April 6, 2021

Hypertension: What You Need to Know

Overview of hypertension

Nearly half of adults in the United States (108 million, or 45%) have hypertension defined as a systolic blood pressure ≥ 130 mm Hg or a diastolic blood pressure ≥ 80 mm Hg or are taking medication for hypertension, according to the CDC. And, only about 1 in 4 adults (24%) with hypertension have their condition 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.

Understanding Your Blood Pressure

  • Systolic = maximum pressure in blood vessels when heart beats
  • Diastolic = minimum pressure in blood vessels when heart relaxes between beats
  • Normal = 120/80 or less


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.

Cholesterol Recommendations

Total Cholesterol

  • Less than 200: optimal
  • 200-239: borderline high
  • 240 and above: high

HDL/Good Cholesterol

  • 60 or higher: optimal
  • 40 or less: risk factor

LDL/Bad Cholesterol

  • Less than 70: optimal
  • 70-100: near optimal
  • 100-130: good
  • 130-160: borderline high
  • 160-190: high
  • 190 and above: very high

Triglyceride (another form of fat in blood)

  • Less than 150: optimal
  • 150-200: borderline high
  • 200-400: high
  • 400 and above: very high

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

Take Control of Your Blood Pressure


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:

  • Take your medicine as directed
  • Limit salt intake to 3 grams/day or less
  • Limit alcohol and caffeine intake
  • Stop smoking
  • Avoid stress
  • Exercise regularly
  • Get enough sleep
  • Maintain optimal weight
  • See your physician regularly


Leading professional organizations recommend the DASH DIET to help lower your blood pressure. The DASH DIET is full of fruits, vegetables, low-fat dairy foods, and limits the amount of saturated fats and processed foods in your meals.

Food Group Servings
Grains & grain products 7-8/day
Vegetables 4-5/day
Fruits  4-5/day
 Low-fat / fat-free dairy foods 2-3/day
Lean meats, poultry & fish 2 or less/day
Nuts, seeds & dry beans 4-5/week
Fats & oils 2-3/day
Sweets 5/week


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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