Intro
High blood pressure (hypertension) is a condition where the force of blood against artery walls is consistently too high.
It is one of the most important risk factors for heart attack, stroke, and kidney disease — and often causes no symptoms until complications occur.
Key Points
- Hypertension usually has no symptoms
- It significantly increases risk of heart disease, stroke, and kidney failure
- It is often caused by a mix of genetics, lifestyle, and aging
- Treatment includes lifestyle changes and medications
- Many people remain poorly controlled despite treatment
Background
Blood pressure is measured using two numbers:
- Systolic (top number): pressure when the heart beats
- Diastolic (bottom number): pressure between beats
General categories:
- Normal: below 120/80
- Elevated: 120–129 / <80
- Hypertension: 130/80 or higher
Hypertension is extremely common and increases with age.
Causes or Mechanisms
Most hypertension is primary (essential), meaning there is no single cause.
Common contributing factors include:
- Genetics
- High salt intake
- Obesity
- Physical inactivity
- Alcohol use
- Chronic stress
Some cases are secondary hypertension, caused by:
- Kidney disease
- Hormonal disorders
- Medications
Emerging Understanding
Recent research suggests that the nervous system may play a larger role than previously thought.
In some people, increased sympathetic (fight-or-flight) activity may help drive persistent high blood pressure.
Symptoms
Hypertension is often called a “silent condition.”
Most people have no symptoms.
When symptoms do occur, they may include:
- Headaches
- Dizziness
- Nosebleeds
These are not reliable indicators, and blood pressure should be checked directly.
Diagnosis
Diagnosis is based on repeated blood pressure measurements.
Methods include:
- Clinic readings
- Home blood pressure monitoring
- 24-hour ambulatory monitoring
A single high reading is not enough — consistent elevation is required.
Treatment / Management
Lifestyle measures
- Reduce salt intake
- Maintain a healthy weight
- Exercise regularly
- Limit alcohol
- Stop smoking
Medications
Common classes include:
- ACE inhibitors
- ARBs
- Calcium channel blockers
- Diuretics
Many people require more than one medication.
Risks / Prognosis
Untreated or poorly controlled hypertension increases risk of:
- Heart attack
- Stroke
- Heart failure
- Kidney disease
- Vision loss
Good control significantly reduces these risks.
FAQ
Q: What is considered high blood pressure?
A: Generally, readings of 130/80 mmHg or higher.
Q: Can you feel high blood pressure?
A: Usually no — most people have no symptoms.
Q: Is hypertension reversible?
A: It can often be improved or controlled, especially with lifestyle changes.
Q: Why is it called a silent condition?
A: Because damage can occur without noticeable symptoms.
Q: Why do some people remain hypertensive despite treatment?
A: Causes may include medication resistance, underlying conditions, or persistent activation of the nervous system.
Further Reading
- High blood pressure: symptoms, causes, and treatment
- 2025 high blood pressure guideline explained
- Circulation Research study abstract