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High blood pressure, or hypertension, is when the force of blood flowing through the blood vessels is consistently too high, and the heart has to work harder to pump blood. Nearly half of American adults have high blood pressure. The best way to know if someone has high blood pressure is to have it checked regularly. People over 40 should have it checked by a healthcare professional at least annually. 


Hypertension is often referred to as a “silent killer” since many people don’t even know they have it.  When left untreated, the damage that high blood pressure does to the circulatory system is a significant contributing factor to heart attack, stroke, and other serious health threats.


Understanding Blood Pressure Readings

Blood pressure is measured in millimeters of mercury (mm Hg) and is recorded as two numbers:

  • Systolic (the top number) measures the pressure the blood exerts against the artery walls when the heart contracts during heartbeats.

  • Diastolic (the bottom number) measures the pressure the blood exerts against the artery walls while the heart is resting between beats.

A blood pressure reading of 130/80 mm Hg or higher is generally considered high.  The blood pressure categories are below; refer to this chart. 

  • Normal blood pressure: lower than 120/80 mm Hg

  • Elevated blood pressure:  the top number ranges from 120 to 129 mm Hg, and the bottom number is below 80 mm Hg

  • Stage 1 hypertension: the top number ranges from 130 to 139 mm Hg, or the bottom number is between 80 and 89 mm Hg

  • Stage 2 hypertension: the top number is 140 mm Hg or higher, or the bottom number is 90 mm Hg or higher

  • Hypertensive emergency or crisis: higher than 180/120 mm Hg. Emergency medical help should be sought. 

Types and Causes of Hypertension (note: types may co-exist)

  • Primary hypertension is the most common type and is caused by aging and lifestyle factors such as unhealthy eating habits, high sodium diet, lack of physical activity, and high consumption of alcoholic beverages.

  • Secondary hypertension is caused by a medical condition such as kidney disease, renal vascular disease, obstructive sleep apnea, or primary aldosteronism (Conn’s syndrome) or medications like immunosuppressants, NSAIDs, and oral contraceptives. It may also be caused by recreational drug use (such as amphetamines and cocaine) and tobacco use, including smoking, vaping, and smokeless tobacco.

  • White coat hypertension is when readings are normal at home but elevated in a healthcare setting.

  • Masked hypertension is when readings are normal in a healthcare setting but elevated at home.

  • Nocturnal hypertension is when blood pressure is elevated during sleep.

Risk Factors that can lead to high blood pressure include:

  • Having biological family members with high blood pressure, cardiovascular disease, or diabetes.

  • Being over age 55

  • Being Black

  • Having  medical conditions such as chronic kidney disease, metabolic syndrome, obstructive sleep apnea, or thyroid disease

  • Being overweight or obese

  • Not getting enough exercise.

  • Eating foods high in sodium

  • Smoking or using tobacco products

  • Drinking too much


Most people with high blood pressure have no symptoms, even if blood pressure readings reach dangerously high levels. Some people may experience headaches, shortness of breath, or nosebleeds. However, these symptoms aren't specific to hypertension and usually don't occur until high blood pressure has reached a severe or life-threatening stage.


Consequences of High Blood Pressure

In most cases, damage occurs over time and, left undetected or uncontrolled, can lead to:


Managing High Blood Pressure

While there is no cure, using medications as prescribed and making lifestyle changes can enhance the quality of life and reduce the risk of heart disease, stroke, kidney disease, and more.

  • Eat a well-balanced diet low in salt and high in potassium.

  • Limit alcohol

  • Enjoy regular physical activity.

  • Manage stress

  • Maintain a healthy weight.

  • Quit smoking

  • Take medications properly

  • Work together with a healthcare professional and learn how to measure blood pressure at home

  • Know and  track  blood pressure readings

Questions to Ask Your Healthcare Provider

  • What’s my average blood pressure reading?

  • What’s an ideal blood pressure reading for me?

  • Should I use a home blood pressure monitor?

  • What lifestyle changes should I make?

  • What kinds of exercise should I do?

  • Do I need medications? If so, which ones and what are the side effects?

  • Are there supplements or nonprescription medications I shouldn’t take?

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