Hypertension causes complications such as heart attack and stroke, and these complications are less likely to occur in women who have undergone menopause than men of the same age. When comparing the complication risks of hypertension between men and women aged between 40 and 70 years, it is seen that men are at a higher risk of developing complications than women.

Current strategies for controlling cardiovascular disease (CVD) risk factors, such as high blood pressure and high cholesterol, are not widely used as standard practice. CDC developed this guide to provide health professionals with evidence-based strategies for effective and sustainable CVD prevention, including health and economic impact and potential for reducing health disparities.
For an accurate diagnosis of hypertension to be made, it is essential for proper blood pressure measurement technique to be used.[76] Improper measurement of blood pressure is common and can change the blood pressure reading by up to 10 mmHg, which can lead to misdiagnosis and misclassification of hypertension.[76] Correct blood pressure measurement technique involves several steps. Proper blood pressure measurement requires the person whose blood pressure is being measured to sit quietly for at least five minutes which is then followed by application of a properly fitted blood pressure cuff to a bare upper arm.[76] The person should be seated with their back supported, feet flat on the floor, and with their legs uncrossed.[76] The person whose blood pressure is being measured should avoid talking or moving during this process.[76] The arm being measured should be supported on a flat surface at the level of the heart.[76] Blood pressure measurement should be done in a quiet room so the medical professional checking the blood pressure can hear the Korotkoff sounds while listening to the brachial artery with a stethoscope for accurate blood pressure measurements.[76][77] The blood pressure cuff should be deflated slowly (2-3 mmHg per second) while listening for the Korotkoff sounds.[77] The bladder should be emptied before a person's blood pressure is measured since this can increase blood pressure by up to 15/10 mmHg.[76] Multiple blood pressure readings (at least two) spaced 1–2 minutes apart should be obtained to ensure accuracy.[77] Ambulatory blood pressure monitoring over 12 to 24 hours is the most accurate method to confirm the diagnosis.[78]
Not only the degree of obesity is important, but also the manner in which the body accumulates extra fat. Some people gain weight around their belly (central obesity or "apple-shaped" people), while others store fat around their hips and thighs ("pear-shaped" people). "Apple-shaped" people tend to have greater health risks for high blood pressure than "pear-shaped" people.
Drinking too much alcohol is a risk factor for high blood pressure. The American Heart Association guidelines recommend the consumption of no more than two alcoholic drinks per day for men and no more than one drink a day for women. One drink is defined as one 12-ounce beer, 4 ounces of wine, 1.5 ounces of 80-proof spirits, or 1 ounce of 100-proof spirits. Adults who consume more than three drinks in one sitting temporarily increase their blood pressure. However, binge drinking can lead to long-term increased blood pressure.
First, we collect and analyze statewide data using telephone surveys, hospital information, and death certificates, so we are able to know which groups of people are experiencing hypertension and the impacts of uncontrolled high blood pressure. This includes looking at geography, age, racial/ethnic status, education levels, and other demographic information. When the data is compiled, we make it available on the DOH web site. We estimate that in 2015, nearly 14,000 deaths and 71,000 hospitalizations were due to heart disease and stroke.
Stress reduction techniques such as biofeedback or transcendental meditation may be considered as an add-on to other treatments to reduce hypertension, but do not have evidence for preventing cardiovascular disease on their own.[125][126][127] Self-monitoring and appointment reminders might support the use of other strategies to improve blood pressure control, but need further evaluation.[128]
It is important to recognise that low blood pressure can cause no symptoms at all, and is a common normal finding in young people and athletes. However, in some people, low blood pressure causes symptoms which can significantly interfere with their quality of life. These can include syncope (fainting), pre-syncope (near fainting, usually associated with feeling light-headed), sweating, tiredness, slow thinking (brain fog), nausea, visual blurring, hearing disturbances, headache, palpitations, neck pain, breathlessness and chest pain.
Severe high blood pressure is referred to as malignant hypertension, in which the diastolic ("bottom") blood pressure reading is over 140 mmHg. Malignant hypertension is a medical emergency and can cause stroke. Symptoms can include nausea, severe headache, blurred vision, and dizziness. Some people with malignant hypertension may develop kidney failure. They may experience a decrease in urine output and swelling (edema), most pronounced in the lower legs.

Hypertension is the most important preventable risk factor for premature death worldwide.[149] It increases the risk of ischemic heart disease,[150] strokes,[23] peripheral vascular disease,[151] and other cardiovascular diseases, including heart failure, aortic aneurysms, diffuse atherosclerosis, chronic kidney disease, atrial fibrillation, and pulmonary embolism.[11][23] Hypertension is also a risk factor for cognitive impairment and dementia.[23] Other complications include hypertensive retinopathy and hypertensive nephropathy.[27]
As you age, prevention becomes even more important. Systolic pressure tends to creep up once you’re older than 50, and it’s far more important in predicting the risk of coronary heart disease and other conditions. Certain health conditions, such as diabetes and kidney disease, may also play a role. Talk to your doctor about how you can manage your overall health to help prevent the onset of hypertension.
^ Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, National Heart, Lung, and Blood Institute (Dec 2011). "Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report". Pediatrics. 128 Suppl 5: S213–56. doi:10.1542/peds.2009-2107C. PMC 4536582. PMID 22084329.
Blood pressure is assessed using two parameters -- the systolic and diastolic pressures -- which measure, respectively, the maximum pressure exerted in the arteries as the heart contracts, and the minimum pressure in those vessels between cardiac contractions. In adults, blood pressure is considered normal if the top number (systolic pressure) is between 90 and 120 and the bottom number (diastolic) is between 60 and 80.
Pulse pressure (the difference between systolic and diastolic blood pressure) is frequently increased in older people with hypertension. This can mean that systolic pressure is abnormally high, but diastolic pressure may be normal or low a condition termed isolated systolic hypertension.[59] The high pulse pressure in elderly people with hypertension or isolated systolic hypertension is explained by increased arterial stiffness, which typically accompanies aging and may be exacerbated by high blood pressure.[60]
Normal systolic blood pressure is 90 to 119 mm of Hg and normal diastolic blood pressure is 60 to 79 mm Hg. Even in this range, the lower blood pressure is better. So even if one has a blood pressure of 118/78 mm Hg, adopting a healthier lifestyle (quitting smoking, reducing alcohol, reducing weight if obese, exercises, reduced salt intake, healthier diet, etc.) is a good choice. However, self-medications to reduce the blood pressure further should never be attempted.

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. 

Stress reduction techniques such as biofeedback or transcendental meditation may be considered as an add-on to other treatments to reduce hypertension, but do not have evidence for preventing cardiovascular disease on their own.[125][126][127] Self-monitoring and appointment reminders might support the use of other strategies to improve blood pressure control, but need further evaluation.[128]
High blood pressure is classified as either primary (essential) high blood pressure or secondary high blood pressure.[5] About 90–95% of cases are primary, defined as high blood pressure due to nonspecific lifestyle and genetic factors.[5][6] Lifestyle factors that increase the risk include excess salt in the diet, excess body weight, smoking, and alcohol use.[1][5] The remaining 5–10% of cases are categorized as secondary high blood pressure, defined as high blood pressure due to an identifiable cause, such as chronic kidney disease, narrowing of the kidney arteries, an endocrine disorder, or the use of birth control pills.[5]
Low blood pressure is diagnosed by a doctor when they check your blood pressure with a sphygmomanometer. For people who experience low blood pressure without other symptoms, it may only require regular monitoring by a doctor during routine exams, and medical treatment may not be necessary. If certain signs suggest an underlying condition, your doctor may recommend one or more of the following tests to diagnose a cause for your hypotension:
Health care providers measure blood pressure with a sphygmomanometer (sfig-mo-muh-NAH-muh-ter), which has a cuff that's wrapped around the upper arm and pumped up to create pressure. When the cuff is inflated, it squeezes a large artery in the arm, stopping the blood flow for a moment. Blood pressure is measured as air is gradually let out of the cuff, which allows blood to flow through the artery again.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
If your blood pressure readings are consistently high, you and your doctor will probably discuss treatment strategies. Treatment for high blood pressure often begins with lifestyle changes such as a weight loss and exercise program as well as a low sodium diet. In fact, the AHA recommends adopting these strategies as a means of preventing the development of high blood pressure and heart disease. If these strategies are not successful in lowering your blood pressure, medications may be recommended.
Your doctor may suggest that you check your blood pressure at home. The easiest way to do this is to use a digital blood pressure monitor. You can get a monitor from your local drug store, hospital, clinic or online. Your doctor can help you find a monitor that is right for you and show you how to use it. Many pharmacies and grocery stores also have in-store monitors that you can use for free.

The findings mean that an additional 14 percent of U.S. adults, or about 30 million people, will now be diagnosed as having high blood pressure, compared with the number diagnosed before the new guidelines. This will bring the total percentage of U.S. adults with high blood pressure to 46 percent, up from 32 percent previously. [9 New Ways to Keep Your Heart Healthy]


Patient-activated event recorder: If the episodes of bradycardia or tachycardia are infrequent, a 24-hour Holter recording may not capture these sporadic episodes. In this situation, a patient can wear a patient-activated event recorder for up to 4 weeks. The patient presses a button to start the recording when he or she senses the onset of an abnormal heart rhythm or symptoms possibly caused by low blood pressure. The doctor then analyzes the recordings later to identify the abnormal episodes.

Current strategies for controlling cardiovascular disease (CVD) risk factors, such as high blood pressure and high cholesterol, are not widely used as standard practice. CDC developed this guide to provide health professionals with evidence-based strategies for effective and sustainable CVD prevention, including health and economic impact and potential for reducing health disparities.


Some high blood pressure medications initially cause drowsiness, dizziness, and lightheadedness. Some even cause fainting on the first dose. The body usually adjusts to the effects of these medications and the side effects disappear. Consuming alcohol during the early phase of antihypertensive treatment could be risky because alcohol can also cause dizziness, drowsiness, and lightheadedness.
Understanding the normal BP range with age can help the doctor and you to estimate your cardiovascular health. Blood pressure levels can fluctuate significantly from one reading to the next and it is important to remember that just one abnormally high reading does not signify that you have high blood pressure. Doctors usually use an average of multiple blood pressure readings taken over a period of several days to arrive at a diagnosis of high blood pressure.
Hypertension is diagnosed on the basis of a persistently high resting blood pressure. The American Heart Association recommends at least three resting measurements on at least two separate health care visits.[74] The UK National Institute for Health and Care Excellence recommends ambulatory blood pressure monitoring to confirm the diagnosis of hypertension if a clinic blood pressure is 140/90 mmHg or higher.[75]

Hypertension occurs in around 0.2 to 3% of newborns; however, blood pressure is not measured routinely in healthy newborns.[33] Hypertension is more common in high risk newborns. A variety of factors, such as gestational age, postconceptional age and birth weight needs to be taken into account when deciding if a blood pressure is normal in a newborn.[33]
Effective lifestyle modification may lower blood pressure as much as an individual antihypertensive medication. Combinations of two or more lifestyle modifications can achieve even better results.[87] There is considerable evidence that reducing dietary salt intake lowers blood pressure, but whether this translates into a reduction in mortality and cardiovascular disease remains uncertain.[96] Estimated sodium intake ≥6g/day and <3g/day are both associated with high risk of death or major cardiovascular disease, but the association between high sodium intake and adverse outcomes is only observed in people with hypertension.[97] Consequently, in the absence of results from randomized controlled trials, the wisdom of reducing levels of dietary salt intake below 3g/day has been questioned.[96]
When the systolic pressure drops below 90 mm Hg and the diastolic pressure falls below 60 mm Hg, this is categorized as low blood pressure. Some people may have low pressure all the time and this may be normal for them. If they do not experience any other signs or symptoms, medical treatment may not be necessary for them. Low blood pressure becomes a concern when it is accompanied by noticeable symptoms, such as dizziness, fainting and, in severe cases, shock. When this occurs, people should seek medical attention to determine if an underlying condition may be responsible for their hypotension.
Although the guidelines do not change the traditional definition of high blood pressure, they do call for more aggressive treatment of the condition through the use of a combination of blood-pressure lowering medications. In fact, they say that most people with high blood pressure will require two or more drugs to achieve a blood pressure goal of less than 140/90. The blood pressure goal in people with diabetes or kidney disease should be less than 130/80.
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.
Creatinine is a chemical waste molecule that is generated from muscle metabolism. Creatinine is produced from creatine, a molecule of major importance for energy production in muscles. Creatinine has been found to be a fairly reliable indicator of kidney function. As the kidneys become impaired the creatinine level in the blood will rise. Normal levels of creatinine in the blood vary from gender and age of the individual.
Blood pressure is measured with a blood pressure cuff (sphygmomanometer). This may be done using a stethoscope and a cuff and gauge or by an automatic machine. It is a routine part of the physical examination and one of the vital signs often recorded for a patient visit. Other vital signs include pulse rate, respiratory rate (breathing rate), temperature, and weight.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
This study is exploring whether use of losartan, a medicine commonly used to lower blood pressure, is effective at treating abnormal nighttime blood pressure in children and young adults who have sickle cell disease. To participate in this study, you or your child must be 5 to 25 years old and have high blood pressure and a certain type of sickle cell disease: hemoglobin SS or Sβ0 thalassemia. This study is located in Birmingham, Alabama.
Unlike high blood pressure symptoms, which are poorly defined and often totally absent, low blood pressure symptoms tend to be more upfront and easily recognizable. The development of symptoms is often a warning sign of a potentially serious underlying disorder. Generally speaking, your blood pressure would need to fall pretty dramatically before symptoms develop.
After menopause, however, blood pressure increases in women to levels even higher than in men. Hormone replacement therapy in most cases does not significantly reduce blood pressure in postmenopausal women, suggesting that the loss of estrogens may not be the only component involved in the higher blood pressure in women after menopause. In contrast, androgens may decrease only slightly, if at all, in postmenopausal women.
The primary symptoms of malignant hypertension is a blood pressure of 180/120 or higher and signs of organ damage. Other symptoms of malignant hypertension include bleeding and swelling of blood vessels in the retina, anxiety, nosebleeds, severe headache, and shortness of breath. Malignant hypertension may cause brain swelling, but this symptom is very rare.
Blood pressure (BP) recordings consist of two numbers. The top one is the systolic blood pressure and relates to the contraction of the left side of the heart and the peak pressure achieved when it pumps blood round the body. The bottom number is the diastolic recording and is the lowest pressure achieved in the circulation; this relates to the relaxation of the heart. Blood pressure is measured in millimetres of mercury (mmHg), e.g. 120/70 mmHg.
Hypertension clinical guidelines from the American Heart Association are comprehensive guidelines for healthcare professionals for the detection and treatment of high blood pressure in a wide range of patients. Included in the 2018 hypertension clinical guidelines are proper methods for measuring blood pressure, risk factors for hypertension, and hypertension treatment for different populations.

In Europe hypertension occurs in about 30-45% of people as of 2013.[12] In 1995 it was estimated that 43 million people (24% of the population) in the United States had hypertension or were taking antihypertensive medication.[141] By 2004 this had increased to 29%[142][143] and further to 32% (76 million US adults) by 2017.[7] In 2017, with the change in definitions for hypertension, 46% of people in the United States are affected.[7] African-American adults in the United States have among the highest rates of hypertension in the world at 44%.[144] It is also more common in Filipino Americans and less common in US whites and Mexican Americans.[6][145] Differences in hypertension rates are multifactorial and under study.[146]


Recognizing heart attack symptoms and signs can help save your life or that of someone you love. Some heart attack symptoms, including left arm pain and chest pain, are well known but other, more nonspecific symptoms may be associated with a heart attack. Nausea, vomiting, malaise, indigestion, sweating, shortness of breath, and fatigue may signal a heart attack. Heart attack symptoms and signs in women may differ from those in men.

Anaphylaxis (anaphylactic shock) is a potentially fatal allergic reaction to medications such as penicillin, intravenous iodine used in some X-ray studies, foods such as peanuts, or bee stings (insect stings). In addition to a severe drop in blood pressure, individuals may also experience hives and wheezing due to constriction of the airways, and a swollen throat, which causes difficulty breathing. The shock is caused by enlargement of blood-containing blood vessels and escape of water from the blood into the tissues.
For example, in a hypertensive patient with asthma, it may be inadvisable to prescribe a beta blocker, as these drugs can aggravate that respiratory condition. Similarly, in patients prone to constipation (the elderly, for example) use of certain calcium channel blockers might best be avoided -- along with diuretics -- as both these classes of drugs can inhibit proper bowel function.
Other causes of dehydration include exercise, sweating, fever, and heat exhaustion or heat stroke. Individuals with mild dehydration may experience only thirst and dry mouth. Moderate to severe dehydration may cause orthostatic hypotension (manifested by lightheadedness, dizziness, or fainting upon standing). Prolonged and severe dehydration can lead to shock, kidney failure, confusion, acidosis (too much acid in the blood), coma, and even death.
The NHLBI is part of the U.S. Department of Health and Human Services’ National Institutes of Health (NIH)—the Nation’s biomedical research agency that makes important scientific discovery to improve health and save lives. We are committed to advancing science and translating discoveries into clinical practice to promote the prevention and treatment of heart, lung, blood, and sleep disorders, including high blood pressure. Learn about the current and future NHLBI efforts to improve health through research and scientific discovery.

Blood pressure is the force exerted by circulating blood on the walls of blood vessels. It constitutes one of the critically important signs of life or vital signs, which include heart rate, breathing, and temperature. Blood pressure is generated by the heart pumping blood into the arteries modified by the response of the arteries to the flow of blood.


In normal blood pressure for elderly & adults over 50, increased systolic blood pressure is a major risk factor for heart disease. Systolic blood pressure tends to increase steadily over time due to stiff arteries, a build-up of plaque, and a higher rate of cardiac and vascular disease. This means older adults need to be even more vigilant about monitoring their blood pressure.
High blood pressure can cause problems for a mother and her baby. High blood pressure can harm a mother’s kidneys and other organs and can cause early birth and low birth weight. If you are thinking about having a baby and have high blood pressure, talk with your doctors so you can take steps to lower or control your high blood pressure before and during the pregnancy.

Stress reduction techniques such as biofeedback or transcendental meditation may be considered as an add-on to other treatments to reduce hypertension, but do not have evidence for preventing cardiovascular disease on their own.[125][126][127] Self-monitoring and appointment reminders might support the use of other strategies to improve blood pressure control, but need further evaluation.[128]

×