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What is Hypertension?

Hypertension, commonly known as high blood pressure, affects millions of Americans, from children to older adults. It is estimated in the US 30% of individuals have high blood pressure at any given point in time. It is extremely likely that at some point in your life you will have high blood pressure. At the same time, the vast majority of people have no symptoms and it is estimated that as many as 1 in 6 people who have hypertension have no idea that they have it. Because it goes undetected, is so prevalent, and has severe health consequences, it is often referred to as a “silent” killer. Learn more about what does hypertension mean for your health.

Definition of Hypertension

Hypertension, or high blood pressure, is the most common cardiovascular disease in the US. The American Heart Association define hypertension as a condition where the pressure your blood puts on your artery walls is higher than normal ranges for a sustained period of time. Similar to the pressure needed to send air through a tube; your blood needs pressure to travel through your arteries. Just like too much pressure can damage a tire, high blood pressure can lead to a number of health conditions including potentially life-threatening conditions like stroke. Illnesses or medications that narrow the arteries increase high blood pressure. This is also why high blood pressure is so much more common with older adults. As we age, our arteries narrow meaning the same amount of pressure in a regular sized artery is equivalent to high blood pressure in a narrowed artery.

There are two types of hypertension. Essential hypertension is where the underlying cause of the high blood pressure is unknown, which may be as many as 95% of cases in the US. Secondary hypertension is when the direct cause of the high blood pressure can be determined. Common causes include kidney disease, tumors and birth control pills and pregnancy in women. Both of these types depend on your medical history and increase in likelihood with certain demographic factors and personal traits.

High blood pressure is more common in certain demographic groups: African-Americans, lower-income, residents of the southeastern US, individuals older than 55, and men. Certain traits also increase your likelihood of having high blood pressure:

  • Overweight: Being more than 15% of the healthy weight for your body mass increases your likelihood of getting high blood pressure significantly. Obese people develop high blood pressure two to six times more often than healthy individuals.

  • Heavy alcohol drinkers: Those who drink more than two drinks a day have higher rates of high blood pressure then those who do not.

  • Inactive: Being inactive contributes to obesity and high blood pressure.

  • Smokers: Smoking negatively affects key body functions, including your ability to exercise and therefore also contributes to obesity and high blood pressure.

Additionally, a diet heavy in salt, regular use of decongestants or medications like ibuprofen or birth control as well as illegal drugs like cocaine all increase your chance of having high blood pressure.

What is Considered High Blood Pressure?

While hypertension / high blood pressure can have serious consequences if left untreated, it is very easy to detect. A doctor or nurse, pharmacy, or even at home monitor can measure your blood pressure with a device called a sphygmomanometer. This device consists of a dial, pump, valve, arm cuff, and stethoscope. The number is made up of two numbers: systolic blood pressure or the pressure when the heart beats and diastolic blood pressure or the pressure between two heartbeats when the heart is resting. High blood pressure is written in millimeters of mercury or mm HG, though most people know it just by the numbers where systolic blood pressure is written over diastolic blood pressure. Normal guidelines are 120/80 in a healthy adult. Different guidelines exist for each age starting with 64/40 at birth. During exercise, your blood pressure increases slightly and competitive athletes have very low resting blood pressure numbers due to constantly engaging in sustained physical activity. Your blood pressure can also increase slightly based on your emotional state. Sometimes called “white coat hypertension”, people may record a higher blood pressure if they are in a doctor’s office and being in such an environment causes anxiety. This is why multiple tests are necessary for diagnosing high blood pressure.

Hypertension is defined for adults as being blood pressure greater than 140/90, but the high blood pressure range can depend on a variety of personal and environmental factors. Usually three readings of hypertension are required for a diagnosis. In addition, a doctor will ask about your medical history and potential risk factors we well as conducting a physical exam or requesting additional tests. If your blood pressure is 180/110 or greater, it is called a hypertensive crisis and you should seek medical attention immediately. About 75 million adults in the US fall into the category called prehypertension. This means that your blood pressure is just slightly above the normal guidelines, usually at 120/80. This type of hypertension can still cause damage to your arteries and organs, though the chances of this happening are much less and there is disagreement in the medical community about whether or not it should be treated like hypertension. In making any decisions, it is very important to consult your doctor or a medical professional. Thus, the high blood pressure range breakdown is:

  • Normal: 120/80

  • Prehypertension: 120-139 / 80-89

  • High Blood Pressure Stage 1: 140-159 / 90-99

  • High Blood Pressure Stage 2: 160-180 / 100-110

  • Hypertensive Crisis: 180/110 or higher

What does High Blood Pressure Feel Like?

Hypertension can be present for years without symptoms, but can still damage your heart and blood vessels. In fact, most people have no symptoms. For those who do show signs or have severe enough hypertension, symptoms of high blood pressure may include:

  • Shortness of breath

  • Nosebleeds

  • Headaches

  • Confusion or fatigue

  • Chest pain

  • Vision problems

  • Blood in urine

  • Irregular heartbeat

  • Pounding in your ears, neck, or chest

Any of these high blood pressure symptoms could lead to a hypertensive crisis eventually increasing the likelihood of a stroke or a heart attack. Even with no symptoms, untreated hypertension can also cause kidney failure, aneurysms, leg pain while walking, or eye problems. High blood pressure may be very serious, but it is extremely easy to detect. You should have semi-regular checkups to check for high blood pressure regardless of whether you have symptoms are not.

What Does High Blood Pressure Mean for Your Health?

Hypertension, or high blood pressure, is often called the “silent” killer, because it may have no signs or symptoms. Untreated high blood pressure can cause a number of diseases and even be life threatening. The most common severe complications of untreated hypertension are:

  • Heart disease: The number one cause of death from high blood pressure is hypertensive heart disease. This includes a group of conditions like heart failure, heart attack, and left ventricular hypertrophy. This results from high blood pressure thickening the heart muscles, and then those muscles becoming less effective.

  • Stroke: A stroke is four to six times more likely for individuals with high blood pressure. Sometimes called a brain attack, a stroke happens when blood flow to parts of the brain are cut off, causing brain cells to be deprived of glucose and oxygen and result in permanent brain damage. Atherosclerosis, caused by untreated, long-term hypertension, happens when there is hardening of large arteries. This can block smaller blood vessels to the brain resulting in stroke.

  • Kidney disease: High blood pressure can damage blood vessels and filters that lead to the kidney. In earlier stages this causes kidney disease or renal disease, and in later stages can cause total kidney failure, where dialysis or kidney transplants are necessary.

  • Eye disease: Along with the problems listed above, hypertension can cause eye disease by damaging the retina blood vessels, or where the eye puts images in focus. Called hypertensive retinopathy, the damage to your vision can be very serious.

When to Contact a Doctor

If you have any of the symptoms described, you should go see a doctor. In general, if you have any of the major risk factors, you should be tested for high blood pressure regularly.

Additionally, you should call 911 immediately if you have any of the following symptoms as they can be a sign of untreated high blood pressure resulting in a hypertensive emergency:

  • Blurred vision or headache

  • Numbness on one side of the body

  • Dizziness

  • Increasing shortness of breath, chest pain, or confusion

  • Swelling

  • Seizure



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