Hypertension
Hypertension, also called high blood pressure, is a common long-term condition that occurs when the force of blood against artery walls stays too high over time. Blood pressure is measured using two numbers: systolic pressure, taken when the heart beats, and diastolic pressure, taken when the heart relaxes. A single high reading does not mean you have hypertension. Diagnosis is based on repeated measurements, sometimes including home or ambulatory monitoring.
Symptoms
Most people with hypertension have no symptoms. When symptoms do occur, they may include headaches, shortness of breath, nosebleeds, chest discomfort or vision changes. These usually appear only when blood pressure is very high or rising quickly.
Causes and Risk Factors
There are two main types of hypertension.
- Primary (essential) hypertension develops gradually and does not have a single cause. Genetics, lifestyle and environmental factors all contribute.
- Secondary hypertension is caused by another condition, such as kidney disease, hormonal disorders, certain medications or sleep apnea.
Common risk factors include aging, family history, obesity, physical inactivity, high salt intake, excess alcohol use, smoking, diabetes and chronic kidney disease.
Complications
Uncontrolled high blood pressure increases the risk of heart attack, stroke, heart failure, kidney disease, vision loss, peripheral artery disease and cognitive decline.
Diagnosis
Hypertension is diagnosed using multiple blood pressure readings taken over time, sometimes including home checks or 24-hour ambulatory monitoring. Your care team will review your medical history, perform a physical exam and may order blood or urine tests, an electrocardiogram (ECG) or imaging to look for organ effects or underlying causes.
Treatment Overview
The goal of treatment is to bring blood pressure into a healthy range and lower the risk of heart and blood vessel disease. Management often begins with lifestyle changes, such as weight loss, following a heart-healthy diet like DASH, reducing sodium, exercising regularly, limiting alcohol, quitting smoking and managing stress. If needed, medications are added. Many people require more than one medication, and treatment is tailored to your overall health and response.
When to Seek Care
Contact your healthcare practitioner if you have repeated high readings, new symptoms such as chest pain, severe headache, confusion or trouble breathing, or difficulty taking your medications. Care at TidalHealth includes regular follow-ups to monitor blood pressure and treatment effects.
What blood pressure numbers are considered normal or high?
Normal blood pressure is generally around 120/80 mm Hg or lower. Hypertension is often diagnosed at average readings of 130/80 mm Hg or higher, though some guidelines use 140/90 mm Hg. Your healthcare practitioner will interpret your numbers in the context of your health.
How is hypertension diagnosed?
Diagnosis requires more than one high reading. Your practitioner may recommend home monitoring or a 24-hour test to confirm ongoing elevation and identify patterns such as white-coat or masked hypertension.
Can hypertension be cured?
Primary hypertension is usually controlled rather than cured, but many people achieve good control with lifestyle changes and medication. Secondary hypertension may improve or resolve if the underlying cause is treated.
What are common treatments for high blood pressure?
Lifestyle changes are often the first step. Medications may include diuretics, ACE inhibitors, angiotensin receptor blockers (ARBs), calcium channel blockers and beta-blockers. Treatment is individualized, and combinations are common.
Are there side effects from blood pressure medicines?
Yes, side effects vary by medication. Diuretics can increase urination and affect electrolytes. ACE inhibitors may cause cough, and calcium channel blockers can lead to ankle swelling. Your care team monitors for side effects and adjusts treatment as needed.
What lifestyle changes help lower blood pressure?
- Following a DASH-style diet
- Reducing sodium
- Maintaining a healthy weight
- Getting at least 150 minutes of moderate exercise each week
- Limiting alcohol
- Quitting smoking
- Managing stress and improving sleep
How often should I check my blood pressure?
If your blood pressure is stable, checks every three to six months may be enough. More frequent monitoring is recommended if readings are high or medications change. Home monitoring offers useful information between visits.
What is white-coat hypertension and masked hypertension?
White-coat hypertension means blood pressure is high in the clinic but normal at home. Masked hypertension is normal in the clinic but high outside it. Extra monitoring may be recommended if either is suspected.
Can high blood pressure cause emergencies?
Yes. A hypertensive emergency involves very high blood pressure with organ damage, such as chest pain, stroke symptoms or severe shortness of breath, and requires immediate care. Hypertensive urgency is also serious and needs prompt evaluation.
Does pregnancy affect blood pressure?
Pregnancy can raise blood pressure and lead to conditions like gestational hypertension or preeclampsia. If you are pregnant or planning pregnancy, discuss blood pressure management with your healthcare practitioner.
How can I prepare for a visit about high blood pressure?
- Bring home blood pressure readings
- List all medications and supplements
- Review your medical and family history
- Note any symptoms
- Bring your home monitor or recorded readings, if available
When should I call my practitioner?
Contact your healthcare practitioner if your blood pressure remains high at home, you develop symptoms such as chest pain, fainting, severe headache, sudden weakness or speech changes, or if medication side effects interfere with daily life.
