What is considered high blood pressure?

Reviewed by:
Dr. Robert Kwok
Director of Health Informatics
Last updated on August 4, 2022 UTC

More than half of adults above 50 years of age have high blood pressure. Sadly, many people with high blood pressure are unaware they have the condition. It is commonly known as the “silent killer” since a person with the disease generally does not show signs and symptoms.

High blood pressure is a health condition also known as hypertension, characterized by increased blood pressure over time. It is one of the most common diseases globally, caused by various underlying conditions and risk factors. Although it is much more prominent in adults over age 60, the obesity epidemic is causing even younger adults to develop hypertension.

What is blood pressure in an individual?

Blood pressure measures the blood's force as it flows within the arteries. As the heart pumps blood, it creates pressure that pushes the blood to all body organs and tissues. Blood pressure needs to be strong enough to ensure that your body tissues and organs receive enough nutrients and oxygen.

It is normal for blood pressure to rise and fall throughout the day due to factors such as physical activity. However, if the blood pressure gradually becomes too much, it becomes harmful to a person’s health. An individual with untreated hypertension is at risk of stroke, heart attack, and kidney failure.

How is blood pressure measured?

Blood pressure is measured [1] by a machine known as a sphygmomanometer, also called a blood pressure monitor. The digital blood pressure monitor is commonly used because it is portable and easy to operate. The cuff is placed on an individual's upper arm in a relaxed state, then inflates. The monitor will take a measurement and display two numbers, the systolic number and the diastolic number.

The systolic number is the blood pressure in arteries when the heart beats (during a pulse), and is the larger number. The diastolic measurement is the blood pressure in the arteries between pulses.

The measuring unit for blood pressure is millimeters of mercury (mmHg). Normal blood pressure is less than 120/80 mmHg, which is said out loud as "120 over 80". However, since everyone is different, the numbers might be slightly below or above the norm.

Anyone can measure blood pressure at home since the blood pressure monitors are easy to operate. However, only a doctor can formally diagnose hypertension and start medications.

Sometimes, a doctor can request ambulatory blood pressure monitoring for an individual. The individual wears a blood pressure monitoring cuff for at least 24 hours. The device will take measurements several times during the day as the person continues their daily activities. The doctor will then have a clearer picture of the person’s daily blood pressure pattern.

What is high blood pressure?

High blood pressure is a disease caused by increased arterial blood pressure. Too much pressure within the arteries will cause strain to the blood vessels’ walls, leading to further tissue or organ damage. High blood pressure[1] can cause severe damage to one’s kidneys, eyes, brain, and heart if left unchecked.

When there is too much strain, the heart and arteries will be overloaded, and they become less efficient in their work. Over time, stress causes further damage to the arteries, narrowing the arteries and limiting the oxygen flow to tissues. Therefore, the risk of stroke, heart failure, and heart attack will increase. 

The American College of Cardiology[2], the American Heart Association, and other health organizations lowered the measurement for diagnosis. Before, one was said to have hypertension if their blood pressure was 140/90 mmHg for adults below age 65.

In 2017 [2], the diagnosis of hypertension became 130/80 mmHg for all adults, regardless of age. Therefore, anything above 129/79 mmHg is considered high blood pressure.

Individuals with mildly elevated blood pressure should carry out specific measures to reduce their pressure. For example, they can make lifestyle changes such as reducing salt and avoiding alcohol for better health.

A person is said to have stage 1 hypertension if their blood pressure is at 130/80 mmHg to 139/89 mmHg. Here, the individual must undertake more interventions to prevent the disease from worsening. The doctor might prescribe them medication to regulate and lower their blood pressure.

Stage 2 hypertension occurs when a person has a blood pressure of 140/90 or higher. At this stage, the individual will need proper medication and lifestyle changes to manage the disease for a longer life.

Anyone with blood pressure at 180/120 and above is at hypertensive risk and may require immediate medical attention. Such a person is at the highest risk of stroke, heart attack, and kidney failure.

What are the causes and risk factors of hypertension?

About 95% of people with hypertension have primary hypertension, also called essential hypertension. It does not have any underlying causes and develops over a long period. It is usually due to a person's genetics, lifestyle, and environment, including how their body changes as they age.

Secondary hypertension usually occurs because of an underlying condition or health problem. Mainly, tumors or abnormalities in the adrenal gland near the kidney can cause an individual to have hypertension. Particular medications, such as birth control pills, can be an underlying factor in someone having hypertension.

Additionally, about 6% of pregnant women [1] with no history of hypertension will have hypertension during their pregnancies. This gestational hypertension occurs during the second half of pregnancy and can cause significant harm to the fetus and the mother.

Some of the risk factors for high blood pressure include:

  • Smoking.
  • High alcohol consumption.
  • Older age. 
  • Hereditary traits, such as a family member with high blood pressure or cardiovascular disease.
  • Poor diet and high salt intake.
  • Obesity. 
  • Stress. 
  • Chronic conditions such as diabetes and kidney diseases.

Therefore, if an individual has one or more risk factors, it is advisable to have their blood pressure measured.

What are the signs and symptoms of hypertension?

Unfortunately, there are generally no signs and symptoms indicate a person is suffering from hypertension[3]. Some people will have shortness of breath, headaches, and poor vision, but these symptoms might mimic other conditions.

Therefore, the only way to diagnose high blood pressure is by measuring one’s blood pressure regularly. Otherwise, it will be undetected and untreated, leading to adverse health effects and even death.

According to the Center for Disease Control[4], almost 400,000 deaths in 2013 were directly caused by hypertension. Thus, individuals should know their blood pressure and see a doctor online or in person if their measurements are elevated.

What measures can an individual take to regulate their blood pressure?

Being newly diagnosed with hypertension can feel scary but there is good reason to be hopeful. One’s doctor can discuss medications and lifestyle interventions to ensure their blood pressure gets under control. Millions of patients have their high blood pressure under good control. Some of the health measures include:

Measuring blood pressure at regular intervals

People with risk factors, such as a family history of hypertension, should periodically measure their blood pressure. That way, they will know when their blood pressure is high and take the proper steps to regulate it.

Ensuring other conditions that may cause hypertension are treated

Treating the underlying conditions, especially diabetes and cardiovascular diseases, is a good way to control hypertension.

Lifestyle changes

Adjusting one's lifestyle is the best approach to maintaining normal blood pressure. Cutting back on excess salty, fatty, and processed foods will go a long way to improve one's health. It is recommended that a person exercise for 150 minutes every week to maintain a healthy body.

Additionally, as one gets older, they are more at risk of having hypertension. Therefore, older adults will require more attention to their lifestyles to control and regulate their blood pressure.

It’s best to avoid smoking and excess alcohol intake as tobacco and alcohol are both directly linked to high blood pressure. Also, using better stress management techniques will reduce the likelihood of having hypertension.

Medication

Upon diagnosis, the doctor can prescribe suitable medication, depending on a patient’s hypertension stage if lifestyle improvements alone are not effective enough. Several first-line drugs work differently to lower and regulate blood pressure. They include:

  • Calcium channel blockers allow relaxation of the heart's muscle cells.
  • Angiotensin-converting enzyme (ACE) inhibitors prevent the narrowing of blood vessels.
  • Diuretics flush excess sodium from the body, and they work together with other blood pressure medicines.
  • Angiotensin II receptor blockers (ARBs) work the same way as ACE inhibitors, preventing the narrowing of blood vessels.

In summary

Hypertension is a serious condition since it usually occurs without showing any apparent signs or symptoms. High blood pressure untreated can lead to damaged arteries and severe organ and tissue damage.

Early diagnosis is the key to prolonged good health, requiring the right interventions, including lifestyle improvements and proper medication. Additionally, one can book an online appointment with a HealthTap doctor here for advice or ongoing care. For more information on hypertension medicine, click here

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