High blood pressure (hypertension)

Causes, symptoms & treatment

What is High Blood Pressure?

A very common condition, high blood pressure is caused by prolonged force of blood through your arteries is so high that it can cause serious health problems like heart disease and stroke.

Blood pressure is measured by the amount of blood pumped and the amount of resistance provided by your arteries. When a nurse or doctor take your blood pressure, the top number (systolic) measures the pressure in your arteries when your heart beats while the bottom number (diastolic) represents the pressure in your arteries between beats. Normal blood pressure is below 130/80 mm Hg. Mild hypertension requires a systolic pressure reading of 130-139 mm Hg and a diastolic measure between 80-89; moderate hypertension is 140/90 mm Hg or higher.

What Causes High Blood Pressure?

Primary hypertension (or essential hypertension) has no known cause and usually develops over many years.

Secondary hypertension is caused by an underlying health condition or medication and often appears suddenly. Some of the most common culprits include:

  • Sleep apnea
  • Congenital defects in blood vessels
  • Kidney disease
  • Adrenal gland tumors
  • Illegal drugs (e.g., cocaine, amphetamines)
  • Over-the counter drugs like cold medications, decongestants, pain relievers
  • Some prescription drugs like birth control pills

Risk factors for developing high blood pressure include:

  • Age (especially 45+)
  • Obesity
  • Tobacco use
  • High-sodium diet
  • Stress
  • African descent
  • Family history
  • Sedentary lifestyle
  • Excessive alcohol consumption
  • Not enough potassium
  • Some chronic conditions like kidney disease and diabetes

High Blood Pressure Symptoms & Complications

Patients with high blood pressure commonly have no symptoms at all, even with dangerously high blood pressure. Sometimes, however, people at life-threatening levels experience the following symptoms:

  • Maux de tête
  • Essoufflement
  • saignements de nez

Some complications associated with high blood pressure include:

  • Heart attack
  • Stroke
  • Aneurysm
  • Memory problems
  • Dementia
  • Metabolic syndrome
  • Heart failure
  • Vision loss
  • Peripheral vascular disease
  • Kidney disease
  • Pregnancy complications

When to See a Doctor

Most of us are accustomed to having our blood pressure taken regularly as a normal part of a doctor's visit. If you have been diagnosed with high blood pressure or have other risk factors, your doctor may recommend getting your blood pressure checked even more frequently.

Because signs of high blood pressure are often nonexistent, it is extremely important to regularly monitor your blood pressure, rather than waiting for severe symptoms to present themselves.

Any reading higher than 180/120 mm Hg suggests a life-threatening situation that requires immediate medical attention.

How to Diagnose High Blood Pressure

As part of a routine doctor's visit, a cuff will be placed on your arm and then inflated to measure your blood pressure. If the reading indicates high blood pressure, your doctor may order additional tests to confirm the diagnosis or check for other comorbidities. These may include:

  • Lab tests (urine and/or blood)
  • Electrocardiogram (ECG/EKG)
  • Echocardiogram
  • 24-hour ambulatory monitoring

High Blood Pressure Treatment

Treatment of hypertension typically involves a combination of medication and lifestyle changes including diet, exercise, weight management, smoking cessation, stress management, and alcohol limitation.

Top Prescribed High Blood Pressure Medications

There are four classifications of drugs that are used most commonly for the treatment of high blood pressure, each with their own set of pros and cons. Patients should discuss their unique symptoms with their doctor to get appropriate guidance as to which medication (and dosage) is most likely to work for them.


  • Chlorthalidone
  • Hydrochlorothiazide (Microzide)
  • Triamterene (Dyazide, Maxide)
  • Spironolactone (Aldactone)
  • Calcium channel blockers

  • Amlodipine (Norvasc)
  • Diltiazem (Cardizem, Tiazac)
  • Angiotensin-Converting Enzyme (ACE) Inhibitors

  • Lisinopril (Prinivil, Zestril)
  • Benazepril (Lotensin)
  • Captopril
  • Angiotensin II Receptor Blockers (ARBs)

  • Candesartan (Atacand)
  • Losartan (Cozaar)