Controlling your blood pressure is one of the most important things you can do for your health, since high blood pressure is associated with so many serious conditions. Heart disease, stroke, kidney disease, and peripheral vascular disease are all life-threatening events that are typically preceded by high blood pressure. But what causes high blood pressure? What are the symptoms of high blood pressure? And what can you do to control it?

What is blood pressure?

Your blood pressure is the force of the blood pressing against the inside walls of your arteries. Your kidneys, hormones, cardiovascular system and neurological system all work together in complex ways to determine blood pressure. When blood pressure is too low, we call it hypotension. When it’s too high, it’s called hypertension. Both conditions are dangerous, but hypertension is a more common problem in the US, with nearly three-quarters of adults over age 75 suffering from it. Over time, uncontrolled high blood pressure takes a physical toll on the heart and blood vessels, reducing their ability to transport nutrients and oxygen to cells throughout the body. In 2020, researchers studying the health outcomes of 1,457 healthy adults found that for every 10-point increase in systolic blood pressure (the “top number” in a blood pressure reading), the risk of a cardiovascular event grew by 53%.

What is the cutoff for high blood pressure?

It’s reasonable to wonder at which level blood pressure becomes dangerously high. But there’s no single, universal numeric cutoff dividing safe from dangerous pressure. Instead, the American College of Cardiology and the American Heart Association offer categories that indicate increasing levels of risk. Those categories reference both systolic pressure (the “top number,” taken as the heart contracts) and diastolic pressure (the “bottom number,” taken as the heart relaxes between beats). A normal, desirable blood pressure is 120/80, meaning 120 millimeters of mercury (abbreviated to 120 mmHg) when the heart contracts and 80 millimeters of mercury (80 mmHg) when the heart relaxes. The basic blood pressure chart looks like this:


 Systolic PressureDiastolic Pressure
Normal<120 mmHg               AND<80 mmHg
Elevated120-129 mmHg         AND<80 mmHg
Hypertension Stage 1130-139 mmHg         OR80-89 mmHg
Hypertension Stage 2>140 mmHg               OR>90 mmHg
Hypertensive Crisis>180 mmHg              AND/OR>120 mmHg

Symptoms of High Blood Pressure

It’s not uncommon for patients to ask questions like, “What are the top 10 symptoms of high blood pressure?” Unfortunately, one of the things that makes high blood pressure so dangerous is that it does not produce noticeable symptoms. For that reason, it’s sometimes called “the silent killer.” People don’t know they have it until they visit a doctor’s office and get their blood pressure taken. That’s one of the reasons it’s so important to get regular checkups. The sooner you detect high blood pressure, the sooner you and your healthcare providers can begin managing it.

Some people do experience symptoms when their blood pressure spikes so excessively as to put them into “hypertensive crisis.” At that point, symptoms are often consistent with heart attack or stroke, such as shortness of breath, shoulder or back pain, and difficulty speaking. But those are not symptoms of high blood pressure per se, but rather the acute effects of organ damage. That’s different from being able to rely upon symptoms to recognize moderately elevated blood pressure.

Myths about hypertension symptoms abound. Many people believe that high blood pressure causes frequent headaches. But chronic headaches are not a symptom of hypertension (although extremely severe headaches do occur in people experiencing hypertensive crisis or in pregnant women with preeclampsia). Another misconception is that high blood pressure causes nosebleeds, but nosebleeds are usually caused by breathing dry air or as a side effect to aspirin or blood thinners. Red face, too, is sometimes mistakenly attributed to high blood pressure. And some people associate dizziness and lightheadedness with hypertension even though they’re frequently caused by its opposite, hypotension or low blood pressure.

Why does blood pressure go up?

Some increases in blood pressure are temporary or fleeting, while others are long-term or chronic. Most people’s blood pressure rises and falls naturally and predictably during their 24-hour cycle of sleeping, waking, and physical activity. Other causes of temporary high blood pressure include medications, alcoholic drinks, coffee or other beverages containing caffeine, going out in the cold, smoking or using nicotine, and intense physical activity.

Controlling high blood pressure

Although hypertension may not directly affect the way you feel, keeping blood pressure under control is a very good idea. Not only will that lower your risk of cardiovascular damage, but it can also improve your chances of a good outcome if you already have a chronic illness. Your goal should be to lower your blood pressure to a healthy level and then to keep it there. Blood pressure that yo-yos dramatically over time appears to be just as dangerous as consistently high blood pressure. In one study of nearly 18,000 patients who had experienced stroke, high variability in blood pressure readings between doctor’s visits had a measurable effect on their risk of dying. As that variability increased by 10 mmHg in systolic and diastolic pressure, risk of death from all causes rose by 24 percent.

Fortunately, despite being such a serious condition, hypertension is something over which we usually do have some control. Adjusting your diet—especially cutting back on sodium and reducing alcohol consumption—is one of the best ways to lower blood pressure fast. Getting enough exercise and good sleep can also help, as can quitting smoking and managing the amount of stress in your life. Because emotional stress increases the amount of cortisol in your blood, which is known to contribute to hypertension, some people do simple breathing exercises to lower blood pressure.

Of course, some people who adopt all these lifestyle behaviors still have trouble controlling their blood pressure. Fortunately, there are very effective antihypertensive medications that your doctor can prescribe.

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