High Blood Pressure:
Can You Prevent It? Lower It?

What levels are too high? (It's surprising!). These and many other high blood pressure questions are answered here. Learn inside tips from a Doctor's Practical Guide.

Prevalence: (How many people have it?)

About 50 million people in the United States have high blood pressure, that is a reading of 140 over 90, or are taking drugs to lower it. This represents a rate of 28.7%. The rates were highest in non-Hispanic blacks (33.5%), people over age 60 (65.4%) and more in women than men. If you don't have hypertension at age 55 to 65 you have a lifetime risk of developing it of 90%! Yes, 9 out of 10 will get it. It's just a question of when?

Also your odds go up as your weight goes up and increase with salt consumption.

Essential hypertension or high blood pressure (see Definition just below) was the most frequent Emergency Room and hospital outpatient diagnosis in the year 2000 (4.3%).

Definition of High Blood Pressure:

The Concept: The incidence of adverse events increases with increasing blood pressure and the incidence decreases with a decrease in blood pressure. We might state it as the pressure at which the benefits of treatment outweigh the risks of treatment

Actual Levels: The above definition is reached at about a pressure level of 140 over 90. Below this the treatment benefits probably do not outweigh the treatment risks.

Blood Pressure Classification
Systolic Diastolic Class
115 75 Desirable
120-139 80-89 Prehypertension
140-159 90-99 Hypertension Stage 1
160 or over 100 or over Hypertension Stage 2

The prehypertension category represents a great place to institute treatment measures that carry no risk such as salt restriction, alcohol restriction, exercise program, stress and weight reduction and smoking cessation.

High blood pressure is divided into two types:

Type one consists of those individuals in whom no cause can be found and is called primary or essential hypertension. These make up about 90% of cases.

Type two consists of those in whom a cause can be found and represents about 5 to 10% of cases. It is called secondary hypertension.

The Consequences of Untreated High blood pressure:

The higher pressure stiffens the arteries and promotes hardening of the arteries (arteriosclerosis) leading to strokes and heart attacks.

It can damage the retina of the eye leading to vision impairment.

It can damage the small filtering units of the kidney leading to impairment of the kidney function and actually kidney failure.

Speaking of failure, the heart, working under increased pressure, eventually fails, congestive heart failure.

Causes of High Blood Pressure:

In most cases (90%) no cause can be found or demonstrated. Obviously there is a cause for everything but our best efforts fail to find one so far.

This topic can only apply to secondary hypertension and the causes are many. See this special page on Causes of High Blood Pressure

There are aggravating factors, which can increase blood pressure:

    • Obesity
    • Salt consumption
    • Excess alcohol
    • Smoking (nicotine)
    • Stress/anxiety
    • Sedentary lifestyle

Symptoms:

Essential or Primary Hypertension:

Basically there are no symptoms associated with this class. There are a number of them that are popularly associated such as dizziness, headache, nosebleed, flushing, tension and fatigue. These are coincidental and not caused by the pressure.
When untreated hypertension has been severe and longstanding enough for damage to occur, then symptoms of the damaged organ manifest themselves.

Secondary Hypertension:

Symptoms usually occur and are associated with the disease state causing the hypertension. Please see my pages on High Blood Pressure Symptoms and High Blood Pressure Signs

Treatment:

The first order of the day is to do whatever you can do about the aggravating factors listed immediately above. These measures carry no risk, only benefit. When the pressure averages 140 over 90 or more then drugs are justified. The only way you can be sure you know your average pressure level is to take it yourself. See How and Why at How to Take Blood Pressure

We have many drugs to treat hypertension; many of them are excellent. Often there are coexisting conditions, which strongly influence the choice. See my page on Lower Blood Pressure on the Navigation Bars at the left side of this page. See these pages Blood Pressure Medication and Blood Pressure Medications

Obviously if there is a cause identifiable (secondary hypertension) then the only sensible (and most effective) treatment is removal or treatment of the cause.

Benefits of Treatment:

The benefits of treatment are the opposite of the consequences. More specifically lowering blood pressure to normal levels reduces the incidence of stroke by 35% to 40%, the incidence of heart attack by 20% to 25% and heart failure by 50%. The greater the reduction in pressure the greater the benefit. In people with Stage one hypertension (see Normal Blood Pressure) and additional cardiovascular risk factors, a 12 mm Hg reduction in systolic over 10 years is estimated to prevent one death for every 11 individuals treated. If cardiovascular disease or target-organ damage is already present then one death for every 9 individuals is prevented.

In the general population a 5 mm Hg average reduction in pressure would result in 14% less stroke mortality, 9% less heart disease mortality, and 7% less overall mortality.

If you are thinking that blood pressure reductions appear to have more effect on stroke than heart disease you are right. Just look again at the statistics. Both get a good benefit.

If you are thinking that you might just directly save your own life by normalizing your blood pressure you are right again. Read my page on why do self-monitoring at How to Take Blood Pressure

High Blood Pressure and Diet:

The role of diet in high blood pressure is mildly controversial. Is it just something you can manipulate to help manage your hypertension once you get it? Or do bad dietary habits actually cause blood pressure to go up in susceptible individuals?
My money goes on a causal relationship. Salt and excess calories (obesity) have a strong effect on blood pressure. Potassium and Calcium also have a lowering effect but much less.
A diet composed of fruits, vegetables, nuts and low-fat dairy products along with reduced intake of saturated and total fat has been studied. It had a very beneficial effect, especially on African Americans and people with hypertension. They called it the DASH diet (Dietary Approaches to Stop Hypertension). See my page on High Blood Pressure Diet on the Navigation Bars on the left.

Doctors Practical Guide:

Remember this: Either number elevated carries the same incidence of adverse events as if both numbers were elevated.

High Blood Pressure is a big subject; that's why I made this page a synopsis of the various aspects with links to more detailed explanations. Use these to learn more about what you are interested in and gain more tips to lower blood pressure and a healthier life. Be sure and read the page on How to Take Blood Pressure You can do it, it's easy. It's the only way you can get the numerous and accurate and reliable readings you need so that you know where you stand. Follow this page with the Homepage