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.
Primary (or essential) hypertension is when the cause is unknown. The majority of hypertension cases are primary. When there is an underlying problem such as kidney disease or hormonal disorders that can cause hypertension, it is called secondary hypertension. When it is possible to correct the underlying cause, high blood pressure usually improves and may even return to normal.

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ACS Breast Cancer Screening Guideline CDC Guideline for Prescribing Opioids CDC Guideline for Prevention of Surgical Site Infections Consensus Definitions for Sepsis and Septic Shock Global Burden of Cancer, 1990-2016 Global Burden of Disease in Children, 1990-2013 Global Burden of Hypertension, 1990-2015 Global Firearm Mortality, 1990-2016 Health Care Spending in the US and Other High-Income Countries Income and Life Expectancy in the US JNC 8 Guideline for Management of High Blood Pressure President Obama on US Health Care Reform Screening for Colorectal Cancer Screening for Depression in Adults Screening for Prostate Cancer Statins for Primary Prevention of Cardiovascular Disease The State of US Health, 1990-2016 US Burden of Cardiovascular Disease, 1990-2016 WMA Declaration of Helsinki, 7th Revision
Don’t assume that your doctor is aware of these facts. If you are diagnosed with mild, high blood pressure, you likely will be prescribed medication, instructed that it is helpful, and told that you must take it for the rest of your life. But before accepting this potentially dangerous treatment, it may be to your advantage to seek answers to the following questions: “What caused my high blood pressure?” and “Can I remove those causes and reverse this condition?”
SOURCES: The Journal of the American Medical Association, May 21, 2003. Aram Chobanian, MD, dean, Boston University School of Medicine and chair of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Claude Lenfant, MD, director of the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health. Edward Roccella, PhD, MPH, coordinator of the National High Blood Pressure Education Program at NHLBI. John Laragh, MD, Cardiovascular Hypertension Center at New York Hospital/Cornell University Medical Center and editor-in-chief of the American Journal of Hypertension. WebMD Medical News: "Diuretics Best for High Blood Pressure."

Enlarged heart. High blood pressure increases the amount of work for your heart. Like any heavily exercised muscle in your body, your heart grows bigger (enlarges) to handle the extra workload. The bigger your heart is, the more it demands oxygen-rich blood but the less able it is to maintain proper blood flow. As a result, you feel weak and tired and are not able to exercise or perform physical activities. Without treatment, your heart failure will only get worse.

Many kids and teens with high blood pressure have an unhealthy lifestyle — a bad diet, excess weight, stress, and too little physical activity. So the health care provider might recommend weight loss, exercise, reduced screen time (time spent watching TV, or using a computer or mobile devices), dietary changes, and even relaxation techniques. Teens with hypertension should not smoke because it can make the long-term associated heart problems worse.
Too much booze is known to raise blood pressure. But having just a little bit could do the opposite. Light to moderate drinking (defined as one drink or fewer per day) is associated with a lower risk for hypertension in women, according to research from Boston’s Brigham and Women’s Hospital. Moderate drinking could play a role in heart disease prevention too, studies show.

The average blood pressure for an adult is 120/80 mm Hg. However, this is only an average and the healthcare provider needs to consider acceptable ranges for individual clients. For example, in adults, normal blood pressure can range from 95–145/60–90 mm Hg. The healthcare provider considers the client’s baseline blood pressure and the client’s current health state in conjunction with subjective data and other objective data. For example, a blood pressure of 90/50 mm Hg may be normal for a healthy, asymptomatic 20-year-old adult.

Dietary changes: The health care provider might recommend a diet that includes more vegetables (especially leafy green vegetables), fruits, low-fat dairy products, and fiber-rich foods, and fewer carbohydrates, fats, processed foods, and sugary drinks. He or she also might recommend preparing low-sodium dishes and not adding salt to foods. Watch out for foods with lots of hidden salt (like bread, sandwiches, pizza, and many restaurant and fast-food options).
You can have high blood pressure, or hypertension, and still feel just fine. That's because high blood pressure often does not cause signs of illness that you can see or feel. But, high blood pressure, sometimes called "the silent killer," is very common in older people and a major health problem. If high blood pressure isn't controlled with lifestyle changes and medicine, it can lead to stroke, heart disease, eye problems, kidney failure, and other health problems. High blood pressure can also cause shortness of breath during light physical activity or exercise.

You can have high blood pressure, or hypertension, and still feel just fine. That's because high blood pressure often does not cause signs of illness that you can see or feel. But, high blood pressure, sometimes called "the silent killer," is very common in older people and a major health problem. If high blood pressure isn't controlled with lifestyle changes and medicine, it can lead to stroke, heart disease, eye problems, kidney failure, and other health problems. High blood pressure can also cause shortness of breath during light physical activity or exercise.
Healthcare professionals use a stethoscope and a manual sphygmomanometer to measure your blood pressure. Typically they take the reading above your elbow. The sphygmomanometer has a bladder, cuff, bulb, and a gauge. When the bulb is pumped it inflates the bladder inside the cuff, which is wrapped around your arm. This inflation will stop the blood flow in your arteries. The stethoscope is used to listen for sound of the heartbeat, and no sound indicates that there is no flow. As the pressure is released from the bladder, you will hear the sound of the blood flowing again. That point becomes systolic reading. The diastolic reading is when you hear no sound again, which means that the blood flow is back to normal. 

There are a number of types and classes of drugs available for the management and treatment of high blood pressure (hypertension). Your doctor or other health care professional will prescribe a drug that fits your specific needs based on your medical condition, and any other existing health problems you may have, for example, kidney disease, heart disease, or diabetes. Your doctor also may recommend other therapies and lifestyle changes like getting more exercise, managing stress, and eating a healthy diet.

‘White coat syndrome’ refers to elevated blood pressure due to nervousness or anxiety when clients have their blood pressure taken by a healthcare provider. This occurs in approximately 20% of clients. Key message: have the client take their blood pressure at home with an automatic home blood pressure cuff and compare the findings. Alternatively, you can ask the client to sit quietly and leave the room while an automatic cuff takes a client’s blood pressure. The automatic cuff can be programmed to take three measurements and the blood pressure documented is an average of the three readings.


When you get a high blood pressure reading at the doctor's office, it might be tough for you to understand exactly what impact those numbers can make on your overall health, since high blood pressure has no unusual day-to-day symptoms. But the truth is, having high blood pressure is a serious health risk—it boosts the risks of leading killers such as heart attack and stroke, as well as aneurysms, cognitive decline, and kidney failure. What's more, high blood pressure is a primary or contributing cause of death in more than 1,000 deaths a day in the United States.

Your total blood pressure reading is determined by measuring your systolic and diastolic blood pressures. Systolic blood pressure, the top number, measures the force your heart exerts on the walls of your arteries each time it beats. Diastolic blood pressure, the bottom number, measures the force your heart exerts on the walls of your arteries in between beats.


Hydralazine has been used for the treatment of high blood pressure since the 1950's. It is believed that hydralazine reduces blood pressure, however there are concerns due to the potential for this drug to cause adverse effects. The aim of this review was to determine the extent to which hydralazine reduces blood pressure, the nature of hydralazines adverse effect profile, and to determine the clinical impact of its use for hypertension. Unfortunately, the search revealed no randomized controlled trials which compared hydralazine to placebo as monotherapy for primary hypertension, therefore we are unable to make firm conclusions regarding its effects on blood pressure, adverse effects, or clinical outcomes. Some of the adverse effects related to hydralazine and that have been reported in the literature include reflex tachycardia, hemolytic anemia, vasculitis, glomerulonephritis, and a lupus-like syndrome.

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