Medical Author: Melissa Conrad Stöppler, MD, Chief Medical Editor
Medically Reviewed on 6/2/2021
Doctor's Notes on High Blood Pressure (Hypertension)
High blood pressure is medically known as hypertension. In high blood pressure, the pressure within the arteries (vessels that carry blood away from the heart) is abnormally elevated. Causes of high blood pressure include familial (inherited) factors and increased stiffness of the arteries. High blood pressure causes a number of health complications including heart disease, stroke, and kidney disease.
High blood pressure typically does not cause specific symptoms or signs. When symptoms do occur or in cases with marked elevation of blood pressure, associated symptoms can include
- dizziness,
- blurred vision,
- shortness of breath,
- nausea,
- headache, and
- a feeling of pulsations in the head or neck.
Symptoms of complications of severe hypertension can include
What Is the Treatment for High Blood Pressure?
Blood pressure control is a lifelong challenge. Hypertension can progress through the years, and treatments that worked earlier in life may need to be adjusted over time. Blood pressure control may involve gradually making lifestyle changes like diet, weight loss, exercise, and possibly taking medication if necessary. In some situations, medications may be recommended immediately. As with many diseases, you and your doctor should work together to find the treatment plan that works for you.
There also is a stepwise approach to treating high blood pressure, and it combines the stage of hypertension with the calculated risk of future atherosclerotic cardiovascular disease (ASCVD, heart attack, or stroke). There are online calculators that are available from the American Heart Association.
- If the person has normal blood pressure, the recommendation is to promote positive lifestyle habits and have blood pressure readings checked every year.
- If there is elevated blood pressure, lifestyle modifications should be attempted and blood pressure should be rechecked in 3-6 months.
- In stage 1 hypertension, if the risk of ASCVD is less than 10%, lifestyle modification is recommended with a recheck in 1-6 months.
- In stage 1 hypertension with ASCVD risk greater than 10%, medications should be added to lifestyle modification with a reassessment in 1 month. If normal blood pressure goals are not met, additional medications may be added.
- With Stage 2 hypertension, medications and lifestyle modification should begin immediately, with a recheck in 1 month and adding additional medications if goals are not met.
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Angina (Ischemic Chest Pain)
Angina pectoris is a term to describe chest pain that occurs when the heart is not getting enough blood. There are two types of angina, stable (the most common) and unstable. Stable angina generally lasts less than five minutes and is relieved by nitroglycerin tablets. Angina may be caused by heart disease, coronary artery spasm, or other causes. Risk factors for angina include high blood pressure, high cholesterol, diabetes, smoking, sedentary lifestyle, family history, aging, and stimulant use. Treatment depends upon the cause of angina. -
Aortic Aneurysm (Abdomen and Thorax - Chest)
An aortic aneurysm is a medical emergency. Abnormal enlargement or bulging of the aorta becomes an aortic aneurysm when this area becomes weakened. Some of the symptoms of an aortic aneurysm include back pain, chest pain, dizziness, sweating, nausea, and vomiting. Common causes of an aortic aneurysm include heart disease, high blood pressure, diabetes, inflammatory aneurysm, or injury to the chest wall. Treatment of aortic aneurysm depends upon the cause. -
Atrial Fibrillation (AFib)
Atrial fibrillation (AFib) describes a rapid, irregular heart rhythm. The irregular rhythm, or arrhythmia, results from abnormal electrical impulses in the heart. Atrial fibrillation may be treated with medications or surgery. There are many causes of atrial fibrillation, for example, pneumonia, heart disease, alcohol use, and thyroid problems. Symptoms of atrial fibrillation include chest pain and/or angina, nausea, dizziness, and heart palpitations. Atrial fibrillation is managed and treated with medication, medical procedures, and surgery. -
Atrial Flutter
Atrial flutter is a type of arrhythmia, that is, an irregularity in the beating of the heart. Symptoms of atrial flutter include heart palpitations, shortness of breath, anxiety, weakness, and a fluttering feeling in the chest. Causes of atrial flutter include heart disease, hypertension, heart muscle disease, heart abnormalities, substances, and diseases that affect other areas of the body. Treatment of atrial flutter includes defibrillation and medication. -
Chronic Kidney Disease
Twenty percent of people over the age of 20 years will develop chronic kidney disease in their lifetime. Chronic kidney disease causes are diseases of the kidney(s), diabetes, uncontrolled high blood pressure, Glomerulonephritis, polycystic disease, medications, and other conditions. Symptoms include; fatigue, nausea and vomiting, edema, itching, easy bruising, anemia, headaches, insomnia, restless leg syndrome, chest pain, and more. Treatment for kidney disease generally involves dialysis, or kidney transplantation depending on the condition of the person and kidney(s). -
Eclampsia
Eclampsia, a life-threatening complication of pregnancy, and results when a pregnant woman diagnosed with preeclampsia (high blood pressure and protein in the urine) develops the symptoms of seizures or coma. Causes of eclampsia are unknown. Signs and symptoms of eclampsia include: High blood pressure Increased urine production Decreased kidney function Nervous system changes (severe headaches, blurred vision, seeing spots) Upper abdominal pain Treatment for is delivery of the baby. -
Heart Attack
A heart attack is an interruption in blood flow to the heart muscle. Arterial plaque rupture is often the cause of a heart attack. Symptoms of a heart attack may include chest pain, shortness of breath, sweating, and nausea. Emergency heart catheterization and thrombolytic therapy may be used to treat a heart attack. -
Heart Disease
Coronary heart disease (CHD) is a group of different types of heart disease. Symptoms of heart disease depend on the cause and inclue chest pain or angina, shortness of breath, palpitations, and dizziness. Many conditions causes heart disease, for example, genetics, obesity, high cholesterol, and smoking. Treatment for heart disease depend on the cause and include diet and other lifestyle changes, medications, procedures, and surgery. The prognosis (outlook) and life span for someone with heart disease varies depending on the cause. -
How Does High Blood Pressure Affect Your Unborn Baby?
High blood pressure during pregnancy is common, and it can affect both the mother and baby. It can cause preterm delivery (premature birth that occurs before 37 weeks of pregnancy), low birth weight (baby weighs less than 5 pounds, 8 ounces at birth), fetal growth restriction, fetal death, and neonatal death. -
Ocular Hypertension
The term ocular hypertension usually refers to any situation in which the pressure inside the eye, called intraocular pressure, is higher than normal. Typically, those with ocular hypertension have any symptoms or signs. Treatment typically involves medicated eyedrops to help lower intraocular pressure. -
Peripheral Vascular Disease (PVD)
Peripheral vascular disease (PVD or peripheral artery disease) refers to any disease or disorder of the circulatory system outside of the brain and heart. Common causes of peripheral vascular disease include blood clots, diabetes, inflammation of the arteries, infection, structural defects, and injury. Symptoms of peripheral artery disease include buttock pain, numbness, tingling, or weakness in the legs, burning or aching pain in the feet or toes while resting, a sore on a leg or a foot that will not heal, one or both legs or feet feel cold or change color (pale, bluish, dark reddish), loss of hair on the legs, and impotence. Tests are used to diagnose peripheral vascular disease. Treatment guidelines include medication, lifestyle changes, and if necessary, surgical intervention. -
Preeclampsia
Preeclampsia is a serious complication of pregnancy. Preeclampsia is associated with high blood pressure and protein in the urine. Preeclampsia is also referred to as toxemia, or toxemia of pregnancy. The cause of preeclampsia is unknown. Symptoms of preeclampsia are high blood pressure, decrease in urine output, edema of the hands and face, rapid weight gain, and nervous system changes. Treatment of preeclampsia depends on the gestation period of the baby and the associated medical conditions of the mother. -
Pulmonary Hypertension
Pulmonary hypertension is an abnormally high pressure in the pulmonary arteries leading from the heart to the lungs. Primary pulmonary hypertension has no underlying condition that has caused this condition. Secondary pulmonary hypertension is caused by other underlying conditions. Treatment depends on the cause of the underlying condition, or the condition of primary pulmonary hypertension. -
Renal Artery Stenosis
One cause of high blood pressure is renal artery stenosis. Renal artery stenosis is caused by hardening of the arteries (atherosclerosis). Risk factors for renal artery stenosis are smoking, high blood pressure, high cholesterol, high blood lipids, and diabetes. Symptoms of renal artery stenosis include fatigue, malaise, or confusion. Treatment depends upon the cause of renal artery stenosis, and the degree of damage to the kidney(s). -
Stroke
Stroke is a medical emergency. When a person has a stroke, part of the blood supply to the brain is cut off or greatly decreased. There are two main types of stroke, ischemic and hemorrhagic. Stroke symptoms include dizziness, sudden headache, weakness in an arm or leg on the same side, weakness in the muscles of the face, difficulty speaking, vision problems, and more. Treatment of stroke depends on the type and severity of the stroke suffered. -
What Causes Hypertension in Pregnancy?
Hypertension (high blood pressure) during pregnancy can potentially cause complications. Its cause is unknown, but risk factors include first-time pregnancy, previous preeclampsia, family history of preeclampsia, multiple pregnancy (twins, triplets, etc.), in vitro fertilization, type 1 or type 2 diabetes, obesity, chronic high blood pressure, chronic kidney disease, and others. -
What Do High Blood Pressure Symptoms Feel Like?
High blood pressure (hypertension) causes the heart to work too hard when pumping blood through the arteries, which puts a person at risk for heart attack, stroke, and kidney disease. High blood pressure often causes no symptoms, but they can include pounding headaches, vomiting, feeling of dizziness, facial flushing, feeling tired, blood spots in the eyes (subconjunctival hemorrhage). -
What Is the Main Cause of Hypertension?
Sedentary lifestyle, poor diet, obesity, alcohol abuse, diabetes, high cholesterol, tobacco smoking and stress may all cause high blood pressure. -
What Is the Main Cause of Pulmonary Hypertension?
Pulmonary hypertension, also called pulmonary arterial hypertension (PAH), is a rare form of abnormally high blood pressure that affects the arteries of the lungs and the right side of the heart. Pulmonary hypertension can be life-threatening if it is left untreated.
REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.