Rates Of High Blood Pressure Control Vary By Sex And Race
Uncontrolled high blood pressure is common however, certain groups of people are more likely to have control over their high blood pressure than others.
- A greater percentage of men have high blood pressure than women .3
- High blood pressure is more common in non-Hispanic black adults than in non-Hispanic white adults , non-Hispanic Asian adults , or Hispanic adults .3
- Among those recommended to take blood pressure medication, blood pressure control is higher among non-Hispanic white adults than in non-Hispanic black adults , non-Hispanic Asian adults , or Hispanic adults .3
How Your Blood Pressure And Circulatory System Work
In order to survive and function properly, your tissues and organs need the oxygenated blood that your circulatory system carries throughout the body. When the heart beats, it creates pressure that pushes blood through a network of tube-shaped blood vessels, which include arteries, veins and capillaries. This pressure blood pressure is the result of two forces: The first force occurs as blood pumps out of the heart and into the arteries that are part of the circulatory system. The second force is created as the heart rests between heart beats.
What Diet Helps Control High Blood Pressure
- Eat foods that are lower in fat, salt and calories, such as skim or 1% milk, fresh vegetables and fruits, and whole-grain rice and pasta.
- Use flavorings, spices and herbs to make foods tasty without using salt. The optimal recommendation for salt in your diet is to have less than 1,500 milligrams of sodium a day. Don’t forget that most restaurant foods and many processed and frozen foods contain high levels of salt. Use herbs and spices that do not contain salt in recipes to flavor your food. Dont add salt at the table.
- Avoid or cut down on foods high in fat or salt, such as butter and margarine, regular salad dressings, fatty meats, whole milk dairy products, fried foods, processed foods or fast foods and salted snacks.
- Ask your provider if you should increase potassium in your diet. Discuss the Dietary Approaches to Stop Hypertension diet with your provider. The DASH diet emphasizes adding fruits, vegetables and whole grains to your diet while reducing the amount of sodium. Since its rich in fruits and vegetables, which are naturally lower in sodium than many other foods, the DASH diet makes it easier to eat less salt and sodium.
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What Is High Blood Pressure
Blood pressure is the measurement of the pressure or force of blood pushing against blood vessel walls. When you have hypertension , it means the pressure against the blood vessel walls in your body is consistently too high. High blood pressure is often called the silent killer because you may not be aware that anything is wrong, but the damage is still occurring within your body.
Your blood pressure reading has two numbers. The top number is the systolic blood pressure, which measures the pressure on the blood vessel walls when your heart beats or contracts. The bottom number is the diastolic blood pressure, which measures the pressure on your blood vessels between beats when your heart is relaxing.
For example, a blood pressure of 110/70 is within the normal range, but a blood pressure of 135/85 is stage 1 hypertension, and so on .
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Can High Blood Pressure Affect Pregnancy
High blood pressure complicates about 10% of all pregnancies. There are several different types of high blood pressure during pregnancy and they range from mild to serious. The forms of high blood pressure during pregnancy include:
Chronic hypertension: High blood pressure which is present before pregnancy.
Gestational hypertension: High blood pressure in the latter part of pregnancy.
Preeclampsia: This is a dangerous condition that typically develops in the latter half of pregnancy and results in hypertension, protein in the urine and generalized swelling in the pregnant person. It can affect other organs in the body and cause seizures .
Chronic hypertension with superimposed preeclampsia: Pregnant people who have chronic hypertension are at increased risk for developing preeclampsia.
Your provider will check your blood pressure regularly during prenatal appointments, but if you have concerns about your blood pressure, be sure to talk with your provider.
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How Can I Be More Active
- Check first with your healthcare provider before increasing your physical activity. Ask your provider what type and amount of exercise is right for you.
- Choose aerobic activities such as walking, biking or swimming.
- Start slowly and increase activity gradually. Aim for a regular routine of activity five times a week for 30 to 45 minutes each session.
Rates Of High Blood Pressure Vary By Geography
High blood pressure is more common in some areas of the United States than in others. Below is a map showing the self-reported rate of hypertension by state in 2011 . However, this map likely underreports the true effect of hypertension in each state, because about 1 in 5 adults with high blood pressure is unaware of it and would not report having it.5
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Home And Ambulatory Blood Pressure Monitoring
The U.S. Preventive Services Task Force recommends out-of-office blood pressure monitoring as an important adjunct to in-office measurements for diagnosing hypertension.16 A major advantage of out-of-office monitoring is the ability to obtain multiple readings over time. Specific indications for out-of-office monitoring in the setting of severe asymptomatic hypertension include suspected white coat hypertension and highly variable in-office blood pressure readings. Additionally, out-of-office monitoring is useful to assess compliance with antihypertensive therapy.
If Your Hypertension Is Resistant
It may take time for you and your doctor to work out a successful lifestyle and medication plan to lower your blood pressure.
Its very likely that youll find a combination of drugs that works, especially since new medications are always under development.
If your hypertension is resistant, its important that you keep working with your doctor and stick with your medication plan.
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What Questions Should I Ask My Provider
- Are there supplements or non-prescription medicines that I shouldnt take?
- Can I keep taking these medicines if I get pregnant?
- What kinds of exercise should I do?
A note from Cleveland Clinic
If you dont treat high blood pressure, it can put you at risk for developing serious illnesses later in life such as heart attack, kidney failure and stroke. But if you follow your providers instructions, you can control your blood pressure. Be sure to take any medicines your provider ordered as instructed. Keep taking them even if your blood pressure numbers begin to fall into the normal range. Living a healthy lifestyle by eating healthy foods, watching your weight and getting regular exercise is also a great way to help control your blood pressure.
Last reviewed by a Cleveland Clinic medical professional on 09/21/2021.
References
Facts About Hypertension In The United States
In 2017, the American College of Cardiology and the American Heart Association published new guidelines for hypertension management and defined high hypertension as a blood pressure at or above 130/80 mmHg. Stage 2 hypertension is defined as a blood pressure at or above 140/90 mmHg. 1
| or | 90 mmHg |
- Having hypertension puts you at risk for heart disease and stroke, which are leading causes of death in the United States.2
- In 2020, more than 670,000 deaths in the United States had hypertension as a primary or contributing cause.2
- Nearly half of adults in the United States have hypertension, defined as a systolic blood pressure greater than 130 mmHg or a diastolic blood pressure greater than 80 mmHg or are taking medication for hypertension.3
- Only about 1 in 4 adults with hypertension have their condition under control.3
- About half of adults with uncontrolled hypertension have a blood pressure of 140/90 mmHg or higher. This includes 37 million U.S. adults. 3
- About 34 million adults who are recommended to take medication may need it to be prescribed and to start taking it. Almost two out of three of this group have a blood pressure of 140/90 mmHg or higher.3
- High blood pressure costs the United States about $131 billion each year, averaged over 12 years from 2003 to 2014.4
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When To See A Healthcare Provider
It is important to go to your regular check-ups with your healthcare provider. 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 waitspeak to your healthcare provider immediately.
Hypertension requires regular visits with your healthcare provider to monitor your progress. If you are already on blood pressure medication and experience any related side effects, contact your healthcare provider to see if your regimen needs to be adjusted.
Hypertension Doctor Discussion Guide
Get our printable guide for your next healthcare provider’s appointment to help you ask the right questions.
- Weakness, numbness, tingling in the arms, legs, or face on one of both sides
- Trouble speaking or understanding words
- Confusion or behavioral changes
Do not attempt to lower extremely elevated blood pressure in yourself or someone else. While the goal is to reduce blood pressure before additional complications develop, blood pressure should be reduced over the course of hours to days, depending on severity. It is important not to lower blood pressure too quickly, because rapid blood pressure reductions can cut off the supply of blood to the brain, leading to brain damage or death.
Glossary Of High Blood Pressure Terms
Angina: chest pain
Angiotensin Converting Enzyme Inhibitors: one kind of medication used to treat high blood pressure by preventing the body from making the chemical angiotensin II. This chemical causes blood vessels to narrow, which can raise blood pressure. ACE inhibitors allow the vessels to expand, which lowers blood pressure. These drugs are also used to treat congestive heart failure, to protect the kidneys in people with diabetes, and to treat people who have had a heart attack.
Atherosclerosis: the build-up of fatty deposits within the arteries, eventually may cause a blockage of blood flow or stiffening of the artery walls.
Balloon Angioplasty: a procedure in which a small balloon at the tip of the catheter is inflated while in an artery to stretch a narrowed artery opening and allow for increased blood flow.
Beta-Blockers: one kind of medication used to treat high blood pressure, chest pain, and irregular heartbeat and to help protect a person from heart disease. Beta-blockers work by blocking the effects of adrenaline in various parts of the body. Beta-blockers relieve stress on the heart so that it requires less blood and oxygen. As a result, the heart doesn’t have to work as hard and blood pressure is lowered.
Cardiac Catheterization: a procedure in which a catheter is inserted into a large artery and guided to the coronary arteries in the heart to determine pressure and blood flow in the heart.
Hypertension: high blood pressure
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What Medications Are Used To Treat High Blood Pressure
Four classes of high blood pressure medications are considered first line when starting treatment. Sometimes other medications are coupled with these first-line drugs to better control your high blood pressure. First-line, pressure-lowering medications are:
- Angiotensin-converting enzyme inhibitors block the production of the angiotensin II hormone, which the body naturally uses to control blood pressure. When angiotensin II is blocked, your blood vessels dont narrow. Examples: lisinopril , enalapril or captopril.
- Angiotensin II receptor blockers block this same hormone from binding with receptors in the blood vessels. ARBs work the same way as ACE inhibitors to keep blood vessels from narrowing. Examples: metoprolol , valsartan or losartan.
- Calcium channel blockers prevent calcium from entering the muscle cells of your heart and blood vessels, allowing these vessels to relax. Examples: amlodipine , nifedipine , diltiazem .
- Diuretics flush excess sodium from your body, reducing the amount of fluid in your blood. Diuretics are often used with other high blood pressure medicines, sometimes in one combined pill. Examples: indapamide, hydrochlorothiazide or chlorothiazide.
How Is High Blood Pressure Diagnosed
Since high blood pressure doesnt have symptoms, your healthcare provider will need to check your blood pressure with a blood pressure cuff. Providers usually check your blood pressure at every annual checkup or appointment. If you have high blood pressure readings at two appointments or more, your provider may tell you that you have high blood pressure.
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Q: Is Hypertension Genetic
A: A family history of hypertension likely plays a role in a person developing the condition. Family environmental factors may also play a part. For example, if a person lives in a household with an older relative with hypertension, they may be more likely to share lifestyle habits that increase their risk of hypertension.
- hypertensive retinopathies in the eye, which can lead to blindness
Regular blood pressure monitoring can help people avoid these more severe complications.
A sphygmomanometer, or blood pressure monitor, can help people keep track of their blood pressure.
A doctors visit is not always necessary for blood pressure monitoring.
Having high blood pressure for a short time can be a normal response to many situations. Acute stress and intense exercise, for example, can briefly elevate blood pressure in an otherwise healthy person.
For this reason, a diagnosis of hypertension requires several readings that show sustained high blood pressure over time.
The International Society of Hypertension defines hypertension as blood pressure that is consistently higher than 140 over 90 millimeters of mercury .
The systolic reading of 130 mm Hg refers to the pressure as the heart pumps blood around the body. The diastolic reading of 80 mm Hg refers to the pressure as the heart relaxes and refills with blood.
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What Should I Do If I Have High Blood Pressure
If your healthcare provider has diagnosed you with high blood pressure, they will talk with you about your recommended blood pressure target or goal. They may suggest that you:
- Check your blood pressure regularly with a home blood pressure monitor. These are automated electronic monitors and are available at most pharmacies or online.
- Quit smoking and/or using tobacco products.
- Work on controlling anger and managing stress.
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Eating More Fruits And Vegetables And Less Fat
People who have high blood pressure or people at high risk for developing high blood pressure should reduce their intake of saturated fats in favor of unsaturated forms.
that those with high blood pressure prioritize more heart-healthy foods, such as:
- whole grain, high fiber foods
- a variety of fruits and vegetables
- pulses, such as chickpeas, beans, and lentils
- nuts
- fish rich in omega-3 twice per week
- nontropical vegetable oils, such as olive oil
- skinless poultry and fish
- low fat dairy products
If a person has high blood pressure or wished to maintain moderate blood pressure, it is important to avoid trans fats, hydrogenated vegetable oils, animal fats, and processed fast foods when creating a diet plan.
However, omega-3 fatty acids, such as those in oily fish and olive oil, have protective effects on the heart. However, these are still fats. While they are typically healthful, people with a risk of hypertension should still include them in their total fat intake.
contribute to hypertension. A fall in blood pressure usually follows weight loss, as the heart does not have to work so hard to pump blood around the body.
A balanced diet with a calorie intake that matches the individuals size, sex, and activity level will help.
What Can I Expect If I Have This Condition
Since high blood pressure doesnt cause many symptoms at first, you probably wont feel any different with a high blood pressure diagnosis. But its important to follow your providers instructions to bring your blood pressure down so it doesnt cause serious illnesses later in life.
How long does high blood pressure last?
If you have primary high blood pressure, youll need to control it for the rest of your life.
If you have secondary high blood pressure, your blood pressure will most likely come down after you receive treatment for the medical problem that caused it. If a medication caused your high blood pressure, switching to a different medicine may lower your blood pressure.
What is the outlook for high blood pressure?
You can get seriously ill if you dont treat your high blood pressure. However, if you take the medicines your provider ordered, you can control your blood pressure. Exercising and eating healthy foods also helps lower your blood pressure.
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Why Is Hypertension An Important Issue In Low
The prevalence of hypertension varies across regions and country income groups. The WHO African Region has the highest prevalence of hypertension while the WHO Region of the Americas has the lowest prevalence of hypertension .
The number of adults with hypertension increased from 594 million in 1975 to 1.13 billion in 2015, with the increase seen largely in low- and middle-income countries. This increase is due mainly to a rise in hypertension risk factors in those populations.
History And Physical Examination
A comprehensive history is essential in the initial evaluation of patients with severe asymptomatic hypertension .6 A medication history should include any new medications illicit substances and, most importantly, compliance with current prescriptions.13 A targeted symptom history should be obtained to identify a potential hypertensive emergency. Severe blood pressure elevations may cause mild symptoms without acute target organ injury, although patients with chest pain should receive appropriate evaluation for chest pain, not severe asymptomatic hypertension.
| Previous hypertension |
| Personal history: coronary artery disease, congestive heart failure, cerebrovascular disease, chronic kidney disease, peripheral vascular disease, diabetes mellitus, sleep apnea |
| Risk factors: family history of hypertension, hyperlipidemia, diabetes, tobacco use, dietary habits, weight gain, sedentary lifestyle |
| Secondary causes: family history of kidney disease, personal history of renal disease, medications and illicit drug use, clinical features of metabolic disorders |
| Target organ injury: neurologic , cardiovascular , renal , peripheral arteries , pulmonary |
| Concurrent medication/drug use: nonsteroidal anti-inflammatory drugs, antidepressants, oral contraceptives, cold medications, sympathomimetics , corticosteroids, herbal remedies |
| Compliance with antihypertensive therapy |
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