What causes high blood pressure and how is it treated?
Almost half of all adults in the United States have high blood pressure (hypertension). But more than three-quarters don't have the condition under control. Uncontrolled hypertension raises the risk of stroke and heart disease, two leading causes of death in the United States. Knowing what causes high blood pressure and what you can do to manage it are essential steps to taking good care of your heart health.
Understanding high blood pressure and why it happens
Blood pressure is the measurement of how hard blood pushes against the walls of the arteries, the tubes that blood moves through in the body. Blood pressure naturally rises and falls throughout the day.
Having high blood pressure over a long period of time can damage your heart, kidneys, brain, and more. Hypertension is usually caused by a combination of risk factors you have no control over and lifestyle factors you can control.
Risk factors you can't change include:
- Family history of high blood pressure
- Sex (men have a higher risk of hypertension until age 64 and women have a higher risk at age 65 and older)
- Race (being African American raises your risk for high blood pressure)
Risk factors you can control include:
- Excess stress
- Physical activity
Occasionally, hypertension is caused by another medical condition, like pregnancy or certain kidney disorders. In these cases, when the main medical condition is treated, hypertension will often go away on its own.
The only way to know if you have high blood pressure is to measure it.
How to measure your blood pressure
Blood pressure is taken using a blood pressure monitor when visiting your healthcare provider at their office, with an at-home device, or by using a blood pressure machine in your community.
Follow these instructions from the American Heart Association when checking your blood pressure to make sure you get an accurate reading.
Blood pressure measurements include two numbers. The first (or top) number is known as systolic blood pressure. This number measures the pressure in the arteries when the heart beats, pushing blood into the rest of the body. The second (or bottom) number is the diastolic blood pressure. This shows the pressure in the arteries when the heart is resting and refilling with blood.
According to the American Heart Association:
- Normal blood pressure is systolic less than 120 and diastolic less than 80
- Elevated blood pressure is systolic from 120 to 129 and diastolic less than 80
- High blood pressure is systolic from 130 of more to diastolic 80 of more
Contact your medical provider right away if your blood pressure reading shows systolic 180 or higher and/or diastolic 120 or higher. This is a hypertensive crisis!
Signs and symptoms of high blood pressure
Many people have hypertension and don't know they have it. In most cases, you can't feel it if you have high blood pressure and there are no signs or symptoms to look out for. The only way to know if you have it is to check your blood pressure regularly.
Using a blood pressure tracking form to keep track of your readings is a good way for you and your provider to monitor your blood pressure.
If you are having a hypertensive crisis, you may experience:
- Severe headache
- Shortness of breath
- Chest pain
- Severe anxiety
If you are experiencing these symptoms and have a blood pressure reading of 180/120, call 911.
Blood pressure and anxiety
Anxiety does not cause hypertension, but it may be a risk factor. Everyone experiences stress. It can be positive (ex. starting a new job) or negative (ex. being in a fender bender). Either way, stress releases hormones in the body that increase heart rate and raise blood pressure. That physical reaction is called anxiety. Anxiety may happen during a stressful moment or while worrying about the moment later.
Most stress and anxiety pass quickly and do not have a lasting impact on blood pressure. However, you may be at higher risk for hypertension if you worry excessively about life stressors for six months or more.
Managing daily stress and anxiety may help prevent high blood pressure. Participating in hobbies, spending time with friends, and taking a walk in nature are great ways to reduce stress and anxiety.
How to lower your high blood pressure
You may be able to lower your blood pressure temporarily by taking a few slow deep breaths or avoiding caffeine for a few days. But long-term lifestyle changes are much more important for controlling high blood pressure.
To help manage or prevent hypertension:
- Eat a healthy diet and reduce salt
- Get at least two and a half hours of physical activity a week
- Get enough sleep
- Limit alcohol
- Don't smoke or quit smoking
- Maintain a healthy weight
- Manage other chronic health conditions
Medications for high blood pressure
Your healthcare provider may also recommend medication to help you manage high blood pressure. There are four main types of blood pressure medications that work in different ways.
Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) are medications that stop your blood vessels from getting too narrow. This lowers the pressure against the artery walls.
Calcium channel blockers keep calcium out of the muscle cells in the blood vessels and heart, which causes the arteries to relax so that the pressure decreases.
Diuretics take out extra salt (sodium) and water from your body. This lowers blood pressure by decreasing the amount of fluid in the blood.
Beta-blockers slow down your heart rate and make the heart beat with less force so that less blood moves through your blood vessels.
Your provider may prescribe only one blood pressure medication. Or they may prescribe two or more depending on your medical history, risk factors, other medications, and other health conditions.