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.

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.


Hypertension is present in many people who are unaware they have this disorder. Hypertension is called a silent killer because too often the first symptom of the disease is a heart attack or stroke. To prevent this, get outside in nature and exercise, enjoy the flowers, and let nature provide a calming respite in life. Also, get regular medical checkups. If hypertension symptoms hypertension arise, seek immediate medical care. Call 911 immediately if someone has passed out unexpectedly.
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Strong Heart Study. Since 1988, the NHLBI has supported the Strong Heart Study (SHS), the largest epidemiologic study of American Indians ever conducted. The SHS aims to estimate the impact of heart and blood vessel diseases and to assess how common and significant standard risk factors are in this community. Thirteen tribes and communities in four states participate in the study. Visit Strong Heart Study for more information.
Most commonly high blood pressure causes no symptoms at all. This means that people with high blood pressure can be having damage occur to their heart, kidneys, eyes, and circulation without feeling badly! It is very important, therefore, to have blood pressure testing as part of the routine physical examination. However, in people with uncomplicated high blood pressure, they may experience

Eat potassium- and magnesium-rich foods. Potassium can help regulate your heart rate and can reduce the effect that sodium has on your blood pressure. Foods like bananas, melons, oranges, apricots, avocados, dairy, leafy green vegetables, tomatoes, potatoes, sweet potatoes, tuna, salmon, beans, nuts, and seeds have lots of potassium.  Magnesium is thought to help blood vessels relax, making it easier for blood to pass through. Foods rich in magnesium include vegetables, dairy, chicken, legumes, and whole grains. It’s better to get vitamins and minerals from food, and a heart-healthy diet like the one we described above is a good way to ensure you get plenty of nutrients. However, you may want to talk to your doctor about whether taking certain supplements might help your blood pressure.
Electrocardiogram (ECG): This tests the heart's electrical activity. This test is more commonly used for patients at high risk of heart problems, such as hypertension and elevated cholesterol levels. The initial ECG is called a baseline. Subsequent ECGs may be compared with the baseline to reveal changes which may point to coronary artery disease or thickening of the heart wall.
Instead of an arbitrary goal to “lose weight,” talk with your doctor about a healthy weight for you. The Centers for Disease Control and Prevention (CDC) recommends a weight loss goal of one to two pounds a week. That means starting off eating 500 calories less per day than what you normally eat. Then decide on what physical activity you can start in order to reach that goal. If exercising five nights a week is too hard to work into your schedule, aim for one more night than what you’re doing right now. When that fits comfortably into your schedule, add another night.
^ Jump up to: a b Brook RD, Appel LJ, Rubenfire M, Ogedegbe G, Bisognano JD, Elliott WJ, Fuchs FD, Hughes JW, Lackland DT, Staffileno BA, Townsend RR, Rajagopalan S, American Heart Association Professional Education Committee of the Council for High Blood Pressure Research, Council on Cardiovascular and Stroke Nursing, Council on Epidemiology and Prevention, and Council on Nutrition, Physical, Activity (Jun 2013). "Beyond medications and diet: alternative approaches to lowering blood pressure: a scientific statement from the American Heart Association". Hypertension. 61 (6): 1360–83. doi:10.1161/HYP.0b013e318293645f. PMID 23608661.
Midwestern kindness runs deep, but throughout the city's neighborhoods, it turns out some residents are more polite than others (or simply complain less). Digital Third Coast, a Chicago-based digital marketing firm, recently analyzed 2018 data of complaints to 311 from the 30 most densely populated neighborhoods. They looked at noise, garbage and dog poop complaints to determine where residents were less than pleased with their surroundings. How did your 'hood fair? Click through to see which 10 city locales yielded the most complaints per capita.  (Darcel Rockett)
^ Jump up to: a b c d e National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (August 2004). "The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents". Pediatrics. 114 (2 Suppl 4th Report): 555–76. doi:10.1542/peds.114.2.S2.555. PMID 15286277.
Obesity: As body weight increases, the blood pressure rises. Obesity is defined as having a body mass index (BMI) greater than 30 kg/m. A BMI of 25-30 kg/m is considered overweight (BMI=weight in pounds x 703/ height in inches). Being overweight increases the risk of high blood pressure. Healthcare professionals recommend that all individuals who are obese and have high blood pressure lose weight until they are within 15% of their healthy body weight.
This chart can help you figure out if your blood pressure is at a healthy level or if you need to improve your numbers. The BP numbers shown in the chart represent “typical” systolic-diastolic pairs. Even if the normal blood pressure for men is 120/80 mm/hg, it can vary slightly according to age. Since our body changes all the time, it is normal for our BP to change, as well.
Resistant hypertension is defined as high blood pressure that remains above a target level, in spite of being prescribed three or more antihypertensive drugs simultaneously with different mechanisms of action.[131] Failing to take the prescribed drugs, is an important cause of resistant hypertension.[132] Resistant hypertension may also result from chronically high activity of the autonomic nervous system, an effect known as "neurogenic hypertension".[133] Electrical therapies that stimulate the baroreflex are being studied as an option for lowering blood pressure in people in this situation.[134]
Quitting smoking. Visit Smoking and Your Heart and the National Heart, Lung, and Blood Institute’s Your Guide to a Healthy Heart [PDF – 2MB]. Although these resources focus on heart health, they include basic information about how to quit smoking. For free help and support to quit smoking, you can call the National Cancer Institute’s Smoking Quitline at 1-877-44U-QUIT (1-877-448-7848).

^ Xie, X; Atkins, E; Lv, J; Bennett, A; Neal, B; Ninomiya, T; Woodward, M; MacMahon, S; Turnbull, F; Hillis, GS; Chalmers, J; Mant, J; Salam, A; Rahimi, K; Perkovic, V; Rodgers, A (30 January 2016). "Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis". Lancet. 387 (10017): 435–43. doi:10.1016/S0140-6736(15)00805-3. PMID 26559744.

Pre-eclampsia is a serious condition of the second half of pregnancy and following delivery characterised by increased blood pressure and the presence of protein in the urine.[23] It occurs in about 5% of pregnancies and is responsible for approximately 16% of all maternal deaths globally.[23] Pre-eclampsia also doubles the risk of death of the baby around the time of birth.[23] Usually there are no symptoms in pre-eclampsia and it is detected by routine screening. When symptoms of pre-eclampsia occur the most common are headache, visual disturbance (often "flashing lights"), vomiting, pain over the stomach, and swelling. Pre-eclampsia can occasionally progress to a life-threatening condition called eclampsia, which is a hypertensive emergency and has several serious complications including vision loss, brain swelling, seizures, kidney failure, pulmonary edema, and disseminated intravascular coagulation (a blood clotting disorder).[23][31]
In November, the American Heart Association and the American College of Cardiology issued new guidelines that change how high blood pressure, or hypertension, is diagnosed. Previously, it wasn’t until an adult’s blood pressure reached 140 mmHg or higher systolic (the top, or first, number) or 90 mmHg diastolic (the bottom, or second, number) or higher that high blood pressure was diagnosed. According to the new parameters, high blood pressure should be treated at 130/80 rather than 140/90, as that is the point when our risk for heart attack, stroke, and other consequences for hypertension almost doubles.
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]

Blood pressure control is a lifelong challenge. Hypertension can progress through the years, and treatments that worked earlier in life may need to be adjusted over time. Blood pressure control may involve gradually making lifestyle changes like diet, weight loss, exercise, and possibly taking medicine if necessary. In some situations, medications may be recommended immediately. As with many diseases, you and your doctor should work together to find the treatment plan that works for you.


Your blood pressure is considered high when you have consistent systolic readings of 140 mm Hg or higher or diastolic readings of 90 mm Hg or higher. Based on research, your doctor may also consider you to have high blood pressure if you are an adult or child age 13 or older who has consistent systolic readings of 130 to 139 mm Hg or diastolic readings of 80 to 89 mm Hg and you have other cardiovascular risk factors.
Changes in blood vessel structure. Blood vessels have layers of the proteins elastin and collagen. Elastin is what makes blood vessels flexible. Collagen, which is stiffer, gives vessels structure. With age, elastin breaks down. Even the elastin that remains becomes less elastic. Meanwhile, collagen deposits in the vessels increase. As a result, blood vessels grow thicker and bend less easily over time. These changes may lead to higher systolic blood pressure.

Again, foods that lower blood pressure are usually high in potassium and similar nutrients. Famously rich in blood pressure-lowering potassium, one banana contains about 420 milligrams, or 11 percent of the 4,700 milligrams the American Heart Association recommends people consume daily. Surprisingly, however, many veggies are actually higher in potassium than these popular fruits. A cup of Swiss chard boasts 960 milligrams, a cup of cooked white beans has nearly 1,200 milligrams, and a whole avocado has 975 milligrams.


7. Visit your chiropractor. A special chiropractic adjustment could significantly lower high blood pressure, a placebo-controlled study suggests. “This procedure has the effect of not one, but two blood–pressure medications given in combination,” study leader George Bakris, MD, told WebMD. Your chiropractor can create an effective protocol that helps normalize blood pressure without medication or other invasive procedures.
^ 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.
A blood pressure reading measures both the systolic and diastolic forces, with the systolic pressure listed first. The numbers show your pressure in units of millimeters of mercury (mm Hg)—how high the pressure inside your arteries would be able to raise a column of mercury. For example, a reading of 120/80 mm Hg means a systolic pressure of 120 mm Hg and diastolic pressure of 80 mm Hg.
“We don’t think, on the basis of our study, that patients should stop taking their antihypertensive medications,” says Naci. It’s one thing to recommend that physicians start prescribing exercise to their patients, but we also need to ensure that the patients that have been referred to exercise interventions can adhere to them and so really derive benefit, he says.
As the body increases production of an enzyme called angiotensin I-converting enzyme, or “ACE”, blood pressure increases. Pharmaceutical drugs called ACE inhibitors work by blocking the formation of this enzyme, but they have multiple side effects. Garlic contains gamma-glutamylcysteine, a natural ACE inhibitor.  This chemical, in combination with the high allicin content, gives garlic its ability to dilate arteries, thereby lowering blood pressure. I usually take one clove of garlic and remove the skin, chew well and swallow. Yes nobody wants to be around me after. You can also buy in pill form.
Changes in blood vessel structure. Blood vessels have layers of the proteins elastin and collagen. Elastin is what makes blood vessels flexible. Collagen, which is stiffer, gives vessels structure. With age, elastin breaks down. Even the elastin that remains becomes less elastic. Meanwhile, collagen deposits in the vessels increase. As a result, blood vessels grow thicker and bend less easily over time. These changes may lead to higher systolic blood pressure.
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.
This drug prevents calcium from entering the smooth muscle cells of the heart and arteries. When calcium enters these cells, it causes a stronger and harder contraction, so by decreasing the calcium, the hearts' contraction is not as forceful. Calcium channel blockers relax and open up narrowed blood vessels, reduce heart rate and lower blood pressure.
In fact, a review of Figure 2 indicates that the most impressive results were observed with the most serious cases. In cases of “moderate” to “severe” hypertension (blood pressures of 174/93 or greater), the average reduction at the conclusion of treatment was a remarkable 46/15! For these cases, which medical practitioners generally would insist need lifetime medical intervention, the average exit blood pressure was 128/78, using no medication whatsoever!

Kiwis are another fruit that positively impacts blood pressure. Some researchers studied how the fruit fares compared to apples. They found that eating three kiwis a day over eight weeks reduced blood pressure in people with slightly high blood pressure more so than eating one apple per day during the same time. A daily serving of kiwi was also found to reduce blood pressure in people with only mildly elevated levels. Kiwis are also an excellent source of vitamin C which can also also improve blood pressure. 
^ Jump up to: a b Go, AS; Bauman, M; King, SM; Fonarow, GC; Lawrence, W; Williams, KA; Sanchez, E (15 November 2013). "An Effective Approach to High Blood Pressure Control: A Science Advisory From the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention". Hypertension. 63 (4): 878–85. doi:10.1161/HYP.0000000000000003. PMID 24243703. Archived from the original on 20 November 2013. Retrieved 20 November 2013.
Cut down on salt. As you get older, the body and blood pressure become more sensitive to salt (sodium), so you may need to watch how much salt is in your diet. Most of the salt comes from processed foods (for example, soup and baked goods). A low-salt diet, such as the DASH diet, might help lower your blood pressure. Talk with your doctor about eating less salt.
For older people, often the first number (systolic) is 130 or higher, but the second number (diastolic) is less than 80. This problem is called isolated systolic hypertension, which is due to age-related stiffening of the major arteries. It is the most common form of high blood pressure in older people and can lead to serious health problems (stroke, heart disease, eye problems, and kidney failure) in addition to shortness of breath during light physical activity, lightheadedness upon standing too fast, and falls. Isolated systolic hypertension is treated in the same way as regular high blood pressure (130 or higher for the first number, or 80 or higher for the second number) but may require more than one type of blood pressure medication. If your doctor determines that your systolic pressure is above a normal level for your age, ask how you can lower it.
When healthy lifestyle changes alone do not control or lower high blood pressure, your doctor may change or update your treatment plan by prescribing medicines to treat your condition. These medicines act in different ways to lower blood pressure. When prescribing medicines, your doctor will also consider their effect on other conditions you might have, such as heart disease or kidney disease. Possible high blood pressure medicines include:

Generally the first sign of experiencing high blood pressure, the tension on the brain can cause a severe headache. These headaches can come in the form of just a dull throbbing to a debilitating migraine. The reason behind the headache is linked to the blood vessels in the brain, which swell due to the higher instance of blood in the system. This swelling then places pressure on sensitive areas of the brain causing pain to radiate throughout the head, in the temples and even down through the neck. Pain can be treating by taking ibuprofen or paracetamol, however these should not be taken too frequently.
Serum creatinine is measured to assess for the presence of kidney disease, which can be either the cause or the result of hypertension. Serum creatinine alone may overestimate glomerular filtration rate and recent guidelines advocate the use of predictive equations such as the Modification of Diet in Renal Disease (MDRD) formula to estimate glomerular filtration rate (eGFR).[27] eGFR can also provide a baseline measurement of kidney function that can be used to monitor for side effects of certain anti-hypertensive drugs on kidney function. Additionally, testing of urine samples for protein is used as a secondary indicator of kidney disease. Electrocardiogram (EKG/ECG) testing is done to check for evidence that the heart is under strain from high blood pressure. It may also show whether there is thickening of the heart muscle (left ventricular hypertrophy) or whether the heart has experienced a prior minor disturbance such as a silent heart attack. A chest X-ray or an echocardiogram may also be performed to look for signs of heart enlargement or damage to the heart.[23]
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.

Yes, exercise is an excellent way to help lower your blood pressure. Of course, before you start any exercise program, be sure to talk to your doctor. With your doctor’s guidance, exercise can be a healthy way to help get your blood pressure under control. Exercise strengthens your heart and makes it work more efficiently. This means it won’t have to pump as hard, which leads to lower blood pressure.
Blood pressure is measure in millimeters of mercury (mmHg) and recorded as two numbers, systolic and diastolic. Systolic is the top number (also the higher one), which measure the pressure in the arteries when the heart beats, so when its muscles contract. Diastolic the bottom number (also the lower one), which measures the pressure in the arteries between heart beats, so when the muscles relax and refill with blood.
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.
Most people with high blood pressure are "salt sensitive," meaning that anything more than the minimal bodily need for salt is too much for them and increases their blood pressure. Other factors that can raise the risk of having essential hypertension include obesity; diabetes; stress; insufficient intake of potassium, calcium, and magnesium; lack of physical activity; and chronic alcohol consumption.
Yes, exercise is an excellent way to help lower your blood pressure. Of course, before you start any exercise program, be sure to talk to your doctor. With your doctor’s guidance, exercise can be a healthy way to help get your blood pressure under control. Exercise strengthens your heart and makes it work more efficiently. This means it won’t have to pump as hard, which leads to lower blood pressure.

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.

Lifelong control of hypertension will minimize the risk of developing heart attack, stroke, kidney failure, blindness, and a variety of other illnesses. Unlike other illnesses in which medications are taken for only a short period of time, high blood pressure medication is usually expected to be taken for the rest of the individual's life. It is uncommon, but not rare, that significant lifestyle changes can lower blood pressure readings to normal.


A sharp increase in blood pressure is not a normal symptom to experience. Many cases of strokes and death have been reported because of a sudden increase in the blood pressure,though individuals who have had normal blood pressure throughout their life are less likely to experience such symptoms. Unanticipated rise in blood pressure is an indication of an underlying heart condition, artery blockage or even a psychological stress. In either case, the after effects can be devastating, which is why a doctor must be consulted immediately.
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.
Fish are a great source of lean protein. Fatty fish like mackerel and salmon are high in omega-3 fatty acids, which can lower blood pressure, reduce inflammation, and lower triglycerides. In addition to these fish sources, trout contains vitamin D. Foods rarely contain vitamin D, and this hormone-like vitamin has properties that can lower blood pressure.
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