Almost half of adults in the U.S. have high blood pressure, according to the American Heart Association. Blood pressure is the force that your blood puts on your artery walls. High blood pressure, also called hypertension, happens when that force is consistently too high.
Detecting and treating high blood pressure is important because over time, it can damage your circulatory system and increase your risk of a heart attack, stroke, and other health problems later in life. In fact, hypertension contributes to one out of every seven deaths in the U.S. In general, the longer you have high blood pressure, the greater the potential for damage to your heart and other organs including your kidneys, brain, and eyes.
High blood pressure before age 40 is a risk factor for developing heart disease later in life.
Most people with high blood pressure aren’t aware of it because there are often no obvious symptoms. The only way to find out if you have high blood pressure is to get tested.
How is blood pressure measured?
Blood pressure was traditionally measured in healthcare settings using a blood pressure cuff with a pressure gauge (sphygmomanometer). This air-filled cuff wraps around the upper arm and obstructs blood flow. By releasing small amounts of air from the cuff, blood slowly flows back into the arm. The pressure measured inside the cuff is the same as the pressure inside the arteries.
There are two numbers measured for blood pressure. Systolic blood pressure is the pressure when your heart beats. Diastolic pressure is when the heart relaxes between beats and the pressure drops. Together, they are written as systolic over diastolic pressure. For instance, a blood pressure of 120/80 mm Hg (millimeters of mercury) corresponds to a systolic pressure of 120 and a diastolic pressure of 80.
Using a sphygmomanometer is still considered the best method but, more commonly, devices that combine a blood pressure cuff with electronic sensors are used to measure blood pressure. Another method is to have you wear a device that monitors and records the blood pressure at regular intervals during the day to evaluate your blood pressure over time. This is especially helpful during the diagnostic process and can help rule out "white coat" hypertension, the high measurements that can occur when you are at the doctor's office and not at other times.
A single measurement of blood pressure is not enough to diagnose hypertension. Typically, multiple readings are taken on different days. A diagnosis of high blood pressure is made if measurements are consistently high.
What is normal blood pressure?
Guidelines on “normal” blood pressure differ. Read the article on Hypertension to find out what your blood pressure readings may mean.
Some risk factors are related to things you can’t change, such as:
- African American descent
- A family history of high blood pressure
- Older age
Others are lifestyle factors that are under your control including:
- Being overweight or obese
- Not getting enough exercise
- Heavy alcohol drinking
- A diet high in salt
Sometimes medication, illegal drug use, or underlying conditions such as diabetes, kidney disease or thyroid disease, can cause hypertension. This is called secondary hypertension and treating these conditions, or stopping the medication, may remove the underlying cause of high blood pressure.
The 2017 American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines recommends annual screening for adults with blood pressure less than 120/80 mm Hg.
- If you have higher blood pressure and are otherwise at low risk for cardiovascular disease, the guidelines recommend re-screening in 3-6 months after the initial high reading. (For details, read Hypertension)
- If you have hypertension, and are at high risk for cardiovascular disease, more frequent screenings are necessary, according to your heart disease risk and your blood pressure readings. Treatment with anti-hypertension drugs is likely necessary in these cases.
The U.S. Preventive Services Task Force (USPSTF), along with the American Academy of Family Physicians, recommends screening every 3 to 5 years for adults 18 to 39 years old with normal blood pressure (less than 130/85 mm Hg), who do not have other risk factors.
- Adults older than age 40, or those at increased risk for high blood pressure, should be screened every year. The USPSTF considers people who have high-normal blood pressure (130 to 139/85 to 89 mm Hg), those who are overweight or obese, or are African American to be at increased risk.
- The USPSTF also recommends confirming high blood pressure measurements outside of an office setting, with repeated measurements before diagnosis and treatment.
Sources (Last Reviewed 4/17/19)
(2017 August 28). Young adults, especially men, fall behind in high blood pressure treatment and control. American Heart Association. Available online at: http://newsroom.heart.org/news/young-adults-especially-men-fall-behind-in-high-blood-pressure-treatment-and-control. Accessed February 2019.
(Reviewed 2014 July 7). Family History and Other Characteristics That Increase Risk for High Blood Pressure. Centers for Disease Control and Prevention. Available online at https://www.cdc.gov/bloodpressure/family_history.htm. Accessed February 2019.
(2016 October 31). What is high blood pressure? American Heart Association. Available online at https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure/what-is-high-blood-pressure. Accessed February 2019.
(Reviewed 2017 November 13). Monitoring your blood pressure at home. American Heart Association. Available online at https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings/monitoring-your-blood-pressure-at-home. Accessed February 2019.
(Reviewed 2017 November 30). Monitor your blood pressure. American Heart Association. Available online at https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure. Accessed February 2019.
(Reviewed 2017 November 30). Understanding blood pressure readings. American Heart Association. Available online at https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings. Accessed February 2019.
(2019 February 13). High blood pressure. Centers for Disease Control and Prevention. Available online at https://www.cdc.gov/bloodpressure/index.htm. Accessed February 2019.
Heart health screenings. American Heart Association. Available online at https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/heart-health-screenings. Accessed February 2019.
Highlights from the 2017 guideline for the prevention, detection, evaluation and management of high blood pressure in adults. American Heart Association. Available online at https://www.heart.org/-/media/data-import/downloadables/hypertension-guideline-highlights-flyer-ucm_497841.pdf. Accessed February 2019.
High blood pressure. National Heart, Lung, and Blood Institute. Available online at https://www.nhlbi.nih.gov/health-topics/high-blood-pressure. Accessed February 2019.