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Hypertension
Overview
Hypertension means having higher than normal blood pressure. Blood pressure is the force of your blood on the walls of your blood vessels. This force, or pressure, helps pump blood throughout your body. Everyone needs this pressure to keep blood circulating.
When the force of blood against your artery walls is too strong, you have hypertension. This causes your:
- Heart to work too hard while pumping blood throughout your body.
- Blood vessels to be damaged over time.
By lowering your blood pressure, you can reduce some of this extra stress on your heart and blood vessels.
Causes and Risk Factors
Hypertension develops due to both lifestyle (behavioral) and family medical history (inherited) risk factors. These factors also affect whether hypertension is mild, moderate, or severe.
Lifestyle
Lifestyle factors include:
- Ongoing high stress
- Eating a high-salt (sodium) diet
- Drinking too much (alcohol misuse)
- Getting too little exercise or other physical activity
- Smoking
- Having untreated sleep apnea
You can help prevent hypertension by making healthy lifestyle choices and taking medication, if needed.
Family medical history
If members of your family have high blood pressure, you’re at higher risk for this condition. We encourage you to pay attention to your blood pressure, get regular checkups, make heart-healthy lifestyle choices, and follow your treatment plan.
Blood pressure tends to increase as we age. Men are more likely than women to have hypertension before age 60. After that, men and women are equally affected.
As a group, African Americans are more likely to have hypertension and develop more medical problems from high blood pressure than other ethnic or racial groups.
Symptoms
Most people with hypertension don’t have symptoms. A small number of people get headaches when their blood pressure is higher than normal (elevated).
Even without noticeable symptoms, hypertension damages your body. It’s important to check your blood pressure regularly and follow your treatment plan.
The damage from hypertension occurs gradually, over time. Controlling high blood pressure limits the damage to important organs such as your brain, heart, and kidneys.
Diagnosis
We diagnose hypertension if your blood pressure readings are higher than goal more than once. Generally, this means 2 or more in-office readings of 140/90 or higher, or 2 home readings of 135/85 or higher.
Healthy blood pressure ranges are as follows:
- When measured in a medical office, the reading is less than or equal to 139/89 mm/Hg.
- When measured at home, the reading is less than or equal to 134/84 mm/Hg.
- The healthiest blood pressure range is 100 to 129/51 to 79 mm/Hg.
What the numbers mean
In your blood pressure reading, the top number is systolic pressure. This is the pressure in your arteries when your heart beats.
The bottom number is diastolic pressure. This is the pressure in your arteries when your heart rests between beats.
Both numbers are important. They need to be in healthy ranges to prevent damage to blood vessels and major organs.
Treatment
When we manage your blood pressure with medication and lifestyle changes, you can avoid many health risks caused by hypertension.
If high blood pressure isn’t controlled by treatment, your risk will be higher risk for:
- Stroke
- Heart attack
- Heart failure
- Kidney failure
- Dementia
Treatment goals
Healthy blood pressure for most people is 130/80 or lower. Ask your doctor about your healthy target range. This can vary from person to person.
Checking your blood pressure at home
Monitoring your blood pressure at home can help you manage it. It also helps your doctor adjust your treatment plan if needed. Your care team looks at numerous blood pressure readings, from home, office visits, and other settings.
Make sure to:
- Keep a record of all your readings.
- Share your blood pressure readings with your doctor. You can do this in a secure message from kp.org or send photos of the readings on the My Doctor Online App.
- Bring your blood pressure records to office visits with your doctor.
You can:
- Buy an (approved) upper arm blood pressure monitor (no prescription needed) at any Kaiser Permanente pharmacy or local and online stores.
- Schedule an appointment for a free blood pressure check with a medical assistant in your doctor’s office. Set this up online or by phone.
- See step-by-step instructions on taking your blood pressure at home.
Keep these points in mind:
Your blood pressure varies throughout the day. It won’t be the same each time it’s measured. Readings are usually higher in the morning. Blood pressure can go up when you’re in pain or stressed.
It’s very important to continue taking your blood pressure medications and making healthier lifestyle choices to manage your blood pressure.
Once your blood pressure is steadily within your target range, you’ll be able to check it less often at home and your doctor’s office.
Medications
Medications can lower your blood pressure and reduce your chances of heart attack, stroke, or developing heart or kidney disease.
We recommend medications for you based on your individual needs and responses to treatment.
Most patients:
- Need more than one medication to control high blood pressure.
- Have few (or no) side effects. Be sure to let us know if you have side effects or aren’t able to take any of your prescribed medications.
These are common medications for hypertension.
Thiazide diuretics
Thiazide diuretics (hydrochlorothiazide, chlorthalidone) lower blood pressure by reducing blood volume and relaxing blood vessels.
ACE inhibitors and ARBs
ACE inhibitors and ARBs (lisinopril) increase blood and oxygen supply to organs and help the heart beat more easily. This can be especially helpful for people with conditions that affect blood vessels (such as diabetes, kidney problems, heart disease, or heart failure) or who have had a stroke. ACE inhibitors and ARBs shouldn’t be taken by women who might become pregnant. These medications may increase birth defects risk.
Combination tablets
Combination tablets (lisinopril-hydrochlorothiazide) are frequently used and contain an ACE inhibitor and a thiazide diuretic to reduce the number of pills you need.
Calcium channel blockers
Calcium channel blockers (Amlodipine) relax the muscles around your arteries. This makes it easier for your heart to pump blood.
Aldosterone blockers
Aldosterone blockers (spironolactone) block aldosterone hormone, which makes it easier for the body to get rid of excess salt.
Beta blockers
Beta blockers (Atenolol) relax the heart muscle and slow heart rate. This reduces work by the heart and allows it to pump blood more easily.
Most blood pressure medications are taken long-term. If you think you need to stop your medication, check with your doctor first. Over time, changes can occur that affect heart and kidney function. You and your doctor may need to adjust your treatment.
Hypertension medications and pregnancy
Specific hypertension medications can cause birth defects. They shouldn’t be taken if you’re trying to get pregnant or may become pregnant.
If you have hypertension and want to get pregnant, please talk with your doctor. It’s best if your blood pressure is well-managed before you try to get pregnant. Hypertension can complicate pregnancy and increase health risks for you and your baby.
If you’re of childbearing age (15 to 49), have hypertension, and are using a blood pressure medication that’s not safe during pregnancy, use an effective form of birth control.
Remembering to take your medication
You can use these tips so you don’t forget.
- Put medications in a pillbox with 7 sections, one for each day of the week.
- Consider setting a daily alarm to remind you to take the medication.
- Make medication part of your daily routine. This could mean taking it at bedtime, at mealtime, or at the beginning of a TV show you watch every day.
Lifestyle Recommendations
Even if you need medication to manage blood pressure, healthier lifestyle choices can help:
- Make your medications more effective at lowering your blood pressure.
- Reduce how much medication you need.
Here are some things you can do:
- Be active. Exercise can directly lower your blood pressure. It’s also excellent for reducing stress, and helps you lose or maintain healthy weight.
- Stop smoking.
- Eat healthier. Include more fruits, vegetables and other high-fiber foods, such as whole grains and beans.
- Limit alcohol, if you drink. Have no more than 1 drink a day (for women) and no more than 2 drinks a day (for men).
- Limit salt (sodium). Use no more than 2,300 mg per day (1 teaspoon).
- Check your blood pressure at home.
Additional References
Disclaimer
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.