Allergic reaction (anaphylaxis): Anaphylactic shock is a sometimes-fatal allergic reaction that can occur in people who are highly sensitive to drugs such as penicillin, to certain foods such as peanuts or to bee or wasp stings. This type of shock is characterized by breathing problems, hives, itching, a swollen throat and a sudden, dramatic fall in blood pressure.
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.

Your doctor can help you measure and track your blood pressure to confirm whether it’s too high. You may need to start taking medications if your blood pressure doesn’t improve after one month of following a healthy lifestyle, especially if you’re already at high risk for heart disease. If you’re at lower risk, your doctor may want to follow up in three to six months after you’ve adopted more healthy habits.
Orthostatic hypotension is caused by a sudden change in body position. This occurs most often when you shift from lying down to standing. This type of low blood pressure usually lasts only a few seconds or minutes. If this type of low blood pressure occurs after eating, it is called postprandial orthostatic hypotension. This type most often affects older adults, those with high blood pressure, and people with Parkinson disease.
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]
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.

Many things can cause your blood pressure to be too low, ranging from normal pregnancy-induced changes to dangerous underlying conditions, like heart problems or hormone disturbances. In some instances, what causes low blood pressure could be a simple case of dehydration brought on by vomiting, intense exercise, or the overuse of diuretics. In fact, even mild dehydration can trigger symptoms such as dizziness, confusion, or other symptoms of low blood pressure.

The first line of treatment for hypertension is lifestyle changes, including dietary changes, physical exercise, and weight loss. Though these have all been recommended in scientific advisories,[111] a Cochrane systematic review found no evidence for effects of weight loss diets on death, long-term complications or adverse events in persons with hypertension.[112] The review did find a decrease in blood pressure.[112] Their potential effectiveness is similar to and at times exceeds a single medication.[12] If hypertension is high enough to justify immediate use of medications, lifestyle changes are still recommended in conjunction with medication.
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.
A hypertensive emergency, unlike the similar sounding hypertensive urgency, is characterized by serious, life-threatening complications. A hypertensive emergency means that the blood pressure is >180 mm Hg or the diastolic pressure is >120 mm Hg, and that end-organ damage is occurring. Signs and symptoms can include shortness of breath, anxiety, chest pain, irregular heart rate, confusion, or fainting. 
High blood pressure is a common disease in which blood flows through blood vessels, or arteries, at higher than normal pressures. Blood pressure is the force of blood pushing against the walls of your arteries as the heart pumps blood. High blood pressure, sometimes called hypertension, is when this force against the artery walls is too high. Your doctor may diagnose you with high blood pressure if you have consistently high blood pressure readings.
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.

We stimulate high-impact research. Our Trans-Omics for Precision Medicine (TOPMed) Program includes participants with high blood pressure, which may help us understand how genes contribute to differences in disease severity and how patients respond to treatment. The NHLBI Strategic Vision highlights ways we may support research over the next decade, including new efforts for studying high blood pressure.
You may be directed to seek medical care if blood pressure readings are elevated if done as part of a community health screening. Isolated elevated blood pressure readings do not necessarily make the diagnosis of hypertension. Blood pressure readings vary throughout the day, and your primary care provider may record a different reading than the one that was measured in a screening that sent you in for care.
In people aged 18 years or older hypertension is defined as either a systolic or a diastolic blood pressure measurement consistently higher than an accepted normal value (this is above 129 or 139 mmHg systolic, 89 mmHg diastolic depending on the guideline).[5][7] Other thresholds are used (135 mmHg systolic or 85 mmHg diastolic) if measurements are derived from 24-hour ambulatory or home monitoring.[79] Recent international hypertension guidelines have also created categories below the hypertensive range to indicate a continuum of risk with higher blood pressures in the normal range. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC7) published in 2003[27] uses the term prehypertension for blood pressure in the range 120–139 mmHg systolic or 80–89 mmHg diastolic, while European Society of Hypertension Guidelines (2007)[86] and British Hypertension Society (BHS) IV (2004)[87] use optimal, normal and high normal categories to subdivide pressures below 140 mmHg systolic and 90 mmHg diastolic. Hypertension is also sub-classified: JNC7 distinguishes hypertension stage I, hypertension stage II, and isolated systolic hypertension. Isolated systolic hypertension refers to elevated systolic pressure with normal diastolic pressure and is common in the elderly.[27] The ESH-ESC Guidelines (2007)[86] and BHS IV (2004)[87] additionally define a third stage (stage III hypertension) for people with systolic blood pressure exceeding 179 mmHg or a diastolic pressure over 109 mmHg. Hypertension is classified as "resistant" if medications do not reduce blood pressure to normal levels.[27] In November 2017, the American Heart Association and American College of Cardiology published a joint guideline which updates the recommendations of the JNC7 report.[88]
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).
If you have been diagnosed with high blood pressure, it is important that you continue your treatment plan. Following your treatment plan, getting regular follow-up care, and learning how to monitor your condition at home are important. Let your doctor know if you are planning to become pregnant. These steps can help prevent or delay complications that high blood pressure can cause. Your doctor may adjust your treatment plan as needed to lower or control your high blood pressure.

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.


^ Ostchega Y, Dillon CF, Hughes JP, Carroll M, Yoon S (July 2007). "Trends in hypertension prevalence, awareness, treatment, and control in older U.S. adults: data from the National Health and Nutrition Examination Survey 1988 to 2004". Journal of the American Geriatrics Society. 55 (7): 1056–65. doi:10.1111/j.1532-5415.2007.01215.x. PMID 17608879.
Sodium, a chemical found in salt, raises blood pressure by promoting the retention of fluid by the body. This increases the workload on the heart. The American Heart Association recommends an upper daily limit for sodium consumption of 1,500 mg. Checking food labels and menus can help you calculate how much sodium you are consuming. Processed foods are particularly high in sodium and make up about 75% of our sodium intake. Among these, lunch meats and canned soups have some of the highest levels of dietary sodium.

High blood pressure, also known as hypertension (See blood pressure chart below) is called the “silent killer” for a reason — there are no obvious symptoms but it can result in heart attack, stroke and even death. The good news is there’s a lot you can do to maintain healthy blood pressure or get back to one, often without the need for medications.


One especially important cause of low blood pressure is orthostatic hypotension, which is sometimes referred to as postural hypotension. This happens when blood pressure drops rapidly during changes in body position—usually when changing from sitting to standing—inducing classic signs that the blood pressure is too low, like dizziness, blurry vision, and fainting. 

A hypertensive emergency, unlike the similar sounding hypertensive urgency, is characterized by serious, life-threatening complications. A hypertensive emergency means that the blood pressure is >180 mm Hg or the diastolic pressure is >120 mm Hg, and that end-organ damage is occurring. Signs and symptoms can include shortness of breath, anxiety, chest pain, irregular heart rate, confusion, or fainting.  

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.

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.


^ 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.
The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.
You are considered to have hypertension if your systolic blood pressure measurements are between 130 and 139 or your diastolic measurement falls between 80 and 89. At this level of blood pressure you may not have any symptoms. When blood pressure reaches 180/120 or higher, a serious condition known as a malignant hypertension or hypertension crisis may occur. This can lead to stroke, kidney damage, heart attacks, or loss of consciousness. If you measure your blood pressure and it is this high, rest a few minutes and measure again. If it remains high, call 911.
High blood pressure is the #2 cause of kidney failure. It accounts for about one-fourth of all cases. High blood pressure can be both a cause of kidney disease and a symptom of kidney disease. When high blood pressure damages your kidneys, they are not able to do all their jobs as well—and one of their jobs is helping your body regulate your blood pressure.
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
Making sure your blood pressure numbers are normal is an investment for your future. Putting unnecessary strain on your arteries and your heart can ultimately lead to a heart attack or stroke. Heart disease and strokes are the leading causes of death in the United States. About 1,000 people die every day from complications stemming from high blood pressure.
If these lifestyle changes don't lower your blood pressure to a safe level, your doctor will also prescribe medicine. You may try several kinds or combinations of medicines before finding a plan that works best for you. Medicine can control your blood pressure, but it can't cure it. You will likely need to take medicine for the rest of your life. Plan with your doctor how to manage your blood pressure.
Some women with normal blood pressure develop high blood pressure during pregnancy. As part of your regular prenatal care, your doctor will measure your blood pressure at each visit. If you develop high blood pressure, your doctor will closely monitor you and your baby and provide special care to lower the chance of complications. With such care, most women and babies have good outcomes.

During relaxation of the heart (diastole), the left ventricle of the heart fills with blood returning from the lungs. The left ventricle then contracts and pumps blood into the arteries (systole). The blood pressure in the arteries during contraction of the ventricle (systolic pressure) is higher because blood is being actively ejected into the arteries. It is lower during relaxation of the ventricle (diastolic pressure) when no blood is being ejected into the arteries. The pulse we feel when we place our fingers over an artery is caused by the contraction of the left ventricle and the ejection of blood.


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]
Meschia JF, Bushnell C, Boden-Albala B, et al; American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Functional Genomics and Translational Biology; Council on Hypertension.. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(12):3754-3832. PMID: 25355838 www.ncbi.nlm.nih.gov/pubmed/25355838.

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.


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.
If you have high blood pressure, it is important to get routine medical care and to follow your prescribed treatment plan, which will include heart-healthy lifestyle changes and possibly medicines. Heart-healthy lifestyle changes can prevent high blood pressure, reduce elevated blood pressure, help control existing high blood pressure, and prevent complications, such as heart attack, heart failure, stroke, vascular dementia, or chronic kidney disease.
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.
People with stage 1 hypertension who don't meet these criteria should be treated with lifestyle modifications. These include: starting the "DASH" diet, which is high in fruit, vegetables and fiber and low in saturated fat and sodium (less than 1,500 mg per day); exercising for at least 30 minutes a day, three times a week; and restricting alcohol intake to less than two drinks a day for men and one drink a day for women, said vice chairman of the new guidelines, Dr. Robert Carey, a professor of medicine and dean emeritus at the University of Virginia Health System School of Medicine. [6 Healthy Habits Dramatically Reduce Heart Disease Risk in Women]
Unfortunately, a problem doesn’t always announce itself with a fanfare of trumpets. Even the highest blood pressure can be entirely asymptomatic. Similarly, low blood pressure also known as hypotension can occur in your patient despite no symptoms seemingly being present. This is particularly true if the patient is lying still in an unmonitored bed.
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.
Hypertension in African-Americans tends to occur earlier in life and tends to be more severe. Plus, some medications that work to lower blood pressure in other ethnicities may have limited effect on African-Americans. Thiazide diuretics (such as HCTZ) or a calcium channel blocker are recommended first choices along with the possible add-on of a second drug from either the ACE inhibitor class or the angiotensin II receptor blocker group.
Historically the treatment for what was called the "hard pulse disease" consisted in reducing the quantity of blood by bloodletting or the application of leeches.[152] This was advocated by The Yellow Emperor of China, Cornelius Celsus, Galen, and Hippocrates.[152] The therapeutic approach for the treatment of hard pulse disease included changes in lifestyle (staying away from anger and sexual intercourse) and dietary program for patients (avoiding the consumption of wine, meat, and pastries, reducing the volume of food in a meal, maintaining a low-energy diet and the dietary usage of spinach and vinegar).
For a manual monitor, you have to hold the pressure gauge in one hand (your weaker hand) and the bulb in the other hand. Inflate the cuff until it reads about 30 points above your normal systolic pressure. At this point, you should not hear your pulse in the stethoscope. When you hear the first heart beat, this is the systolic pressure. As you deflate the cuff, keep listening for a heart beat. When you can no longer hear it, that is your diastolic pressure.
Measuring blood pressure in both the lying (supine) and standing positions usually is the first step in diagnosing low blood pressure. In patients with symptomatic low blood pressure, there often is a marked drop in blood pressure upon standing, and patients may even develop orthostatic symptoms. The heart rate often increases. The goal is to identify the cause of the low blood pressure. Sometimes the causes are readily apparent (such as loss of blood due to trauma, or sudden shock after receiving X-ray dyes containing iodine). At other times, the cause may be identified by testing:
2. Take the right nutrients. Talk with your chiropractor or other healthcare professional about the wide range of well-studied nutrients that, along with dietary and lifestyle modifications, can help normalize your blood pressure. One meta-analysis found magnesium supplements could lower blood pressure. Likewise, researchers find a small but significant decline in blood pressure for people with hypertension who use fish oil. (You can get all of fish oil’s benefits combined with anti-inflammatory flax oil and GLA in our Optimal Omega.) 
The guidelines also say that a patient's blood pressure levels should be based on an average of two to three readings on at least two different occasions. It's also reasonable for doctors to screen for "white-coat hypertension," which occurs when blood pressure is elevated in a medical setting but not in everyday life, the authors said. This can be done by having patients measure their blood pressure at home. 
If these lifestyle changes don't lower your blood pressure to a safe level, your doctor will also prescribe medicine. You may try several kinds or combinations of medicines before finding a plan that works best for you. Medicine can control your blood pressure, but it can't cure it. You will likely need to take medicine for the rest of your life. Plan with your doctor how to manage your blood pressure.
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.
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