 80 mmHg or higher.
Types of hypertension
Hypertension is categorized based on its cause or pattern:
Primary (essential) hypertension: Develops gradually, usually due to genetics, age, and lifestyle factors.
Secondary hypertension: Caused by an underlying condition, medication, or substance use.
Other patterns include:
White coat hypertension: High readings in a clinic, normal at home.
Masked hypertension: Normal in a clinic, high at home.
Sustained hypertension: High blood pressure in all settings.
Nocturnal hypertension: Blood pressure rises during sleep.
Symptoms
Most people with hypertension feel well and notice no symptoms. Severe or prolonged high blood pressure may cause:
Headaches or dizziness
Chest discomfort or palpitations
Vision changes
Swelling in the legs or face
Reduced urine output
A hypertensive emergency is a medical emergency. If blood pressure reaches 180/120 mmHg or higher with symptoms such as chest pain, severe headache, confusion, or sudden weakness, call emergency services immediately.
Causes and risk factors
High blood pressure often arises from multiple factors rather than a single cause:
Modifiable factors:
Excess sodium in the diet
Overweight or obesity
Sedentary lifestyle
Smoking or tobacco use
Heavy alcohol consumption
Non-modifiable factors:
Age
Family history of hypertension
Sex and hormonal changes (e.g., menopause)
Certain medical conditions, such as kidney disease, thyroid disorders, or sleep apnea
Medications and substances like corticosteroids, ADHD medications, and stimulants can also elevate blood pressure.
Complications
Uncontrolled hypertension can affect multiple organs and systems:
Heart: Heart attack, heart failure, atrial fibrillation, coronary artery disease
Brain: Stroke, cognitive impairment, dementia
Kidneys: Chronic kidney disease
Eyes: Hypertensive retinopathy and vision loss
Blood vessels: Peripheral artery disease
Other: Erectile dysfunction
Early detection and treatment reduce these risks significantly.
Diagnosis
Blood pressure is measured using a cuff at your doctor’s office or at home. Diagnosis typically requires multiple readings on different days.
Blood pressure categories:
Category | Systolic (mmHg) | Diastolic (mmHg) |
Normal | <120 | <80 |
Elevated | 120–129 | <80 |
Stage 1 Hypertension | 130–139 | 80–89 |
Stage 2 Hypertension | ≥140 | ≥90 |
Hypertensive Emergency | ≥180 | ≥120 with symptoms |
Hypertension can involve either the systolic, diastolic, or both readings. Older adults often develop isolated systolic hypertension, while younger adults may develop isolated diastolic hypertension.
Management and treatment
Managing blood pressure involves a combination of lifestyle adjustments and medications when necessary.
Lifestyle approaches:
Maintain a healthy weight
Follow a heart-healthy diet (DASH or Mediterranean) low in sodium and rich in fruits, vegetables, whole grains, and low-fat dairy
Increase physical activity, aiming for 150 minutes of moderate aerobic exercise per week
Quit smoking
Limit alcohol
Manage stress
Medications:
Diuretics
ACE inhibitors or ARBs
Calcium channel blockers
Beta-blockers
Medication choice depends on your blood pressure readings, underlying conditions, and overall cardiovascular risk.
Living with high blood pressure
With regular monitoring, treatment, and healthy habits, most people with hypertension can live active, full lives. Key steps include:
Take medication as prescribed and report side effects
Check your blood pressure at home and track results
Attend regular check-ups
Adjust lifestyle habits to support long-term heart and vascular health
Prognosis:
Primary hypertension usually requires lifelong management, while secondary hypertension may improve if the underlying cause is treated. Early diagnosis and consistent care help protect your heart, kidneys, brain, and eyes for years to come.