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]
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. 

Modern understanding of the cardiovascular system began with the work of physician William Harvey (1578–1657), who described the circulation of blood in his book "De motu cordis". The English clergyman Stephen Hales made the first published measurement of blood pressure in 1733.[152][153] However, hypertension as a clinical entity came into its own with the invention of the cuff-based sphygmomanometer by Scipione Riva-Rocci in 1896.[154] This allowed easy measurement of systolic pressure in the clinic. In 1905, Nikolai Korotkoff improved the technique by describing the Korotkoff sounds that are heard when the artery is ausculated with a stethoscope while the sphygmomanometer cuff is deflated.[153] This permitted systolic and diastolic pressure to be measured.


With low blood pressure, the patient may feel faint or lose consciousness. This is due to lack of blood flow to the brain, and usually laying the patient supine will help them come round. This is also known as a blackout, and it could be accompanied by a dizzy feeling and light-headedness. Generally, your patient will report trouble focusing, difficulty keeping upright and lack of coordination.
Unlike high blood pressure, low blood pressure is defined primarily by signs and symptoms of low blood flow and not by a specific blood pressure number. Some individuals routinely may have blood pressure numbers of 90/50 with no symptoms and therefore do not have low blood pressure. However, others who normally have higher blood pressures may develop symptoms of low blood pressure if their blood pressure drops to 100/60.
Some forms of postural hypotension may require a test called a "tilt table" test. This test evaluates the body's reaction to changes in position. The person lies on a table, is safely strapped in, and the table is raised to an upright position for up to an hour. Blood pressure, heart rate, and symptoms are recorded. Often, medications are given to help guide treatment.
Excellent point! I can’t speak for anyone specifically, but I can say that generally, doctors make the worst patients. We don’t always follow the textbook guidelines nor abide by health recommendations. Then, there’s genetics, a pretty powerful force, and one over which we have little control. And, of course, there is just plain bad luck (or fate, finger of God, however you choose to describe it). So, many factors can come into play when a doctor gets diagnosed with what can otherwise be considered a preventable disease.
Unlike high blood pressure symptoms, which are poorly defined and often totally absent, low blood pressure symptoms tend to be more upfront and easily recognizable. The development of symptoms is often a warning sign of a potentially serious underlying disorder. Generally speaking, your blood pressure would need to fall pretty dramatically before symptoms develop.
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.
A number of medications contribute to heart disease, including corticosteroids, oral contraceptives, some decongestants, medications that contain caffeine, and many others. In general, it is best to check the label to see if hypertension is one of the side effects of any medications you take, especially if you already have hypertension or if you are at increased risk for it.
tilt table test – usually recommended if your doctor suspects you might have orthostatic hypotension or NMH (During this diagnostic test, a person lies on a table and then the table is tilted to raise the upper part of their body. This simulates the change in position from sitting or lying down to standing up. People with orthostatic hypotension or NMH may feel dizzy, lightheaded, or even faint when their position changes.)
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.
^ 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.
Recognizing heart attack symptoms and signs can help save your life or that of someone you love. Some heart attack symptoms, including left arm pain and chest pain, are well known but other, more nonspecific symptoms may be associated with a heart attack. Nausea, vomiting, malaise, indigestion, sweating, shortness of breath, and fatigue may signal a heart attack. Heart attack symptoms and signs in women may differ from those in men.
NHLBI-funded Research Supports Development of Guidelines for High Blood Pressure Management. The Systolic Blood Pressure Intervention Trial (SPRINT) found that treating to a lower systolic blood pressure target—less than 120 mm Hg—reduced complications from high blood pressure and saved lives. SPRINT results informed recent high blood pressure clinical guidelines that aim to improve treatment for millions of people. SPRINT Memory and Cognition in Decreased Hypertension (SPRINT-MIND) is examining whether treating to the lower blood pressure target can reduce the rate of dementia and slow cognitive decline in the SPRINT participants.
Your doctor may diagnose you with high blood pressure 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.
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]
At the most basic level, hypotension can cause dizziness or blurry vision, which may increase the risk of falling or contribute to accidents. In more serious cases, it reduces the blood flow to the brain and other vital organs. This decreases the amount of oxygen and nutrients being delivered to these organs and impairs their ability to carry out normal functions. Hypotension may also indicate a more serious underlying health condition.
However, the guidelines stress that, for most of the newly classified patients, the recommended treatment will be lifestyle modifications, such as weight loss and changes in diet and exercise levels, as opposed to medications. Only a small increase in the percentage of U.S. adults receiving blood pressure medications — about 2 percent — is expected, the authors said.
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.
However, if a patient has any kind of cardiovascular disease and stage 1 hypertension (a blood pressure over 130 systolic or 80 diastolic), or no existing cardiovascular disease but a significant risk of developing it (over 10% risk within the next 10 years), then lifestyle changes plus medications are recommended. And, even if someone has less than a 10% risk, if their blood pressure is over 140 systolic or 90 diastolic, which is now stage 2 high blood pressure, they ought to be treated with medication as well.

Although it's most common in older adults, hypertension can also affect children. The normal blood pressure for a child is dependent upon the child's age, gender, and height. Your doctor can tell if your child's blood pressure is abnormal. Children are at higher risk for hypertension if they are overweight, African-American, or if they have a family history of the condition. Children with high blood pressure may benefit from the DASH diet and taking medications. Children with high blood pressure should also maintain a healthy weight and avoid tobacco smoke.
Recognizing heart attack symptoms and signs can help save your life or that of someone you love. Some heart attack symptoms, including left arm pain and chest pain, are well known but other, more nonspecific symptoms may be associated with a heart attack. Nausea, vomiting, malaise, indigestion, sweating, shortness of breath, and fatigue may signal a heart attack. Heart attack symptoms and signs in women may differ from those in men.

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.


Before measuring your blood pressure, do not smoke, drink caffeinated beverages, or exercise for at least 30 minutes before the test. Rest for at least five minutes before the measurements and sit still with your back straight and supported. Feet should be flat on the floor and not crossed. Your arm should also be supported on a flat surface like a table with the upper arm at heart level.
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).
Calcium channel blockers are drugs that reduce the movement of calcium into cells of the heart and vessels. This reduces the strength of heart contractions and relaxes the arteries, allowing them to remain more open, lowering blood pressure. Side effects of calcium channel blockers can include heart palpitations, dizziness, swollen ankles, and constipation. Calcium channel blockers can be taken alone or with other blood pressure medications. They should be taken with food or milk. Because of potential interactions, those taking calcium channel blockers should avoid alcohol and grapefruit juice.
Dizziness : While dizziness can be a side effect of some blood pressure medications, it is not caused by high blood pressure. However, dizziness should not be ignored, especially if the onset is sudden. Sudden dizziness, loss of balance or coordination and trouble walking are all warning signs of a stroke. High blood pressure is a leading risk factor for stroke.
Anyone can develop hypotension, but certain groups of people are more likely to experience it, and there are different types. For instance, orthostatic (positional) hypotension, which occurs when you stand up after sitting or lying down, is more common in older adults. Typically, “your body has certain compensatory mechanisms to prevent your blood pressure from falling when you stand up,” explains Willie Lawrence, MD, an interventional cardiologist at Research Medical Center in Kansas City, Missouri, and a spokesperson for the American Heart Association. But, he adds, “orthostatic hypotension is a problem for some people because these reflexes that should occur, don’t occur.”
In Europe hypertension occurs in about 30-45% of people as of 2013.[12] In 1995 it was estimated that 43 million people (24% of the population) in the United States had hypertension or were taking antihypertensive medication.[141] By 2004 this had increased to 29%[142][143] and further to 32% (76 million US adults) by 2017.[7] In 2017, with the change in definitions for hypertension, 46% of people in the United States are affected.[7] African-American adults in the United States have among the highest rates of hypertension in the world at 44%.[144] It is also more common in Filipino Americans and less common in US whites and Mexican Americans.[6][145] Differences in hypertension rates are multifactorial and under study.[146]
A number of medications contribute to heart disease, including corticosteroids, oral contraceptives, some decongestants, medications that contain caffeine, and many others. In general, it is best to check the label to see if hypertension is one of the side effects of any medications you take, especially if you already have hypertension or if you are at increased risk for it.
In Europe hypertension occurs in about 30-45% of people as of 2013.[12] In 1995 it was estimated that 43 million people (24% of the population) in the United States had hypertension or were taking antihypertensive medication.[141] By 2004 this had increased to 29%[142][143] and further to 32% (76 million US adults) by 2017.[7] In 2017, with the change in definitions for hypertension, 46% of people in the United States are affected.[7] African-American adults in the United States have among the highest rates of hypertension in the world at 44%.[144] It is also more common in Filipino Americans and less common in US whites and Mexican Americans.[6][145] Differences in hypertension rates are multifactorial and under study.[146]
1. Concentrate on foods that lower blood pressure. Sugary, processed foods contain salt, sugar, damaged fats, and food sensitivities like gluten that contribute to or exacerbate high blood pressure. Shifting to a whole, unprocessed foods diet can dramatically impact your blood pressure. Many whole, unprocessed foods are rich in potassium, a mineral that supports healthy blood pressure. Some research shows that too much sodium and low amounts of potassium – can contribute to high blood pressure. Research shows people with high blood pressure can benefit from increased potassium in foods including avocado, spinach, wild-caught salmon, and sweet potatoes.
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. 

However, if a patient has any kind of cardiovascular disease and stage 1 hypertension (a blood pressure over 130 systolic or 80 diastolic), or no existing cardiovascular disease but a significant risk of developing it (over 10% risk within the next 10 years), then lifestyle changes plus medications are recommended. And, even if someone has less than a 10% risk, if their blood pressure is over 140 systolic or 90 diastolic, which is now stage 2 high blood pressure, they ought to be treated with medication as well.
Beta-blockers cause the heart to slow down and so some of their side effects can be traced to that mechanism of action. Dizziness, weakness, fatigue, and fainting are possible. Beta-blockers also affect the respiratory system, so other side effects include shortness of breath, difficulty breathing, and chest pain. Beta-blockers should not be withdrawn suddenly, as that could result in a heart attack or sudden death.
As you age, prevention becomes even more important. Systolic pressure tends to creep up once you’re older than 50, and it’s far more important in predicting the risk of coronary heart disease and other conditions. Certain health conditions, such as diabetes and kidney disease, may also play a role. Talk to your doctor about how you can manage your overall health to help prevent the onset of hypertension.

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.
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.
All material copyright MediResource Inc. 1996 – 2019. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/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.

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]

Because of the need for emergency care, it is important to recognize the early signs of malignant hypertension. The first giveaway is blood pressure of 180/120. You might have bleeding in the eyes due to rupture of the small blood vessels. Other malignant hypertension symptoms can include chest pain, dizziness, a headache, numbness in your extremities, and confusion.
The new guidelines also encourage additional monitoring, using a wearable digital monitor that continually takes blood pressure readings as you go about your life, or checked with your own cuff at home. This additional monitoring can help to tease out masked hypertension (when the blood pressure is normal in our office, but high the rest of the time) or white coat hypertension (when the blood pressure is high in our office, but normal the rest of the time). There are clear, helpful directions for setting patients up with a home blood pressure monitor, including a recommendation to give people specific instructions on when not to check blood pressure (within 30 minutes of smoking, drinking coffee, or exercising) and how to take a measurement correctly (seated comfortably, using the correct size cuff). The home blood pressure cuff should first be validated (checked in the office, for accuracy).
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.
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.
Sodium (salt) sensitivity: Some people have high sensitivity to sodium (salt), and their blood pressure increases if they use salt. Reducing sodium intake tends to lower their blood pressure. Americans consume 10-15 times more sodium than they need. Fast foods and processed foods contain particularly high amounts of sodium. Many over-the-counter medicines also contain large amounts of sodium. Read food labels and learn about salt content in foods and other products as a healthy first step to reducing salt intake. Fast food restaurants also make the salt and calorie content of their food available to consumers at their restaurants,
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:
A slow heart rate (bradycardia) can decrease the amount of blood pumped by the heart. The resting heart rate for a healthy adult is between 60 and 100 beats/minute. Bradycardia (resting heart rates slower than 60 beats/minute) does not always cause low blood pressure. In fact, some highly trained athletes can have resting heart rates in the 40s and 50s (beats per minute) without any symptoms. The slow heart rates are offset by more forceful contractions of the heart that pump more blood than in non-athletes. However, in many patients bradycardia can lead to low blood pressure, lightheadedness, dizziness, and even fainting.
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:
Excellent point! I can’t speak for anyone specifically, but I can say that generally, doctors make the worst patients. We don’t always follow the textbook guidelines nor abide by health recommendations. Then, there’s genetics, a pretty powerful force, and one over which we have little control. And, of course, there is just plain bad luck (or fate, finger of God, however you choose to describe it). So, many factors can come into play when a doctor gets diagnosed with what can otherwise be considered a preventable disease.
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]
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.
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.
Being overweight increases the risk of getting hypertension and increases the workload required of your heart. Diets designed to control blood pressure are often designed to reduce calories as well. Most of these diets require decreasing consumption of fatty foods and sugars while increasing your intake of lean protein, fiber, fruits, and vegetables. A weight loss of just 10 pounds can make a significant difference in your blood pressure.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Your doctor may suggest that you check your blood pressure at home. The easiest way to do this is to use a digital blood pressure monitor. You can get a monitor from your local drug store, hospital, clinic or online. Your doctor can help you find a monitor that is right for you and show you how to use it. Many pharmacies and grocery stores also have in-store monitors that you can use for free.

It is important to go to your regular check-ups with your doctor. Hypertension is a common condition and, if caught, can be treated with medication to prevent complications. However, if you experience any of the symptoms of hypertension, such as frequent headaches, recurrent dizziness, nosebleeds, shortness of breath, nausea or vomiting, don't wait—speak to your doctor immediately.
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

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.
"The implications and potential benefits of such healthier lifestyles could be great, particularly since about 22% of the adult population falls into the prehypertensive category," says Chobanian, who is also dean of the Boston University School of Medicine. "In fact, the blood pressure effects of weight reduction or adoption of the DASH eating plan can be comparable to those achieved with any single blood pressure medication."
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