High blood pressure

Alternative names
HBP; Blood pressure - high


Hypertension (high blood pressure) is when your blood pressure frequently goes over 140/90.

Pre-hypertension is blood pressure readings from 120-139 over 80-89 on most measurements. If you have pre-hypertension, you are likely to develop high blood pressure at some point, unless you make lifestyle changes to lower your blood pressure to normal.


High blood pressure can affect all types of people. Most people feel no symptoms with uncomplicated high blood pressure. Essential hypertension (hypertension with no known cause) is not fully understood, but accounts for between 90-95% of all hypertension cases in people over 45 years of age.

Even though many times high blood pressure does not have a known cause, the condition can still be treated effectively with both lifestyle modification and medications.

Lifestyle modification includes following a low sodium diet, exercising, quitting smoking, losing weight, and avoiding excessive alcohol intake. There are dozens of different medications available for the management of high blood pressure.

About 1 in every 5 adults in the U.S. has high blood pressure. High blood pressure occurs more often in men than in women, and in African Americans almost twice as often as in Caucasians.

Common Causes

Most of the time, no cause is identified and this is called essential hypertension. Other times, there may be an identifiable reason why your blood pressure is high. This is called secondary hypertension. Some of the secondary reasons why you may have high blood pressure are as follows:

  • Medications (such as appetite suppressants, cold preparations, and migraine medications)  
  • Habitual alcohol use  
  • Excess sodium (salt) in your diet  
  • Obesity  
  • Anxiety or stress  
  • Arteriosclerosis  
  • Coarctation of the aorta  
  • Pain  
  • Renal artery stenosis  
  • Diabetes  
  • Drugs such as alcohol toxicity or cocaine  
  • Renal disease

Home Care

For high blood pressure caused by essential hypertension or if you have prehypertesion, a proper diet, weight loss, exercise, and salt and alcohol reduction are often recommended. If these measures alone are not enough, your health care provider will talk to you about taking medication to lower your blood pressure.

If your blood pressure reading is consistently above 140/90 mmHg, drugs for hypertension may be prescribed by the health care provider. If you have any other risk factors for heart disease, especially diabetes, your doctor will consider starting medications sooner rather than later.

If you have high blood pressure, the goal is to bring your blood pressure below 140/90 on all readings. If you also have diabetes or kidney disease, the goal is for your blood pressure to be consistently below 130/80.

For high blood pressure caused by medication, consult with your health care provider about changing or discontinuing drugs. DO NOT CHANGE YOUR MEDICATION WITHOUT CONSULTING YOUR HEALTH CARE PROVIDER.

Call your health care provider if

  • There is unexplained and persistent high blood pressure. (This assumes home blood pressure monitoring.)  
  • Your blood pressure should be checked routinely by your health care provider if you are over the age of 40, obese, smoke, drink alcohol regularly, or have a family history of high blood pressure.

What to expect at your health care provider’s office

Your health care provider will perform a thorough physical examination. The physical examination will include blood pressure measurement. Your blood pressure may need to be monitored several times over a period of weeks or months.

He or she will also ask questions such as:

  • Time pattern       o Has your blood pressure increased recently?       o Did it suddenly become high?  
  • Quality       o What is the blood pressure?       o When the blood pressure is measured on multiple occasions, what is the average systolic and diastolic blood pressure (the lower number)?       o How much has the blood pressure gone up within the past two weeks?       o What is the blood pressure now?       o What was the previous blood pressure?  
  • What other symptoms are present?

Diagnostic tests that may be performed include:

  • Blood tests, such as a chem-20  
  • Urinalysis  
  • X-rays of the kidneys  
  • EKG or echocardiogram

see High blood pressure in Encyclopedia

High blood pressure

High blood pressure

Johns Hopkins patient information

Last revised: December 3, 2012
by Martin A. Harms, M.D.

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