Your doctor can help you measure and track your blood pressure to confirm whether it’s too high. You may need to start taking medications if your blood pressure doesn’t improve after one month of following a healthy lifestyle, especially if you’re already at high risk for heart disease. If you’re at lower risk, your doctor may want to follow up in three to six months after you’ve adopted more healthy habits.
Doctors typically use an inflatable arm cuff to measure blood pressure, which is recorded in millimeters of mercury (abbreviated as “mmHg”) and has two numbers. The top number, called systolic blood pressure, measures pressure in the arteries when the heart beats. The bottom number, called diastolic blood pressure, refers to blood pressure when the heart is at rest. When patients have a blood pressure above normal (120/80 mmHg), they are considered to have prehypertension or hypertension.

Blood pressure is more than just a number. Managing hypertension can reduce your risk of heart attack, stroke, and early death. If you’re committed to making positive lifestyle changes and managing your blood pressure, you can reduce or even eliminate your need for blood pressure medication. Lower your blood pressure and take control of your health.
Most doctors do not make a final diagnosis of high blood pressure until they measure your blood pressure several times (at least 2 blood pressure readings on 3 different days). Some doctors ask their patients to wear a portable machine that measures their blood pressure over the course of several days. This machine may help the doctor find out whether a patient has true high blood pressure or what is known as “white-coat hypertension.” White-coat hypertension is a condition in which a patient’s blood pressure rises during a visit to a doctor when anxiety and stress probably play a role.
High blood pressure (hypertension) can quietly damage your body for years before symptoms develop. Left uncontrolled, you may wind up with a disability, a poor quality of life or even a fatal heart attack. Roughly half the people with untreated hypertension die of heart disease related to poor blood flow (ischemic heart disease) and another third die of stroke.
Essential hypertension is also greatly influenced by diet and lifestyle. The link between salt and high blood pressure is especially compelling. People living on the northern islands of Japan eat more salt per capita than anyone else in the world and have the highest incidence of essential hypertension. By contrast, people who add no salt to their food show virtually no traces of essential hypertension.
In some cases, medication is necessary to lower blood pressure. It really depends on how high your blood pressure is and other risk factors, like family history of heart attack and stroke. Based on these risks and your current lifestyle, your doctor may prescribe common hypertension medications like lisinopril, amlodipine, losartan, and hydrochlorothiazide.
Essential hypertension is also greatly influenced by diet and lifestyle. The link between salt and high blood pressure is especially compelling. People living on the northern islands of Japan eat more salt per capita than anyone else in the world and have the highest incidence of essential hypertension. By contrast, people who add no salt to their food show virtually no traces of essential hypertension.
Kidney failure. High blood pressure is one of the most common causes of kidney failure. That's because it can damage both the large arteries leading to your kidneys and the tiny blood vessels (glomeruli) within the kidneys. Damage to either makes it so your kidneys can't effectively filter waste from your blood. As a result, dangerous levels of fluid and waste can accumulate. You might ultimately require dialysis or kidney transplantation.
Sodium: An essential nutrient found in many foods and table salt. Sodium helps your muscles and nerve cells work and controls your blood pressure. Only a little is needed. Too much sodium in your body can cause high blood pressure and bloating. The daily recommended limit for sodium is 2,300 milligrams (equal to one teaspoon of table salt). If you have high blood pressure or other health problems, your doctor will likely recommend even less.
Your doctor can help you measure and track your blood pressure to confirm whether it’s too high. You may need to start taking medications if your blood pressure doesn’t improve after one month of following a healthy lifestyle, especially if you’re already at high risk for heart disease. If you’re at lower risk, your doctor may want to follow up in three to six months after you’ve adopted more healthy habits.
Transient ischemic attack (TIA). Sometimes called a ministroke, a transient ischemic (is-KEE-mik) attack is a brief, temporary disruption of blood supply to your brain. It's often caused by atherosclerosis or a blood clot — both of which can arise from high blood pressure. A transient ischemic attack is often a warning that you're at risk of a full-blown stroke.

Physical examination may include listening to the heart and lungs, feeling for pulse in the wrist and ankles, and feeling and listening to the abdomen looking for signs of an enlarged aorta. The examiner may also listen in the neck for carotid bruits (sounds made by a narrowed artery in the neck) and in the abdomen for bruits made by an abdominal aortic aneurysm.
Excessive daytime sleepiness is suggestive of sleep apnea syndrome, but a sleep study is required to diagnose the disorder. Chronic excessive alcohol consumption can also lead to IDH. This may be especially likely if liver damage occurs since angiotensin is usually degraded in the liver. IDH may also be caused by medications, such as oral contraceptives, corticosteroids or nonsteroidal anti-inflammatory drugs like ibuprofen.
Vegetables give you fiber, vitamins, and minerals. They don't have a lot of calories or fat -- a good recipe for controlling blood pressure. Have four to five servings of vegetables a day. That’s 1/2 cup of cooked or raw vegetables, 1 cup of raw leafy vegetables, or 1/2 cup of vegetable juice for each serving. Iffy about veggies? Start by adding a salad at lunch and dinner.

Hypertension: Another word for high blood pressure, hypertension is a common condition in which blood flows through your arteries too forcefully. Blood pressure is measured by two numbers. The top number is called the systolic blood pressure, and the bottom number is the diastolic blood pressure. Your blood pressure is high when it’s at or above 130/80. Normal blood pressure is 120/80 or lower.


Blood pressure refers to the force exerted by circulating blood on the walls of blood vessels and constitutes one of the principal vital signs. The pressure of the circulating blood decreases as blood moves through arteries, arterioles, capillaries, and veins; the term blood pressure generally refers to arterial pressure, i.e., the pressure in the larger arteries, arteries being the blood vessels which take blood away from the heart.
Whelton PK, et al. (2017). Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology, published online November 13, 2017. DOI: 10.1016/j.jacc.2017.11.006. Accessed November 20, 2017.
Recent updates to guidelines from the American Heart Association and the American College of Cardiology changed the definition of high blood pressure or hypertension for most people. High blood pressure is now generally defined as 130 or higher for the first number, or 80 or higher for the second number (previously it was 140/90). However, there are important considerations for older adults in deciding whether to start treatment for high blood pressure, including other health conditions and overall fitness. If your blood pressure is above 130/80, your doctor will evaluate your health to determine what treatment is needed to balance risks and benefits in your particular situation.
In isolated systolic high blood pressure (isolated systolic hypertension, or ISH), systolic blood pressure is elevated (140 mm Hg or higher), but diastolic blood pressure stays below 90 mm Hg. This type of high blood pressure is more common in older adults, especially older women. In fact, the majority of people older than 60 who have hypertension have isolated systolic hypertension.
Half of American adults have this life-threatening condition, yet many are unaware or simply don’t take it seriously. But it doesn’t have to be that way. Hypertension is manageable and even preventable, but you have to know your risk factors and get your blood pressure checked (regularly!) to see if you’re at risk. Let’s take a closer look at what blood pressure actually is, how hypertension works, and how you can prevent the effects of high blood pressure to stave off heart disease.
Not enough info for you? Geek out on blood pressure and hypertension with these studies and stats from the most trusted sources on the interwebs. And if you have any questions or you think we missed something important, leave a comment or book a consultation with me or one of these trained medical professionals and we’ll answer your questions and concerns in no time.
For older people, often the first number (systolic) is 130 or higher, but the second number (diastolic) is less than 80. This problem is called isolated systolic hypertension, which is due to age-related stiffening of the major arteries. It is the most common form of high blood pressure in older people and can lead to serious health problems (stroke, heart disease, eye problems, and kidney failure) in addition to shortness of breath during light physical activity, lightheadedness upon standing too fast, and falls. Isolated systolic hypertension is treated in the same way as regular high blood pressure (130 or higher for the first number, or 80 or higher for the second number) but may require more than one type of blood pressure medication. If your doctor determines that your systolic pressure is above a normal level for your age, ask how you can lower it.
Isolated systolic hypertension occurs when the top number of a blood pressure reading (systolic blood pressure) is high and the bottom number (diastolic blood pressure) is normal. Isolated systolic hypertension is most common along older adults, but is also found in young and middle-aged adults. It’s important for patients with isolated systolic hypertension to work with their doctors to determine the best possible treatment to achieve a healthy blood pressure and reduce risk of complications.
Elevated blood pressures in the medical setting may not necessarily reflect the individuals real status. "White coat hypertension" describes a patient whose blood pressure is elevated because of the stress of the visit to the doctor or other healthcare professional, and the worry that their blood pressure might be elevated. Repeated blood pressure checks at the doctor's office or the use of a home blood pressure monitoring device may be used to confirm that you have high blood pressure.

Though essential hypertension remains somewhat mysterious, it has been linked to certain risk factors. High blood pressure tends to run in families and is more likely to affect men than women. Age and race also play a role. In the United States, blacks are twice as likely as whites to have high blood pressure, although the gap begins to narrow around age 44. After age 65, black women have the highest incidence of high blood pressure.


By the Numbers. High Blood Pressure: 1 in 3 Adults has high blood pressure; 1 in 3 Adults with high blood pressure does not get treatment; 1 in 2 Adults with high blood pressure does not have it under control. High Cholesterol: 1 in 3 Adults has high cholesterol; 1 in 2 Adults with high cholesterol does not get treatment; 2 in 3 Adults who have high cholesterol do not have it under control.
A later study, published in the Journal of Hypertension, found similar results. Researchers analyzed data from 4,680 participants aged 40 to 59 years from 17 different areas in Japan, China, the United Kingdom, and the United States. They looked at blood pressure, cholesterol levels, and diet over the previous 24 hours. The results showed that cholesterol was directly related to blood pressure for all participants.
A blood pressure reading measures both the systolic and diastolic forces, with the systolic pressure listed first. The numbers show your pressure in units of millimeters of mercury (mm Hg)—how high the pressure inside your arteries would be able to raise a column of mercury. For example, a reading of 120/80 mm Hg means a systolic pressure of 120 mm Hg and diastolic pressure of 80 mm Hg.
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