High Blood Pressure
What is a high blood pressure?
- High blood pressure, or hypertension, is a condition in which the pressure of the blood against blood vessel walls is too strong.
- High blood pressure can cause damage to the vessels and lead to other problems, including heart disease, stroke, and kidney disease.
- Blood pressure is measured using two numbers. The first number, called systolic blood pressure, is the pressure in your blood vessels when your heart beats. The second number, called diastolic blood pressure, is the pressure in your blood vessels when your heart rests between beats.
What does your blood pressure reading mean?
- Normal blood pressure: systolic less than 120 and diastolic less than 80
- Prehypertension: systolic of 120 to 139 or diastolic of 80 to 89
- High blood pressure (hypertension): systolic of 140 or higher or diastolic of 90 or higher1
- Guidelines from the American Heart Association and American College of Cardiology released in 2017 suggest new definitions for high blood pressure: systolic of 130 or higher or diastolic of 80 or higher. This is controversial, but the guideline encourages patients and providers to work together to identify the most appropriate blood pressure goal.2
- Your blood pressure can change with activity, posture, movement, and other factors. This is why it is important to take your blood pressure after rest in a sitting position.
- A single high reading does not mean that you have high blood pressure, but if your numbers stay high over time, your health care provider may recommend a treatment program.
- Unusually low blood pressure should also be checked by your health care provider.
What are the risk factors for high blood pressure that cannot be changed?3,4
Age: Blood vessels become less flexible as we age, which increases blood pressure throughout our circulatory system.
Sex: Up until age 45, men are more likely to have high blood pressure than women, but after age 65, women are more likely to have high blood pressure than men.
Race/ethnicity: African Americans are more likely to experience high blood pressure than other racial groups.
Family history: Several studies have shown the risk of high blood pressure is increased for individuals with family members who have high blood pressure. This includes not only shared genes, but also the sharing of cultural, environmental, and lifestyle factors within families that increase risk of high blood pressure.
What are the risk factors for high blood pressure that can be changed?4
High sodium consumption/poor diet: Diets high in sodium (salt) are directly associated with increased blood pressure. The average daily consumption of sodium by Americans is more than twice the recommended level for the majority of adults, and has increased significantly since the 1970s. Diets high in sodium are also often high in calories, fat and sugars. These diets are lower in nutritional value and contribute directly to poor health in addition to obesity. 4
Physical inactivity: Several studies have shown that physical inactivity increases the risk of hypertension. Fewer than 1 in 4 Minnesota adults get the recommended amount of exercise or physical activity. Fewer than 23% of Minnesota adults get the recommended amount of aerobic and strength exercise (2015), and 18% of adults in Minnesota are not physically active at all (2016). 3
Overweight and obesity: A growing body of evidence shows that blood pressure increases with weight. In Minnesota, 64% of adults are overweight, including more than 27% who are obese (2016). 3
Drinking too much alcohol: Heavy and regular use of alcohol can increase blood pressure. In 2016, 7.5% of Minnesota adults reported being heavy drinkers (more than 2 drinks per day for men or more than 1 drink per day for women). This is significantly higher than in 18 other states. 3
How can blood pressure be controlled?
Know your numbers: If you have high blood pressure, your healthcare provider should check your blood pressure during every visit. Also talk to your provider about how to monitor your blood pressure at home.
Set a goal: You should discuss strategies for reaching your blood pressure goal with your provider or pharmacist.
Lifestyle changes: Eating a healthier diet, increasing physical activity, reducing your weight, and reducing your intake of alcohol are all strategies that may help to reduce blood pressure.
Medication: Your health care provider may also recommend antihypertensive medications to control high blood pressure. These medications include diuretics, beta blockers, vasodilators, ACE inhibitors, and calcium channel blockers. It can take some fine tuning to find the right dose and combination of medications to effectively lower blood pressure.
1 The 2014 JNC 8 and 2017 AHA/ACC Guidelines for Management of High Blood Pressure in Adults. Online at: https://sites.jamanetwork/com/jnc8/index.html.
2 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Online at: http://hyper.ahajournal.org/content/71/6/e13.
3Minnesota Behavioral Risk Factor Surveillance System, Age-adjusted prevalence.
4 CDC DHDSP. Sodium: the facts. Online at: http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/docs/Sodium_Fact_Sheet.pdf.