David Cohen, M.D.·Published 21 March 2005·4 min read
Key points
Pre-hypertension is when your systolic blood pressure is between 120 and 139 or your diastolic blood pressure is between 90 and 99 on multiple readings.
Blood pressure is determined by the amount of blood pumped by the heart, and the size and condition of the arteries.
If your headache is severe, or if you experience any of the symptoms below, you must be seen by a doctor right away.
Hypertension may be suspected when the blood pressure is high at any single measurement.
Systolic blood pressure is consistently over 140 (systolic is the "top" number of your blood pressure measurement, which represents the pressure generated when the heart beats)
Diastolic blood pressure is consistently over 90 (diastolic is the "bottom" number of your blood pressure measurement, which represents the pressure in the vessels when the heart is at rest)
Either or both of these numbers may be too high.
Pre-hypertension is when your systolic blood pressure is between 120 and 139 or your diastolic blood pressure is between 90 and 99 on multiple readings. If you have pre-hypertension, you are likely to develop high blood pressure at some point. Therefore, your doctor will recommend lifestyle changes to bring your blood pressure down to normal range.
Causes, incidence, and risk factors
Blood pressure is determined by the amount of blood pumped by the heart, and the size and condition of the arteries. Many other factors can affect blood pressure, including volume of water in the body; salt content of the body; condition of the kidneys, nervous system, or blood vessels; and levels of various hormones in the body.
"Essential" hypertension has no identifiable cause. It may have genetic factors and environmental factors, such as salt intake or others. Essential hypertension comprises over 95% of all high blood pressure.
"Secondary" hypertension is high blood pressure caused by another disorder. This may include:
adrenal gland tumors
Cushing's syndrome
kidney disorders o glomerulonephritis (inflammation of kidneys) o renal vascular obstruction or narrowing o renal failure
use of medications, drugs, or other chemicals
oral contraceptives
hemolytic-uremic syndrome
Henoch-Schonlein purpura
periarteritis nodosa
radiation enteritis
retroperitoneal fibrosis
Wilms' tumor
other disorders
Symptoms
Written and revised by
David Cohen, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
health.am provides general information, not medical advice. Always consult a qualified health professional about your own health.
Usually, no symptoms are present. Occasionally, you may experience a mild headache. If your headache is severe, or if you experience any of the symptoms below, you must be seen by a doctor right away. These may be a sign of dangerously high blood pressure (called malignant hypertension) or a complication from high blood pressure.
tiredness
confusion
vision changes
angina-like chest pain (crushing chest pain)
heart failure
blood in urine
nosebleed
irregular heartbeat
ear noise or buzzing
Signs and tests
Hypertension may be suspected when the blood pressure is high at any single measurement. It is confirmed through blood pressure measurements that are repeated over time. Blood pressure consistently elevated over 140 systolic or 90 diastolic is called hypertension. Your doctor will look for signs of complications to your heart, kidneys, eyes, and other organs in your body.
Systolic blood pressure consistently between 130 and 139 or diastolic blood pressure consistently between 80 and 89 is called pre-hypertension. Your doctor will recommend and encourage lifestyle changes including weight loss, exercise, and nutritional changes.
Tests for suspected causes and complications may be performed. These are guided by the symptoms presented, history, and results of examination.
Treatment
The goal of treatment is to reduce blood pressure to a level where there is decreased risk of complications. Treatment may occur at home with close supervision by the health care provider, or may occur in the hospital.
MEDICATIONS may include diuretics, beta-blockers, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), or alpha blockers. Medications such as hydralazine, minoxidil, diazoxide, or nitroprusside may be required if the blood pressure is very high.
Have your blood pressure checked at regular intervals (as often as recommended by your doctor.)
Lifestyle changes may reduce high blood pressure, including weight loss, exercise, and dietary adjustments (see "Prevention").
Expectations (prognosis)
Hypertension is controllable with treatment. It requires lifelong monitoring, and the treatment may require adjustments periodically.
Even if you have not been diagnosed with high blood pressure, it is important to have your blood pressure checked at annual exams, especially if you have a history of high blood pressure in your family.
If you have high blood pressure, you will have regularly scheduled appointments with your doctor.
In between appointments, if you have any of the symptoms listed below or your blood pressure remains high even with treatment (this assumes the use of a home blood pressure monitor), then call your doctor right away.
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