Hypertension - High Blood Pressure

Hypertension, or high blood pressure, is a condition in which the heart pumps blood against elevated blood pressure and has to work harder. The constant high pressure can lead to other health problems. The normal range of blood pressure can vary with age. An acceptable range of blood pressure is anywhere from 120 to 139 systolic and 79 to 89 diastolic. Your doctor will discuss this with you and make recommendations. Out-of-range blood pressure can lead to stroke, heart attack, kidney failure, torn blood vessels in the eye causing damage to vision, and damage to blood vessels in the brain which can lead to dementia.

Primary and Secondary Hypertension

Primary or the idiopathic hypertension develops over many years. We do not know the cause of high blood pressure.

Secondary hypertension may be caused by conditions like sleep apnea, certain kidney problems, adrenal gland tumors, thyroid problems like hyperthyroidism, congenital birth defects in blood vessels, medications like birth control pills, cold remedies, decongestants, over-the-counter pain relievers and illegal drugs such as cocaine and amphetamines.

Risk Factors for Developing High Blood Pressure

Besides certain medical conditions which lead to secondary hypertension, risk factors can contribute to primary hypertension. These include older age, being African American, strong family history of high blood pressure in a first-degree relative, obesity, sedentary lifestyle, smoking addiction, high sodium diet, alcoholism or drinking too much, and stress.

Symptoms of Hypertension

High blood pressure can be completely asymptomatic, even if blood pressure readings reach dangerously high levels. For that reason it is called a “silent killer.”

Some people with high blood pressure may present with headaches, shortness of breath or nosebleeds, but these signs and symptoms are also nonspecific and can be present in many other disease states.


You can have high blood pressure for years without any symptoms. Even without symptoms, it can cause damage to blood vessels and your heart, and cause heart attack and stroke. High blood pressure generally develops over many years, and it can be easily detected with the help of a blood pressure cuff. 
High blood pressure is usually diagnosed at a regular annual physical visit with a primary care physician, or sometimes at an acute visit. Starting at age 18, blood pressure should be checked every two years. From age 40 onward, it should be checked every year. Two to three high blood pressure readings done on two to three different occasions can result in a diagnosis of hypertension. If you are diagnosed with high blood pressure, it will be monitored more closely. Blood pressure machines in public places can also be used for monitoring.


Lifestyle changes like eating food with less salt, exercising regularly, losing weight if obese and moderate alcohol intake (one drink/day for women and two/day for men) will help improve blood pressure. Your doctor may prescribe medications to help control blood pressure if lifestyle changes alone are not sufficient. If your blood pressure is difficult to control, you may be referred to a kidney specialist called a nephrologist.

High blood pressure isn't a problem you can treat and then ignore. It's a condition you need to manage for the rest of your life. To keep your blood pressure under control:

  • Take your medications regularly. Contact your doctor if you experience side effects or are unable to afford medications.
  • Schedule regular doctor visits. Take notes or bring questions for good management of hypertension.
  • Adopt a healthy lifestyle by eating more fruits and vegetables, and consuming less salt and alcohol. Quit smoking and lose weight.
  • Manage stress. 
  • Get regular exercise.