Everything you need to know about Hypertension – High Blood Pressure 140/90mmHg or higher

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High blood pressure, or hypertension, rarely has noticeable symptoms. But if untreated, it increases your risk of serious problems such as heart attacks and strokes.

Around a third of adults in the UK have high blood pressure, although many will not realise it.

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What is high blood pressure?

Blood pressure is recorded with 2 numbers. The systolic pressure (higher number) is the force at which your heart pumps blood around your body.

high blood pressure Hypertension
High Blood Pressure -Hypertension

The diastolic pressure (lower number) is the resistance to the blood flow in the blood vessels.

They’re both measured in millimetres of mercury (mmHg).

As a general guide:

  • high blood pressure is considered to be 140/90mmHg or higher (or 150/90mmHg or higher if you’re over the age of 80)
  • ideal blood pressure is usually considered to be between 90/60mmHg and 120/80mmHg

Blood pressure readings between 120/80mmHg and 140/90mmHg could mean you’re at risk of developing high blood pressure if you do not take steps to keep your blood pressure under control.

Everyone’s blood pressure will be slightly different. What’s considered low or high for you may be normal for someone else.

What are the symptoms of hypertension?

Hypertension is generally a silent condition. Many people won’t experience any symptoms. It may take years or even decades for the condition to reach levels severe enough that symptoms become obvious. Even then, these symptoms may be attributed to other issues.

Symptoms of severe hypertension can include:

  • headaches
  • shortness of breath
  • nosebleeds
  • flushing
  • dizziness
  • chest pain
  • visual changes
  • blood in the urine

These symptoms require immediate medical attention. They don’t occur in everyone with hypertension, but waiting for a symptom of this condition to appear could be fatal.

The best way to know if you have hypertension is to get regular blood pressure readings. Most doctors’ offices take a blood pressure reading at every appointment.

If you only have a yearly physical, talk to your doctor about your risks for hypertension and other readings you may need to help you watch your blood pressure.

For example, if you have a family history of heart disease or have risk factors for developing the condition, your doctor may recommend that you have your blood pressure checked twice a year. This helps you and your doctor stay on top of any possible issues before they become problematic.

What causes high blood pressure?

It’s not always clear what causes high blood pressure, but certain things can increase your risk.

You’re at an increased risk of high blood pressure if you:

  • are over the age of 65
  • are overweight
  • are of African or Caribbean descent
  • have a relative with high blood pressure
  • eat too much salt and do not eat enough fruit and vegetables
  • do not do enough exercise
  • drink too much alcohol or coffee (or other caffeine-based drinks)
  • smoke
  • do not get much sleep or have disturbed sleep

Making healthy lifestyle changes can help reduce your chances of getting high blood pressure and help lower your blood pressure if it’s already high.

What are the Risks of high blood pressure

If your blood pressure is too high, it puts extra strain on your blood vessels, heart and other organs, such as the brain, kidneys and eyes.

Persistent high blood pressure can increase your risk of a number of serious and potentially life-threatening health conditions, such as:

If you have high blood pressure, reducing it even a small amount can help lower your risk of these health conditions.

How To Diagnose High Blood Pressure

Diagnosing hypertension is as simple as taking a blood pressure reading. Most doctors’ offices check blood pressure as part of a routine visit. If you don’t receive a blood pressure reading at your next appointment, request one.

If your blood pressure is elevated, your doctor may request you have more readings over the course of a few days or weeks. A hypertension diagnosis is rarely given after just one reading. Your doctor needs to see evidence of a sustained problem. That’s because your environment can contribute to increased blood pressure, such as the stress you may feel by being at the doctor’s office. Also, blood pressure levels change throughout the day.

All adults over 40 are advised to have their blood pressure checked at least every 5 years. 

Getting this done is easy and could save your life.

You can get your blood pressure tested at a number of places, including:

  • at your GP surgery
  • at some pharmacies
  • as part of your NHS Health Check
  • in some workplaces

You can also check your blood pressure yourself with a home blood pressure monitor.

Find out more about getting a blood pressure test

How to understand high blood pressure readings

Two numbers create a blood pressure reading:

  • Systolic pressure: This is the first, or top, number. It indicates the pressure in your arteries when your heart beats and pumps out blood.
  • Diastolic pressure: This is the second, or bottom, number. It’s the reading of the pressure in your arteries between beats of your heart.

Five categories define blood pressure readings for adults:

  • Healthy:A healthy blood pressure reading is less than 120/80 millimeters of mercury (mm Hg).
  • Elevated:The systolic number is between 120 and 129 mm Hg, and the diastolic number is less than 80 mm Hg. Doctors usually don’t treat elevated blood pressure with medication. Instead, your doctor may encourage lifestyle changes to help lower your numbers.
  • Stage 1 hypertension: The systolic number is between 130 and 139 mm Hg, or the diastolic number is between 80 and 89 mm Hg.
  • Stage 2 hypertension: The systolic number is 140 mm Hg or higher, or the diastolic number is 90 mm Hg or higher.
  • Hypertensive crisis: The systolic number is over 180 mm Hg, or the diastolic number is over 120 mm Hg. Blood pressure in this range requires urgent medical attention. If any symptoms such as chest pain, headache, shortness of breath, or visual changes occur when blood pressure is this high, medical care in the emergency room is needed.

A blood pressure reading is taken with a pressure cuff. For an accurate reading, it’s important you have a cuff that fits. An ill-fitting cuff may deliver inaccurate readings.

Blood pressure readings are different for children and teenagers. Ask your child’s doctor for the healthy ranges for your child if you’re asked to monitor their blood pressure.

What are the Causes of high blood pressure

It’s not always clear what causes high blood pressure, but certain things can increase your risk.

You’re at an increased risk of high blood pressure if you:

  • are over the age of 65
  • are overweight
  • are of African or Caribbean descent
  • have a relative with high blood pressure
  • eat too much salt and do not eat enough fruit and vegetables
  • do not do enough exercise
  • drink too much alcohol or coffee (or other caffeine-based drinks)
  • smoke
  • do not get much sleep or have disturbed sleep

Making healthy lifestyle changes can help reduce your chances of getting high blood pressure and help lower your blood pressure if it’s already high.

Treatment for high blood pressure

Doctors can help you keep your blood pressure to a safe level using:

  • lifestyle changes
  • medicines

What works best is different for each person.

Talk to your doctor to help you decide about treatment.

This patient decision aid (PDF, 132kb) can also help you to understand your treatment options.

Lifestyle changes to reduce blood pressure

These lifestyle changes can help prevent and lower high blood pressure:

Some people with high blood pressure may also need to take 1 or more medicines to stop their blood pressure getting too high.

Medicines for high blood pressure

If you’re diagnosed with high blood pressure, your doctor may recommend taking 1 or more medicines to keep it under control.

These come as tablets and usually need to be taken once a day.

Common blood pressure medicines include:

The medicine recommended for you will depend on things like how high your blood pressure is, your age and your ethnicity.

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