Hypertension results from a complex interaction of genes and environmental factors. Numerous common genetic variants with small effects on blood pressure have been identified[34] as well as some rare genetic variants with large effects on blood pressure.[35] Also, genome-wide association studies (GWAS) have identified 35 genetic loci related to blood pressure; 12 of these genetic loci influencing blood pressure were newly found.[36] Sentinel SNP for each new genetic locus identified has shown an association with DNA methylation at multiple nearby CpG sites. These sentinel SNP are located within genes related to vascular smooth muscle and renal function. DNA methylation might affect in some way linking common genetic variation to multiple phenotypes even though mechanisms underlying these associations are not understood. Single variant test performed in this study for the 35 sentinel SNP (known and new) showed that genetic variants singly or in aggregate contribute to risk of clinical phenotypes related to high blood pressure.[36]
Postural hypotension is considered to be a failure of a person's cardiovascular system or nervous system to react appropriately to sudden changes. Usually, when a person stands up, some of their blood pools in their lower extremities. If this remains uncorrected, it would cause the person's blood pressure to fall or decrease. A person's body usually compensates by sending messages to their heart to beat faster and to their blood vessels to constrict, offsetting the drop in blood pressure. If this does not happen, or does not happen quickly enough, postural hypotension is the result.
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]
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.
Chronic low blood pressure with no symptoms is almost never serious. But health problems can occur when blood pressure drops suddenly and the brain is deprived of an adequate blood supply. This can lead to dizziness or lightheadedness. Sudden drops in blood pressure most commonly occur in someone who's rising from a lying down or sitting position to standing. This kind of low blood pressure is known as postural hypotension or orthostatic hypotension. Another type of low blood pressure can occur when someone stands for a long period of time. This is called neurally mediated hypotension. When it leads to passing out, if is called vasovagal syncope.
Even occasional dizziness or lightheadedness may be a relatively minor problem — the result of mild dehydration from too much time in the sun or a hot tub, for example. Still, it's important to see your doctor if you have signs or symptoms of hypotension because they can point to more-serious problems. It can be helpful to keep a record of your symptoms, when they occur and what you're doing at the 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]
NHLBI Expert Panel on Cardiovascular Health and Risk Reduction in Children and Adolescents. We have supported the development of guidelines based on up-to-date research to evaluate and manage risk of heart disease in children and adolescents, including high blood pressure. Visit Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents for more information.
An electrocardiogram is known by the acronyms "ECG" or "EKG" more commonly used for this non-invasive procedure to record the electrical activity of the heart. An EKG generally is performed as part of a routine physical exam, part of a cardiac exercise stress test, or part of the evaluation of symptoms. Symptoms evaluated include palpitations, fainting, shortness of breath, dizziness, fainting, or chest pain.

Most doctors do not make a final diagnosis of high blood pressure until they measure your blood pressure several times (at least 2 blood pressure readings on 3 different days). Some doctors ask their patients to wear a portable machine that measures their blood pressure over the course of several days. This machine may help the doctor find out whether a patient has true high blood pressure or what is known as “white-coat hypertension.” White-coat hypertension is a condition in which a patient’s blood pressure rises during a visit to a doctor when anxiety and stress probably play a role.

For example, a 2015 study known as the SPRINT trial found that patients who lowered their systolic blood pressure to around 120 mm Hg were 27 percent less likely to die during the study period, compared with those whose treatment target was to lower their blood pressure to less than 140 mm Hg. (The SPRINT study made headlines in 2015 when the trial was abruptly cut short because the findings were so significant.)
High blood pressure is more common in older people. At age 45, more men have hypertension than women. By age 65, this is reversed and more women are affected. People with diabetes have a greater risk of hypertension than those without diabetes. Having a close family member with high blood pressure also increases your risk of developing it. About 60% of all people with diabetes also have hypertension.
What is a normal blood pressure? Blood pressure is essential to life because it forces the blood around the body, delivering all the nutrients it needs. Here, we explain how to take your blood pressure, what the readings mean, and what counts as low, high, and normal. The article also offers some tips on how to maintain healthy blood pressure. Read now
Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated.[10] High blood pressure typically does not cause symptoms.[1] Long-term high blood pressure, however, is a major risk factor for coronary artery disease, stroke, heart failure, atrial fibrillation, peripheral vascular disease, vision loss, chronic kidney disease, and dementia.[2][3][4][11]
There is no treatment available for the causes of portal hypertension. However, treatment can prevent or manage the complications. Diet, medication (nonselective beta-blockers), endoscopic therapy, surgery, and radiology procedures can all help in treating or preventing symptoms of portal hypertension. If these treatments are unsuccessful in treating symptoms, transjugular intrahepatic portosystemic shunt (TIPS) or distal splenorenal shunt (DSRA) are two procedures that may reduce pressure in the portal veins. Maintaining a healthy lifestyle may help to prevent portal hypertension.
Stage 1 and Stage 2 hypertensions require therapy with anti-hypertensive drugs to bring down the blood pressure. Lifestyle modifications are also necessary, but often it is not sufficient for satisfactory control of blood pressure. Hypertension is often asymptomatic in the early course of disease. Symptoms like headache, lightheadedness, palpitations and easy fatigability may occur and chances of them being present increases with increasing blood pressure.
To make an official diagnosis of high blood pressure you will need to see your doctor. Often your blood pressure will be checked on at least two different visits, at different times of the day. Your doctor may ask you to keep a blood pressure log for a short time in order to see your overall blood pressure trends. If your blood pressure is consistently over 134/80, your doctor will work with you to determine the best regimen for treating your high blood pressure.
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.
Blood pressure often increases in stages. A person in her thirties may have mild to moderately elevated blood pressure readings. As she ages, blood pressure may continue to slowly rise. If someone develops high blood pressure before the age of 50, the risk of heart attack and stroke is greatly increased. If untreated, high blood pressure can reduce life expectancy by 10 or more years.
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.


Vasovagal reaction is a common condition in which a healthy person temporarily develops low blood pressure, slow heart rate, and sometimes fainting. A vasovagal reaction typically is brought on by emotions of fear or pain such as having blood drawn, starting an intravenous infusion, or by gastrointestinal upset. Vasovagal reactions are caused by activity of the involuntary (autonomic) nervous system, especially the vagus nerve, which releases hormones that slow the heart and widen the blood vessels. The vagus nerve also controls digestive tract function and senses activity in the digestive system. Thus, some people can have a vasovagal reaction from straining at a bowel movement or vomiting.
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.
The cuff is placed around the upper arm and inflated with an air pump to a pressure that blocks the flow of blood in the main artery that travels through the arm. The arm is held at the side of the body at the level of the heart, and the pressure of the cuff is gradually released. As the pressure decreases, a health practitioner listens with a stethoscope over the artery at the front of the elbow or an electronic machine senses the pulsation. The pressure at which the practitioner (or machine) first hears a pulsation from the artery is the systolic pressure (the top number). As the cuff pressure decreases further, the pressure at which the pulsation finally stops is the diastolic pressure (the bottom number).
These guidelines help guide healthcare practices, and can be related to patient reimbursement and healthcare coverage. The tenth revision of the International Statistical Classification of Diseases and Related Health Problems, or ICD-10, is the set of codes used to designate specific health conditions and allow for reimbursement through health insurance programs.
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.
As mentioned earlier, blood pressure increases with age, beginning from infancy to older adulthood. Since most healthy babies and children are typically not at risk for blood pressure problems, most doctors do not check their blood pressure routinely. But, the normal BP range for all adults, regardless of their age, is considered to be lesser than 120/80.
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.
A person consistently showing blood pressure higher than 140/90 over several readings is considered to have hypertension. Doctors advise these people to make effective lifestyle changes to help lower their blood pressure, such as maintaining a healthy weight, including exercise in their daily routine, limiting salt and alcohol intake, and quitting smoking. The doctors will also recommend medication for hypertension depending on how much higher the BP is as compared to the normal blood pressure range and any other health problems that the patient faces.
In the 19th and 20th centuries, before effective pharmacological treatment for hypertension became possible, three treatment modalities were used, all with numerous side-effects: strict sodium restriction (for example the rice diet[152]), sympathectomy (surgical ablation of parts of the sympathetic nervous system), and pyrogen therapy (injection of substances that caused a fever, indirectly reducing blood pressure).[152][158] 

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]
Many mechanisms have been proposed to account for the rise in peripheral resistance in hypertension. Most evidence implicates either disturbances in the kidneys' salt and water handling (particularly abnormalities in the intrarenal renin–angiotensin system)[61] or abnormalities of the sympathetic nervous system.[62] These mechanisms are not mutually exclusive and it is likely that both contribute to some extent in most cases of essential hypertension. It has also been suggested that endothelial dysfunction and vascular inflammation may also contribute to increased peripheral resistance and vascular damage in hypertension.[63][64] Interleukin 17 has garnered interest for its role in increasing the production of several other immune system chemical signals thought to be involved in hypertension such as tumor necrosis factor alpha, interleukin 1, interleukin 6, and interleukin 8.[65]
^ Nagele, Eva; Jeitler, Klaus; Horvath, Karl; Semlitsch, Thomas; Posch, Nicole; Herrmann, Kirsten H.; Grouven, Ulrich; Hermanns, Tatjana; Hemkens, Lars G.; Siebenhofer, Andrea (2014). "Clinical effectiveness of stress-reduction techniques in patients with hypertension". Journal of Hypertension. 32 (10): 1936–44. doi:10.1097/HJH.0000000000000298. ISSN 0263-6352. PMID 25084308. 

^ 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.
The guidelines also redefined the various categories of hypertension. It eliminated the category of prehypertension, which had been defined as systolic blood pressure of 120 to 139 mm Hg or diastolic pressure (the lower number in a reading) of 80 to 89 mm Hg. Instead, people with those readings are now categorized as having either elevated pressure (120 to 129 systolic and less than 80 diastolic) or Stage 1 hypertension (130 to 139 systolic or 80 to 89 diastolic).

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.

Normal blood pressure can differ substantially between breeds but hypertension in dogs is often diagnosed if systolic blood pressure is above 160 mm Hg particularly if this is associated with target organ damage.[170] Inhibitors of the renin-angiotensin system and calcium channel blockers are often used to treat hypertension in dogs, although other drugs may be indicated for specific conditions causing high blood pressure.[170]


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 issues may happen; however, when a person's blood pressure suddenly drops and their brain is deprived of an adequate blood supply. The condition may lead to lightheadedness or dizziness. A sudden drop in blood pressure usually happens in a person who has risen from a prone or sitting position to a standing one. When this occurs it is referred to as, 'orthostatic hypotension,' or, 'postural hypotension.' Another type of low blood pressure may happen when a person stands for extended periods of time; it is referred to as, 'neurally mediated hypotension.'
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.
As people age, they get plaque buildup inside the blood vessels, and the flexible walls of the arteries become stiff. Now, when the heart squeezes and pushes the blood out, the blood vessels can't expand like they used to do and sustain higher pressure. Over time, the heart has to push so hard against the pressure that it starts to fail, Bauman said.
^ 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.
If dehydration contributes to the problem, increased fluid intake would be needed based in part on your body mass index (BMI). For example, a person with a normal BMI would likely only need eight to ten 8-ounce glasses of water per day to maintain ideal hydration. People with a high BMI may need far more. Adding more salt to your diet may also aid in normalizing your blood pressure.

She'll inflate the cuff to a pressure higher than your systolic blood pressure, and it will tighten around your arm. Then she'll release it. As the cuff deflates, the first sound she hears through the stethoscope is the systolic blood pressure. It sounds like a whooshing noise. The point where this noise goes away marks the diastolic blood pressure.


^ Nagele, Eva; Jeitler, Klaus; Horvath, Karl; Semlitsch, Thomas; Posch, Nicole; Herrmann, Kirsten H.; Grouven, Ulrich; Hermanns, Tatjana; Hemkens, Lars G.; Siebenhofer, Andrea (2014). "Clinical effectiveness of stress-reduction techniques in patients with hypertension". Journal of Hypertension. 32 (10): 1936–44. doi:10.1097/HJH.0000000000000298. ISSN 0263-6352. PMID 25084308.

Certain medications: A number of drugs can cause low blood pressure, including diuretics and other drugs that treat hypertension; heart medications such as beta blockers; drugs for Parkinson’s disease; tricyclic antidepressants; erectile dysfunction drugs, particularly in combination with nitroglycerine; narcotics and alcohol. Other prescription and over-the-counter drugs may cause low blood pressure when taken in combination with high blood pressure medications.

About This Image: Person receiving a blood pressure test. Medical research shows that as we age blood pressure rises slightly to accommodate an increased demand of oxygen and nutrients. It is completely natural for the first number (systolic) to be 100 plus our age. A recent study by a group of UCLA researchers came very close to corroborating Dr. Piette's guide for blood pressure of 100 plus your age for men, subtracting 10 for women, and this is after this rule had been in use for five or more decades. Are we now being taught that Dr. Piette's guide for blood pressure is wrong merely for drug company profit?
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