Hypertension (high blood pressure) is a condition in which the force of blood pumping through the arteries is consistently too high. When this occurs, the walls of the arteries are expanded beyond their normal limit, which can cause damage and scarring and put people at risk for heart attack, stroke, and kidney disease.
- Facial flushing
- Blood spots in the eyes (subconjunctival hemorrhage)
- More common in people who also have diabetes
Mild (140 to 159/90 to 99 mmHg) or moderate (160 to 179/100 to 109 mmHg) hypertension does not generally cause headaches.
- Adrenal tumor (pheochromocytoma, benign or malignant)
- Hypertension crisis without encephalopathy
- An acute and severe elevation in blood pressure without damage or disease of the brain
- Hypertensive encephalopathy
- An acute and severe elevation in blood pressure with damage or disease of the brain
- Pre-eclampsia and eclampsia
- A condition that occurs during pregnancy in which blood pressure rises to a dangerous level (over 140/90 mmHg)
- Acute pressure response to an exogenous agent
- Often related to drug use or withdrawal
- Can be caused by use of cocaine, amphetamines, oral contraceptives, and monoamine oxidase inhibitors (MAOI), especially when interacting with tyramine-containing foods
- May also occur following the withdrawal of beta-blockers, alpha-stimulants (e.g., clonidine), or alcohol
If you have known hypertension and develop a headache, see a doctor, because it is often a sign of an underlying condition.
What Causes Hypertension?
Secondary hypertension is caused by an underlying medical condition, such as:
- Kidney disease
- Sleep apnea
- Thyroid or adrenal gland problems
- Some medications
- High cholesterol
Risk factors for developing hypertension include:
- Family history of hypertension
- Men are more likely to develop hypertension than women up to age 64
- Starting at age 65, women are more likely to develop hypertension than men
- African-Americans in the U.S. tend to develop high blood pressure more often than other races
- Sedentary lifestyle
- Poor diet, especially one high in salt (sodium), saturated and trans fats, calories, and sugars
- Excess alcohol intake
- Smoking and tobacco use
How Is Hypertension Diagnosed?
Blood pressure is expressed in two numbers:
- Systolic blood pressure (the first/top number): measures the pressure in the blood vessels when the heart beats
- Diastolic blood pressure (the second/bottom number): measures the pressure in the blood vessels when the heart is at rest between beats
High, elevated, and normal blood pressure is usually defined in the following ranges:
- High blood pressure (hypertension) is 140/90 mmHg or more
- Elevated blood pressure levels between 120/80 and 139/89 are considered prehypertension and mean a person is at higher risk for developing high blood pressure
- Normal blood pressure is less than 120/80 mmHg
Blood pressure is measured with a pressure cuff (sphygmomanometer) placed around the upper arm and manually or electronically inflated. When inflated, the cuff compresses the brachial artery, the major blood vessel of the upper arm, stopping blood flow briefly. Then the air in the cuff is released slowly while the person performing the measurement listens with a stethoscope or monitors an electronic readout.
Adults 20 years of age and older should have their blood pressure checked during regular doctor visits.
What Is the Treatment for Hypertension?
Lifestyle changes are usually the first line treatment for hypertension, and may include:
- Maintaining a healthy weight
- Exercising regularly
- Managing stress
- Eating a balanced diet that is low in salt
- Limiting or avoiding alcohol
- Not smoking
- Getting enough sleep
- Taking medications as directed
Medications used to treat hypertension include:
- ACE inhibitors
- Calcium channel blockers
- Peripherally acting alpha-adrenergic blockers
- Diuretics (“water pills”)
- Angiotensin II antagonists (ARBs)
- Centrally-acting alpha adrenergics
- Renin inhibitors
- Combination medicines, made up of two or more different kinds of blood pressure medicines
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