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High Blood Pressure

Chances are, you know high blood pressure can harm your health. But you may not know how or even if you have it.

Almost half of U.S. adults have high blood pressure, also called hypertension. Yet only 24% have their blood pressure under control.

Having high blood pressure increases your risk of stroke and heart disease — the leading causes of disability and early death.

At UPMC, we can help you manage your heart health, including helping you prevent and control high blood pressure.

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What Is High Blood Pressure?

Blood pressure is the measured pressure of blood flow against the walls of your arteries. These vital blood vessels carry oxygen-rich blood from your heart to all parts of your body.

For most adults, a normal or good blood pressure is less than 120/80 mm Hg.

The systolic blood pressure is the upper number in the reading. It's how much pressure your blood exerts on your artery walls when your heart contracts.

The diastolic blood pressure is the lower number in the reading. It's how much pressure your blood exerts on your artery walls while your heart muscle rests between contractions.

Hypertension happens when the pressure against your artery walls is too high. This extra pressure forces your heart to work harder to move blood through your body.

You may wonder, What is hypertension?

Doctors define high blood pressure as having at least:

  • A systolic blood pressure reading greater than 130 mmHg

or

  • A diastolic blood pressure greater than 80 mmHg.

What are the types of high blood pressure?

The American Heart Association guidelines have five blood pressure categories.

Normal blood pressure

This is when your:

  • Systolic pressure is less than 120 mm Hg.
  • And diastolic pressure is less than 80 mm Hg.

Elevated blood pressure

This is when your:

  • Systolic pressure ranges from 120 to 129 mm Hg.
  • And diastolic pressure is less than 80 mm Hg.

If you have elevated blood pressure, you can get hypertension if you don't make lifestyle changes to control it.

High blood pressure (hypertension) stage 1

This is when your:

  • Systolic pressure often ranges from 130 to 139 mm Hg.
  • Or diastolic pressure often ranges from 80 to 89 mm Hg.

High blood pressure (hypertension) stage 2

This is when your:

  • Systolic pressure is often 140 mm Hg or higher.
  • Or diastolic blood pressure is often 90 mm Hg or higher.

Hypertensive crisis

This is when your:

  • Systolic pressure is higher than 180 mm Hg.
  • And/or diastolic pressure is higher than 120.

Signs of a hypertensive crisis and related organ damage include:

  • Back or chest pain.
  • Change in vision.
  • Trouble speaking.
  • Numbness/weakness.
  • Shortness of breath.

If you're in a hypertensive crisis, you need to see a doctor right away. Call 911.

What causes high blood pressure?

High blood pressure often happens over time.

With normal blood pressure, your blood pressure rises and falls throughout the day.

For some people, their blood pressure stays elevated. When your blood pressure stays elevated, you get high blood pressure.

What are high blood pressure risk factors and complications?

Your risk of getting hypertension depends on whether you have one or more risk factors.

High blood pressure risk factors

Your risk of hypertension increases if:

  • You're older. Blood pressure rises as you get older, so your risk of hypertension increases with age.
  • You have a genetic or family history of high blood pressure. Hypertension runs in families.
  • You're overweight or obese.
  • You're African American.

Certain health issues can increase your risk of hypertension.

These include:

Lifestyle choices can also lead to high blood pressure. Making better choices may help reduce your risk of hypertension.

Lifestyle risk factors include:

  • Drinking too much alcohol. That's more than 1 drink a day for women and 2 drinks a day for men.
  • Eating an unhealthy diet, especially too much sodium and too little potassium.
  • Using illicit drugs.
  • Sitting too much and not moving enough.
  • Not getting enough physical activity on a routine basis.
  • Smoking and tobacco use.

While not a specific risk factor, uncontrolled stress plays a role in poor lifestyle choices that can lead to hypertension.

Complications of high blood pressure

It's vital to know if you have high blood pressure. Left undiagnosed and untreated, hypertension can lead to other severe health problems.

These include:

  • Angina or chest pain.
  • Atherosclerosis, a hardening of your arteries.
  • Heart attack.
  • Heart disease, including microvascular disease.
  • Heart failure.
  • Kidney disease or failure.
  • Peripheral artery disease (PAD).
  • Sexual dysfunction in both men and women.
  • Stroke.
  • Vision loss.

Hypertension caused or played a part in more than 690,000 deaths in 2021.

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High Blood Pressure Symptoms and Diagnosis

What are the signs and symptoms of high blood pressure?

Doctors often call hypertension the “silent killer." Most people with high blood pressure don't have symptoms so they don't know they have it.

When your blood pressure gets too high, some people may have hypertension symptoms, like:

  • Feeling dizzy or lightheaded.
  • Headaches.
  • Rapid heart rate.

How do you prevent high blood pressure?

The best way to prevent and control high blood pressure is to know your blood pressure numbers. The Office of Disease Prevention and Health Promotion suggests checking your blood pressure regularly starting at age 18.

After that, a health provider should check your blood pressure:

  • Every 3 to 5 years, if you're age 18 to 39 and aren't at increased risk for high blood pressure.
  • At least once a year, if you're age 40 and older, or if you're at risk for high blood pressure.

How do you diagnose high blood pressure?

Using a device called a blood pressure cuff, your doctor or nurse will take a blood pressure reading. The numbers from that reading show if you have high blood pressure.

You can also find blood pressure cuffs online or at a pharmacy or health fair. These readings can serve as a starting point to talk to your doctor.

Don't diagnose yourself. Only a health professional can diagnose high blood pressure and prescribe medicine to treat it.

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How Do You Treat High Blood Pressure?

If you have high blood pressure, it's critical to treat it. Over time, hypertension can damage your heart muscle and other organs in your body.

Based on your blood pressure reading, your doctor will discuss your treatment options.

Lifestyle changes

The lifestyle choices you make can help prevent or control high blood pressure.

You should:

  • Avoid or limit alcohol.
  • Eat a healthful diet. This includes lowering sodium and eating potassium-rich foods.
  • Work out on a regular basis.
  • Lose or control your weight if you're overweight or obese.
  • Manage stress.
  • Quit smoking and using illicit drugs.

Blood pressure medication

Medicines can lower or control your blood pressure.

What high blood pressure medicines you take depends on your health history, other health issues, and tolerance to drugs.

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Last reviewed by Thomas Robert Wojda, MD on 2024-04-17.