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Overview of hypertension

High blood pressure, or hypertension, affects approximately 1 in 3 Americans (or 70 to 80 million people). Of this total number, only about half of these people have their blood pressure under control.

High blood pressure on its own often has no initial symptoms but is a severe and life-threatening condition that affects all the organs in the body and can significantly increase your risk of a heart attack, organ damage, or a stroke.


High blood pressure is known as a “silent” disease because there are typically no apparent symptoms even when blood pressure readings are very high. High blood pressure can go unnoticed for years and lead to irreversible damage.

However, regular blood pressure screenings can help a doctor diagnose dangerously high levels and recommend the right course of treatment. The American Heart Association recommends regular blood pressure checks every two years, starting at age 20.


Hypertension arises when the force of the blood pumping through your arteries is too high. Some types of hypertension have no known cause. Hypertension often gradually develops over time.

Some medications and health conditions can contribute to hypertension, including some hormonal imbalances, kidney issues, and sleep apnea.

Pregnant women may also develop hypertension. This typically occurs after 20 weeks of gestation. Gestational hypertension often returns to normal on its own after birth and does not harm the mother or baby.

However, it can raise your chance of developing hypertension later in life. If it is severe, gestational hypertension can also increase your risk of preeclampsia, preterm birth, and low birth weight. If you are pregnant, you should speak with your doctor about whether your blood pressure is cause for concern.


There are two types of hypertension:

  • Primary hypertension. There is no known cause. This form gradually develops over time and is the most common type of hypertension.
  • Secondary hypertension. This is caused by an underlying medical condition such as thyroid disease, kidney problems, or certain medications.

Both types can often be effectively managed through medication and lifestyle changes. If your hypertension does not respond to lifestyle changes and three or more medications, it may be categorized as “resistant hypertension,” which can be more challenging to treat.

Because hypertension often develops slowly over time, it is also sometimes measured in terms of “stages,” which identify the progression and severity of the condition.

Blood pressure measurements include systolic pressure (the first number), or the pressure exerted on your vessels while your heart beats, and diastolic pressure (the second, lower number), or the pressure exerted while your heart pauses between beats.

  • Normal blood pressure (readings of 120/80 or lower, depending on your age and activity level).
  • Elevated blood pressure (readings of 120129 systolic, and less than 80 diastolic). Having high blood pressure readings increases the likelihood that you will develop hypertension later in life.
  • Stage 1 hypertension (readings of 130-139 systolic, 80-89 diastolic).
  • Stage 2 hypertension (consistent readings above 140 systolic and 90 diastolic). At this stage, doctors are likely to begin considering interventions and medication to help reduce your blood pressure.
  • Hypertensive crisis (readings above 180/120). A hypertensive crisis requires immediate medical attention. If you experience a single reading above these numbers, wait five minutes, and measure them again. If both measurements are this high, seek emergency care. If you are experiencing other symptoms such as shortness of breath, chest or back pain, dizziness, numbness, weakness, or vision changes, call 9/11 immediately.

Risk factors

Risk factors for high blood pressure include:

  • African American ethnicity
  • Age: almost 65 percent of adults older than 60 have high blood pressure
  • Family history
  • Gender: men are more likely to develop high blood pressure in middle age, while women are more likely to develop it at an older age
  • Lifestyle factors, including smoking, poor diet, stress, not exercising, not getting enough sleep, and consuming alcohol
  • Obesity or being overweight
  • Pregnancy


Since many cases of hypertension do not have a known cause, it is challenging to eliminate your risk of developing high blood pressure. However, you can minimize your risk by:

  • Managing your weight through diet and exercise
  • Eating a diet that is lower in sodium but rich in nutrients and minerals such as potassium, fiber, and protein
  • Engaging in regular physical activity as recommended by your doctor
  • Limiting alcohol consumption
  • Stopping smoking
  • Getting enough sleep

The information contained in this article is meant for educational purposes only and should not replace advice from your healthcare provider.

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