Blood pressure is written as two numbers, such as 112/78 mm Hg. The top, systolic, number is the pressure when the heart beats. The bottom, diastolic, number is the pressure when the heart rests between beats. Normal blood pressure is below 120/80 mm Hg. If you’re an adult and your systolic pressure is 120 to 139, or your diastolic pressure is 80 to 89 (or both), you have pre-hypertension. High blood pressure is a pressure of 140 systolic or higher and/or 90 diastolic or higher that stays high over time.
Hypertension with certain specific additional signs and symptoms may suggest secondary hypertension, i.e. hypertension due to an identifiable cause. For example, Cushing's syndrome frequently causes truncal obesity, glucose intolerance, moon face, a hump of fat behind the neck/shoulder (referred to as a buffalo hump), and purple abdominal stretch marks.[23] Hyperthyroidism frequently causes weight loss with increased appetite, fast heart rate, bulging eyes, and tremor. Renal artery stenosis (RAS) may be associated with a localized abdominal bruit to the left or right of the midline (unilateral RAS), or in both locations (bilateral RAS). Coarctation of the aorta frequently causes a decreased blood pressure in the lower extremities relative to the arms, or delayed or absent femoral arterial pulses. Pheochromocytoma may cause abrupt ("paroxysmal") episodes of hypertension accompanied by headache, palpitations, pale appearance, and excessive sweating.[23] 

In short, everyone. The motivation behind the change was to make people healthier. With more sensitive guidelines, we are able to get in control of our blood pressure sooner and improve heart health before reaching levels that could cause more serious health problems. For some, the changing guidelines may result in antihypertensive (blood pressure lowering) medication, along with lifestyle management, but that will not be the case for everyone.
An exception to this is those with very high blood pressure readings especially when there is poor organ function.[79] Initial assessment of the hypertensive people should include a complete history and physical examination. With the availability of 24-hour ambulatory blood pressure monitors and home blood pressure machines, the importance of not wrongly diagnosing those who have white coat hypertension has led to a change in protocols. In the United Kingdom, current best practice is to follow up a single raised clinic reading with ambulatory measurement, or less ideally with home blood pressure monitoring over the course of 7 days.[79] The United States Preventive Services Task Force also recommends getting measurements outside of the healthcare environment.[80] Pseudohypertension in the elderly or noncompressibility artery syndrome may also require consideration. This condition is believed to be due to calcification of the arteries resulting in abnormally high blood pressure readings with a blood pressure cuff while intra arterial measurements of blood pressure are normal.[81] Orthostatic hypertension is when blood pressure increases upon standing.[82]
If your blood pressure remains high for a long period of time, you run the risk of damaging your blood vessels. Your stroke risk rises significantly, too. And because your heart is working harder to push blood through your system, that very valuable muscle can become overworked and grow thicker. An enlarged heart causes further complications, including heart failure. Medications and special implantable pumps can help boost heart function. But if you can manage your blood pressure before it gets too high and puts your heart at risk, you may be able to avoid a lot of complications down the road.
According to the American College of Cardiology and the American Heart Association, the goal of blood pressure treatment is to attain a blood pressure reading that's less than 130/80 mmHg systolic and less than 80mmHg diastolic. In general, if you have hypertension, it is likely that you will need to be treated for the duration of your life to maintain this target blood pressure. 

Hypertension does not usually cause any noticeable symptoms. When it does, you might experience dizziness, shortness of breath, headaches, and nosebleeds, which could indicate that your blood pressure is rising. Complications such as heart disease, stroke, and kidney failure can occur if long-term hypertension is not adequately treated. A hypertensive emergency, which is an uncommon and dangerous event, may cause blurry vision, nausea, chest pain and anxiety.

If you suddenly find yourself with high blood pressure (hypertension) under the new guidelines from the American Heart Association and the American College of Cardiology, you might be wondering what to do. The guidelines, which were released in November, lowered the definition for high blood pressure to 130/80 from 140/90 millimeters of mercury (mm Hg), meaning more women now meet the criteria for stage 1 hypertension.
My husband went into the local hospital on Thursday with a continuance of lightnheadedness and very shakey legs. Three hours after arriving at the ER. He was totally unable to swing his legs up into the bed or move them. He was given injections of steroids and admitted. Original diagnosis was inflammation of the lower back. He was given a little insulin to counteract the steroids (and my husband is not a diabetic).
Up to 40% of patients taking clonidine (Catapres) will experience dry mouth and about a third will have drowsiness, headache, and sleepiness. Other common side effects include constipation, dizziness, and local skin reactions with use of the Catapres-TTS skin patch. Reserpine use is linked with possible side effects including nightmares, stuffy nose, depression, and an inability to fall asleep. Diarrhea and heartburn are also possible. Guanadrel and guanethidine can cause diarrhea and other gastrointestinal issues – as well as dizziness and drowsiness.
According to the Centers for Disease Control and Prevention (CDC), an estimated 75 million Americans have high blood pressure. Many risk factors for high blood pressure are out of your control, such as age, family history, gender, and race. But there are also factors you can control, such as exercise and diet. A diet that can help control blood pressure is rich in potassium, magnesium, and fiber and lower in sodium.
Many expert groups recommend a slightly higher target of 150/90 mmHg for those over somewhere between 60 and 80 years of age.[99][100][101][105] The JNC-8 and American College of Physicians recommend the target of 150/90 mmHg for those over 60 years of age,[13][106] but some experts within these groups disagree with this recommendation.[107] Some expert groups have also recommended slightly lower targets in those with diabetes[99] or chronic kidney disease with protein loss in the urine,[108] but others recommend the same target as for the general population.[13][103] The issue of what is the best target and whether targets should differ for high risk individuals is unresolved,[109] although some experts propose more intensive blood pressure lowering than advocated in some guidelines.[110]
If your blood pressure is above the normal range for up to 5 readings (taken at different visits), your doctor will likely diagnose you with high blood pressure. Sometimes the doctor may diagnose you after a fewer number of readings, depending on how high above normal your blood pressure is and if you have other medical conditions. Blood pressure tends to be at its highest during exercise, physical work, or stress, and lowest during sleep. Everyone can have a temporary increase in blood pressure at one time or another, which is why it's important to take multiple readings.
As you get older, high blood pressure, especially isolated systolic hypertension, is more common and can increase your risk of serious health problems. Treatment, especially if you have other medical conditions, requires ongoing evaluation and discussions with your doctor to strike the best balance of reducing risks and maintaining a good quality of life.
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.
Hypertension is rarely accompanied by symptoms, and its identification is usually through screening, or when seeking healthcare for an unrelated problem. Some people with high blood pressure report headaches (particularly at the back of the head and in the morning), as well as lightheadedness, vertigo, tinnitus (buzzing or hissing in the ears), altered vision or fainting episodes.[20] These symptoms, however, might be related to associated anxiety rather than the high blood pressure itself.[21] 

^ Jump up to: a b c d e f Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr. JL, Jones DW, Materson BJ, Oparil S, Wright Jr. JT, Roccella EJ, et al. (December 2003). "Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure". Hypertension. Joint National Committee On Prevention. 42 (6): 1206–52. doi:10.1161/01.HYP.0000107251.49515.c2. PMID 14656957. Archived from the original on 20 May 2012. Retrieved 1 January 2012.

All of these steps and techniques are things you should ask your doctor about as part of your personalized health plan. Preventative care from an experienced physician is the best way to fend off many health problems, and hypertension is no exception. Find a skilled St. Joseph Health primary care physician or heart specialist using our online provider directory. Download our health numbers report card to help you track your blood pressure and other common markers that measure heart health.

It's tough to get a reading on your average blood pressure if you only measure it at the doctor's office. Buy a home monitoring kit at your local pharmacy. Take two readings a day, morning and night, for a few days. Repeat these steps a few times a year, and share the results with your doctor. Better understanding of your blood pressure is the first step to preventing heart disease and stroke.
Finding out what genetic patterns contribute to high blood pressure risk. NHLBI-funded researchers identified dozens of new genetic variations that affect blood pressure. Scientists discovered the new genetic regions—and confirmed the role of many previously known ones by looking specifically at cigarette smoking behavior, one of many lifestyle factors that impact blood pressure. The analysis of the large samples was possible through the work of researchers in the Gene-Lifestyle Interactions Working Group of the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium.

Johns Hopkins researchers have identified the genes responsible for aortic ballooning and the sequence of events leading to aortic aneurysms. Dr. Hal Dietz currently conducts clinical trials of therapies for people with inherited aortic aneurysms to improve health and quality of life for these patients.Learn more about Dr. Deitz and his aortic ballooning therapies.

This study will assess whether minocycline, an antibiotic with anti-inflammatory effects, can improve blood pressure control in patients who do not respond to medicines in combination with lifestyle changes, such as physical activity, weight loss, and healthy eating patterns. To participate you must be at least 18 years old and have high blood pressure that does not respond to treatment with three different high blood pressure medicines even when used at the maximum doses. Please note that this study is in Gainesville, Florida.
^ 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.
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.
A blood pressure reading contains two numbers: systolic pressure and diastolic pressure. Systolic pressure is the top or first number in your blood pressure reading; it indicates the pressure within your arteries when your heart pumps out blood. Diastolic pressure is the bottom number, and shows the pressure in your arteries while your heart is filling with blood.
Most doctors have been taught that once a diagnosis of “high blood pressure” has been made, blood pressure medication is the treatment of choice. As a result, many physicians believe that the current definition of “high” blood pressure is also the same level of blood pressure at which drug treatments are worthwhile. Unfortunately, this is not the case.
Some people may ask why doctors are lowering the threshold for high blood pressure, when it was already difficult for many patients to achieve the previous blood pressure targets of below 140 mm Hg/90 mm Hg, said Dr. Pamela B. Morris, a preventive cardiologist and chairwoman of the ACC's Prevention of Cardiovascular Disease Leadership Council. However, Morris said that the guidelines were changed because "we now have more precise estimates of the risk of [high] blood pressures," and these new guidelines really communicate that risk to patients. So, just because it's going to be difficult for people to achieve, "I don't think it's a reason not to communicate the risk to patients, and to empower them to make appropriate lifestyle modifications," Morris told Live Science.
Secondary hypertension results from an identifiable cause. Kidney disease is the most common secondary cause of hypertension.[23] Hypertension can also be caused by endocrine conditions, such as Cushing's syndrome, hyperthyroidism, hypothyroidism, acromegaly, Conn's syndrome or hyperaldosteronism, renal artery stenosis (from atherosclerosis or fibromuscular dysplasia), hyperparathyroidism, and pheochromocytoma.[23][47] Other causes of secondary hypertension include obesity, sleep apnea, pregnancy, coarctation of the aorta, excessive eating of liquorice, excessive drinking of alcohol, and certain prescription medicines, herbal remedies, and illegal drugs such as cocaine and methamphetamine.[23][48] Arsenic exposure through drinking water has been shown to correlate with elevated blood pressure.[49][50]
Events in early life, such as low birth weight, maternal smoking, and lack of breastfeeding may be risk factors for adult essential hypertension, although the mechanisms linking these exposures to adult hypertension remain unclear.[43] An increased rate of high blood urea has been found in untreated people with hypertension in comparison with people with normal blood pressure, although it is uncertain whether the former plays a causal role or is subsidiary to poor kidney function.[44] Average blood pressure may be higher in the winter than in the summer.[45] Periodontal disease is also associated with high blood pressure.[46]
Another important step is to lose weight and maintain a healthy weight. Being overweight elevates your risk for high blood pressure and many other diseases and conditions. Losing just 5 percent of your body weight can have a significant positive impact on your blood pressure. Studies have shown that the combination of exercising and losing weight improves blood pressure numbers even more than either one alone. It may seem daunting to lose weight, but it is possible. Talk to your doctor about how other people have done it. And consider seeing a weight loss counselor too. You can do this! And after only a few pounds of healthy weight loss, you should start seeing your blood pressure numbers drop.
Hypertension defined as elevated blood pressure over several visits affects 1% to 5% of children and adolescents and is associated with long term risks of ill-health.[89] Blood pressure rises with age in childhood and, in children, hypertension is defined as an average systolic or diastolic blood pressure on three or more occasions equal or higher than the 95th percentile appropriate for the sex, age and height of the child. High blood pressure must be confirmed on repeated visits however before characterizing a child as having hypertension.[89] Prehypertension in children has been defined as average systolic or diastolic blood pressure that is greater than or equal to the 90th percentile, but less than the 95th percentile.[89] In adolescents, it has been proposed that hypertension and pre-hypertension are diagnosed and classified using the same criteria as in adults.[89]
^ Sacks, F. M.; Svetkey, L. P.; Vollmer, W. M.; Appel, L. J.; Bray, G. A.; Harsha, D.; Obarzanek, E.; Conlin, P. R.; Miller, E. R. (2001-01-04). "Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group". The New England Journal of Medicine. 344 (1): 3–10. doi:10.1056/NEJM200101043440101. ISSN 0028-4793. PMID 11136953.
How do you check your own blood pressure? It is common to have your blood pressure checked at the doctor's office, but there are many cases where it is important to monitor it at home. It is easy to check blood pressure with an automated machine, but it can also be done manually at home. Learn how to check your own blood pressure and what the results mean. Read now

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]
One side effect of diuretics is a loss of potassium, which is carried out of the body in urine along with the sodium. Potassium is needed for proper muscular movement and a deficiency of this mineral can result in fatigue, weakness, leg cramps, and even problems with the heart. So often, patients on traditional diuretics will be advised to take their medication with a potassium-rich food, such as orange juice or a banana, or they'll be prescribed a potassium supplement.
The JAMA study was an extensive chart review of over 38,000 patients at low risk for heart disease who had stage two hypertension (blood pressure between 149/90 and 159/99) and were treated with blood pressure medications. Over an average follow-up time of almost six years, they found no reduction in the risk of cardiovascular disease events or risk of death with medication use. They did, however, find an increased risk for low blood pressure, fainting, and acute kidney injury among those treated with medications.
As of 2014, approximately one billion adults or ~22% of the population of the world have hypertension.[137] It is slightly more frequent in men,[137] in those of low socioeconomic status,[6] and it becomes more common with age.[6] It is common in high, medium, and low income countries.[137][138] In 2004 rates of high blood pressure were highest in Africa, (30% for both sexes) and lowest in the Americas (18% for both sexes). Rates also vary markedly within regions with rates as low as 3.4% (men) and 6.8% (women) in rural India and as high as 68.9% (men) and 72.5% (women) in Poland.[139] Rates in Africa were about 45% in 2016.[140]
^ Jump up to: a b Burt VL, Cutler JA, Higgins M, et al. (July 1995). "Trends in the prevalence, awareness, treatment, and control of hypertension in the adult US population. Data from the health examination surveys, 1960 to 1991". Hypertension. 26 (1): 60–69. doi:10.1161/01.HYP.26.1.60. PMID 7607734. Archived from the original on 2012-12-20. Retrieved 5 June 2009.
Medication use. Overuse of certain drugs can increase your blood pressure, for instance, NSAIDS such as ibuprofen and aspirin. In addition, taking birth control pills and several other drugs together can also cause an increase in blood pressure unexpectedly. Drug abuse in case of cocaine and marijuana is also responsible for heart arrest due to persistent increase in blood pressure.
This study is assessing whether a low-sodium and low-calorie eating pattern, along with aerobic exercise, can improve blood pressure in patients who do not respond to high blood pressure medicines. To participate you must be at least 35 years and have high blood pressure that does not respond to medicines. Please note that this study is in Durham, North Carolina.
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]
This study will assess whether minocycline, an antibiotic with anti-inflammatory effects, can improve blood pressure control in patients who do not respond to medicines in combination with lifestyle changes, such as physical activity, weight loss, and healthy eating patterns. To participate you must be at least 18 years old and have high blood pressure that does not respond to treatment with three different high blood pressure medicines even when used at the maximum doses. Please note that this study is in Gainesville, Florida. 

Hypertension, or high blood pressure, refers to the pressure of blood against your artery walls. Over time, high blood pressure can cause blood vessel damage that leads to heart disease, kidney disease, stroke, and other problems. Hypertension is sometimes called the silent killer because it produces no symptoms and can go unnoticed — and untreated — for years.
^ Jump up to: a b c Members, Authors/Task Force; Mancia, Giuseppe; Fagard, Robert; Narkiewicz, Krzysztof; Redon, Josep; Zanchetti, Alberto; Böhm, Michael; Christiaens, Thierry; Cifkova, Renata (13 June 2013). "2013 ESH/ESC Guidelines for the management of arterial hypertension". European Heart Journal. 34 (28): 2159–219. doi:10.1093/eurheartj/eht151. hdl:1854/LU-4127523. ISSN 0195-668X. PMID 23771844. Archived from the original on 27 January 2015.
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.
Exercise every day. Moderate exercise can lower your risk of high blood pressure. Set some goals so you can exercise safely and work your way up to exercising at least 30 minutes a day most days of the week. Check with your doctor before starting an exercise plan if you have any health problems that are not being treated. You can find more information about exercise and physical activity at Go4Life.
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]
Medications used to lower blood pressure include diuretics (e.g., hydrochlorothiazide*), beta-blockers (e.g., atenolol, metoprolol), ACE inhibitors (e.g., ramipril, enalapril, lisinopril), calcium channel blockers (e.g., nifedipine, amlodipine), angiotensin II receptor blockers (e.g., losartan, valsartan), and direct renin inhibitors (e.g., aliskiren).
Another important step is to lose weight and maintain a healthy weight. Being overweight elevates your risk for high blood pressure and many other diseases and conditions. Losing just 5 percent of your body weight can have a significant positive impact on your blood pressure. Studies have shown that the combination of exercising and losing weight improves blood pressure numbers even more than either one alone. It may seem daunting to lose weight, but it is possible. Talk to your doctor about how other people have done it. And consider seeing a weight loss counselor too. You can do this! And after only a few pounds of healthy weight loss, you should start seeing your blood pressure numbers drop.
Exercise could be just as effective in lowering high blood pressure as prescribed medication. Researchers pooled data from nearly 400 trials and found that for people with high blood pressure, activity such as walking, swimming and simple weight training seemed to be just as good as most drugs used to treat it. However, the team warns people should not stop taking their medication until further studies are carried out.

James, P.A., Oparil, S., Carter, B.L., Cushman, W.C., Dennison-Himmelfarb, C., Handler, J., & Ortiz, E. (2013, December 18). 2014 evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the eighth joint national committee. Journal of the American Medical Association. Retrieved from http://jamanetwork.com/journals/jama/fullarticle/1791497
Finding out what genetic patterns contribute to high blood pressure risk. NHLBI-funded researchers identified dozens of new genetic variations that affect blood pressure. Scientists discovered the new genetic regions—and confirmed the role of many previously known ones by looking specifically at cigarette smoking behavior, one of many lifestyle factors that impact blood pressure. The analysis of the large samples was possible through the work of researchers in the Gene-Lifestyle Interactions Working Group of the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium.
If your blood pressure is always on the low side and you do not have any of the above symptoms, there is usually no cause for concern. Similarly, if you have a single at-home blood pressure reading that is abnormally low without any symptoms, you probably do not need to see your doctor. It is normal for your blood pressure to rise and fall over time, and your body is usually able to get your blood pressure back to normal.

One reason to visit your doctor regularly is to have your blood pressure checked. Routine checks of your blood pressure will help pick up an early rise in blood pressure, even though you might feel fine. If there's an indication that your blood pressure is high at two or more checkups, the doctor may ask you to check your blood pressure at home at different times of the day. If the pressure stays high, even when you are relaxed, the doctor may suggest exercise, changes in your diet, and, most likely, medications.
Lastly, we conduct statewide outreach to health care organizations. We make and distribute a suite of materials available to encourage accurate and consistent blood pressure self-management in English, Spanish, Russian, Chinese and Vietnamese. We also work closely with Washington Information Network 211 so people can call or search online for places to get their blood pressure checked nearby.

James, P.A., Oparil, S., Carter, B.L., Cushman, W.C., Dennison-Himmelfarb, C., Handler, J., & Ortiz, E. (2013, December 18). 2014 evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the eighth joint national committee. Journal of the American Medical Association. Retrieved from http://jamanetwork.com/journals/jama/fullarticle/1791497
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