Overview
High blood pressure (hypertension) is a condition in which the pressure of blood against the artery walls is higher than normal. It affects roughly 1 in 3 adults and usually has no symptoms; that is why it is known as the "silent killer."
Untreated, it can lead to serious complications such as heart attack, stroke, kidney failure, and heart failure. With early diagnosis and regular follow-up it can be brought under control.
Blood pressure values:
- Normal: below 120/80 mmHg
- Elevated: 120-129 / below 80 mmHg
- Stage 1 hypertension: 130-139 / 80-89 mmHg
- Stage 2 hypertension: 140/90 mmHg or higher
Symptoms
Most patients have no symptoms. At very high values, the following may occur:
- Headache (especially in the back of the head, in the morning)
- Dizziness
- Ringing in the ears
- Nosebleeds
- Shortness of breath
- Palpitations
- Blurred vision
- Weakness
Causes
Primary (essential) hypertension: 90% of cases. There is no single cause; it develops over years.
Secondary hypertension: Caused by an underlying condition:
- Kidney disease
- Thyroid disorders
- Adrenal tumors (pheochromocytoma)
- Sleep apnea
- Certain congenital vascular abnormalities
- Some medications (birth control pills, decongestants, NSAIDs)
- Drug use (cocaine, amphetamines)
Risk Factors
- Age: Men after 45, women after 55
- Family history
- Excess weight and obesity
- Sedentary lifestyle
- High salt intake
- Potassium deficiency
- Excessive alcohol use
- Smoking
- Stress
- Diabetes
- Chronic kidney disease
Complications
- Heart attack and stroke
- Aneurysm
- Heart failure
- Kidney failure
- Vision loss (hypertensive retinopathy)
- Increased risk of dementia
- Metabolic syndrome
When to See a Doctor
- If your reading is above 180/120 mmHg, seek immediate care
- If you have severe headache, chest pain, shortness of breath, or blurred vision
- Regular yearly check-up if you have been diagnosed with hypertension
Diagnosis and Treatment
Diagnosis: Made by detecting elevated values on more than one measurement. 24-hour ambulatory monitoring may be done.
Treatment:
- Lifestyle changes are the first step
- Medications (ACE inhibitors, ARBs, calcium channel blockers, diuretics, beta blockers)
- Medications are usually lifelong and should not be stopped without medical advice
Prevention
- Reduce salt intake to below 5 g per day
- Maintain a healthy weight
- Exercise at least 150 minutes per week
- Eat plenty of fruits, vegetables, and whole grains (DASH diet)
- Limit alcohol
- Quit smoking
- Manage stress
- Measure your blood pressure regularly at home