Blood Pressure Matters
Keep Hypertension in Check
\n ![\"Illustration](\"https://newsinhealth.nih.gov/files/jan2016/images/feature1.jpg\")
\n About 1 in 3 adults in the U.S. has high blood pressure, but many don\u2019t realize it. High blood pressure is sometimes called a \u201csilent killer,\u201d because it usually has no warning signs, yet it can lead to life-threatening conditions like heart attack or stroke. The good news is that high blood pressure, or hypertension, can often be prevented or treated. Early diagnosis and simple, healthy changes can keep high blood pressure from seriously damaging your health.
\nNormal blood flow delivers nutrients and oxygen to all parts of your body, including important organs like your heart, brain, and kidneys. Your beating heart helps to push blood through your vast network of blood vessels, both large and small. Your blood vessels, in turn, constantly adjust. They become narrower or wider to maintain your blood pressure and keep blood flowing at a healthy rate.
\nIt\u2019s normal for your blood pressure to go up and down throughout each day. Blood pressure is affected by time of day, exercise, the foods you eat, stress, and other factors. Problems can arise, though, if your blood pressure stays too high for too long.
\nHigh blood pressure can make your heart work too hard and lose strength. The high force of blood flow can damage your blood vessels, making them weak, stiff, or narrower. Over time, hypertension can harm several important organs, including your heart, kidneys, brain, and eyes.
\n\u201cHypertension is a leading risk factor for death and disability worldwide,\u201d says Dr. Paul Whelton, an expert in hypertension and kidney disease at Tulane University. \u201cHigh blood pressure raises the risk of having a heart attack, heart failure, stroke, or kidney disease.\u201d
\nAnyone, even children, can develop high blood pressure. But the risk for hypertension rises with age. \u201cOnce people are in their 60s, about two-thirds of the population is affected by hypertension,\u201d Whelton says.
\nExcess weight or having a family history of high blood pressure also raises your risk for hypertension.
\nAfrican Americans are especially likely to get hypertension. Compared to Caucasian or Hispanic American adults, African Americans tend to develop hypertension at a younger age and to have a higher blood pressure on average.
\nBecause it usually has no symptoms, the only way to know for sure that you have hypertension is to have a blood pressure test. This easy, painless test involves placing an inflated cuff with a pressure gauge around your upper arm to squeeze the blood vessels. A health care provider may then use a stethoscope to listen to your pulse as air is released from the cuff, or an automatic device may measure the pressure.
\nBlood pressure is given as 2 numbers. The first number represents the pressure in your blood vessels as the heart beats (called systolic pressure). The second is the pressure as your heart relaxes and fills with blood (diastolic pressure). Experts generally agree that the safest blood pressure\u2014or \u201cnormal\u201d blood pressure\u2014is 120/80 or lower, meaning systolic blood pressure is 120 or less and diastolic pressure is 80 or less.
\n\u201cHypertension is defined as having an average blood pressure of above 140/90,\u201d says NIH\u2019s Dr. Lawrence Fine, who oversees research on the treatment and prevention of hypertension. Since blood pressure can vary widely from day to day, a diagnosis of hypertension is usually based on an average of 2 or more readings taken on 2 or more occasions.
\nIf your blood pressure falls between \u201cnormal\u201d and \u201chypertension,\u201d it\u2019s sometimes called prehypertension. People with prehypertension are more likely to end up with high blood pressure if they don\u2019t take steps to prevent it.
\n\u201cWe know we can prevent high blood pressure through diet, weight loss, and physical activity,\u201d Whelton says. \u201cWe can also treat it, and we can treat it effectively.\u201d
\nIf you\u2019re diagnosed with high blood pressure, your doctor will prescribe a treatment plan. You\u2019ll likely be advised to make healthy lifestyle changes (see the Wise Choices box). You may also need to take medications. The goal of treatment is to reduce your blood pressure enough to avoid more serious problems.
\nHow low should you aim when reducing your blood pressure? The answer depends on many factors, which is why it\u2019s important to work with your doctor on blood pressure goals. Most current guidelines recommend aiming for a systolic pressure below 140. These medical guidelines are sometimes adjusted as new research is reported.
\nA large NIH-funded study recently found there may be benefits to aiming for a much lower systolic pressure\u2014120 or less, instead of 140\u2014at least for some people. The study looked at adults ages 50 and up who had increased risk for cardiovascular disease but didn\u2019t have diabetes. Half aimed for a systolic pressure of 120. The rest aimed for a pressure of 140.
\nThe study was stopped early, after about 3 years, when clear benefits were seen in the lower blood pressure group. \u201cWhen treating to the lower goal of 120, the risk of having a cardiovascular complication such as a heart attack or stroke was reduced by 25%, and the risk of death from all causes was reduced by 27%,\u201d Fine says. This lower-goal group, though, tended to need 1 additional blood pressure medication; they also had more hospitalizations for side effects, including low blood pressure, fainting, and possible kidney damage.
\n\u201cResults to date suggest that for older people with hypertension and an increased risk for cardiovascular disease, it may make sense to aim for a lower blood pressure. But there may be drawbacks as well, and each patient is different,\u201d Whelton says. \u201cResearchers generate the evidence, so health care providers can have informed discussions with their patients about blood pressure targets.\u201d
\nNIH-funded studies have clearly shown that healthy lifestyle changes can improve your blood pressure. \u201cMaking even small changes over time can really add up,\u201d says Kathryn McMurry, a nutrition science expert at NIH. \u201cIn terms of diet, our best advice is to follow the DASH eating plan.\u201d
\nDASH stands for Dietary Approaches to Stop Hypertension. \u201cIt\u2019s not a diet to go on for a short period of time, but one that\u2019s meant to be part of a healthy lifestyle and enjoyed for life,\u201d McMurry says.
\nThe DASH eating plan requires no special foods. Instead, it provides daily and weekly nutritional goals. It\u2019s high in vegetables, fruit, whole grains, and low-fat dairy foods but low in saturated fat and added sugar.
\n\u201cDASH is beneficial even for people who have normal blood pressure or who have prehypertension. It can help keep blood pressure from progressing to higher levels,\u201d McMurry says. Learn more about DASH at www.nhlbi.nih.gov/health/health-topics/topics/dash.
\nFor more heart-healthy food ideas, visit healthyeating.nhlbi.nih.gov, which has nearly 200 recipes developed with input from professional chefs. \u201cThe recipes are tasty, heart healthy, and easy to make. They\u2019re meals the whole family will enjoy,\u201d McMurry says.
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Reference: A Randomized Trial of Intensive versus Standard Blood-Pressure Control. SPRINT Research Group. N Engl J Med. 2015 Nov 26;373(22):2103-16. doi: 10.1056/NEJMoa1511939. Epub 2015 Nov 9. PMID: 26551272.
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