Hypertension

Causes

The body has many steps to help keep blood pressure in a healthy range. It is not clear what changes happen that lead to high blood pressure. Things that may play a role are:

• Genetics
• Lack of physical activity
• Diet
• Being overweight or obese

Risk Factors

This problem usually starts when a person is between 20 and 50 years of age. The risk increases with age. Other things that may raise the risk are:

• Having other family members with this problem
• Being overweight
• Alcohol use disorder
• Smoking
• Use of oral contraceptives (birth control pills)
• An inactive lifestyle
• Kidney disease
• Diabetes
• A diet that is high in fat and salt
• Stress

Symptoms

Most people do not have symptoms until blood pressure is very high. Problems may be:

• Headache
• Blurry or double vision
• Belly pain
• Chest pain
• Shortness of breath
• Lightheadedness

Diagnosis

High blood pressure is often found during a doctor's visit. If the reading is high, you will come back for repeat checks. High blood pressure will be confirmed after more than two readings over more than two visits.

A doctor's office can make some people nervous. This can cause higher than normal blood pressure. You may be asked to measure your blood pressure at home or in another location.

Treatment

The goal of treatment is to lower blood pressure. The methods used may need to be changed over time. Choices are:

Lifestyle Changes

Lifestyle changes are often the first method used to lower blood pressure. Options are:

• Reaching and maintaining a healthy weight
• Exercising regularly
• Not smoking
• Eating a healthful diet that is low in fat, salt, and processed foods and rich in fiber, fruits, and vegetables
• Limiting alcohol
• Reducing stress

Medicine

People who are not helped by lifestyle changes may need medicine. Options are:

• to decrease the amount of fluid in the blood
• Beta blockers to decrease heartbeat force and rate
• Medicines that help keep blood vessels from tightening and narrowing, such as:
  • Angiotensin converting enzyme (ACE) inhibitors
  • Angiotensin receptor blockers
  • Calcium channel blockers
  • Alpha blockers
  • Vasodilators
• Aldosterone blockers to increase the amount of salt that is lost through urine

Prevention

The risk of this problem may be lowered by:

• Eating a healthful diet that is low in fat, salt, and processed foods and rich in fiber, fruits, and vegetables
• Exercising regularly
• Reaching and maintaining a healthy weight
• Not smoking
• Limiting alcohol