Hypertension | Symptoms, Causes and Treatment Options for High Blood Pressure

Hypertension is another name for high blood pressure. It can lead to severe health complications and increase the risk of heart disease, stroke, and sometimes death.

Hypertension | Symptoms, Causes and Treatment Options for High Blood Pressure
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Blood pressure is the force that a person’s blood exerts against the walls of their blood vessels. This pressure depends on the resistance of the blood vessels and how hard the heart has to work. Almost half of all adults in the United States have high blood pressure, but many may not know they have it.

Hypertension is a primary risk factor for cardiovascular disease, including stroke, heart attack, heart failure, and aneurysm. Managing blood pressure is vital for preserving health and reducing the risk of these dangerous conditions.

In this article we will be looking at why blood pressure can increase, how to monitor it, and ways to keep it within a typical range.

Are there Symptoms?

Most of the time, high blood pressure has no symptoms. It is known as the silent killer.

Symptoms people may think are due to high blood pressure include:

  • headaches
  • difficulty sleeping
  • nosebleeds
  • sweating
  • facial flushing
  • nervousness
  • blood spots in the eyes
  • dizziness

However, these symptoms may not be due to high blood pressure, and anyone experiencing them should speak to a doctor as they may also be signs of other health conditions or side effects of medications.

People cannot rely on only physical symptoms to alert them of high blood pressure. To diagnose or monitor hypertension, a person should measure their blood pressure regularly.

Blood pressure readings are in millimetres of mercury (mm Hg). The top number (systolic) indicates the pressure in the arteries as the heart beats. The lower number (diastolic) indicates the pressure as the heart rests between beats.

As long as a person measures their blood pressure correctly, the results are just as reliable as a doctor’s measurement.

When to see a doctor

Although high blood pressure does not usually cause symptoms, anyone experiencing a sudden, severe headache or nosebleed should check their blood pressure.

If their blood pressure is above 180/120 mm Hg, they should stay rested for 5 minutes and recheck their blood pressure. If the blood pressure is still higher than 180/120 mm Hg, they need to seek medical help at their doctor’s office.

If a person is experiencing severe symptoms, such as chest pain, shortness of breath, or visual difficulty, they need to call 911 for emergency medical treatment as they may be experiencing a hypertensive crisis.

Medications to reduce blood pressure can cause side effects such as dizziness. If this side effect does not go away or affects a person’s daily activities, they should speak with their family doctor.


Researchers have shown a clear relationship between higher systolic and diastolic blood pressure and increased risk of cardiovascular disease.

In an analysis of 61 studies, researchers found that a 20 mm Hg higher systolic and a 10 mm Hg higher diastolic blood pressure were each associated with a doubling of the risk of:

  • stroke
  • heart disease
  • other vascular diseases

Another study including 1.25 million participants, showed that higher blood pressure had associations with:

  • increased risk of cardiovascular disease incidence
  • angina
  • heart attack
  • heart failure
  • stroke
  • peripheral arterial disease
  • abdominal aortic aneurysm

Causes and risk factors


According to the CDC, high blood pressure can be affected by genetics.

One review states that a person’s chance of inheriting high blood pressure is roughly 30–50%. The review also notes that although researchers have isolated genes that control blood pressure, these gene variants accounted for only 2–3% of genetic variations in blood pressure.

Lifestyle factors

The following environmental factors may influence a person’s blood pressure:

  1. Excessive salt intake: The National Heart, Lung, and Blood Institute (NHLBI) recommend that people consume no more than 2.4 grams (g) of sodium per day, which is about 1 teaspoon (tsp) of table salt per day.
  2. Low potassium intake: Potassium helps the body remove sodium. The AHA recommend a person consumes 4,700 milligrams (mg) per day.
  3. Weight: According to a comprehensive report by the American College of Cardiology and the AHA Task Force, people can expect to lower their blood pressure by around 1 mm Hg per 1 kilogram (2.2 pounds) of weight loss.
  4. Exercise: A 2015 study indicated that aerobic exercise could reduce blood pressure by 5–7 mm Hg.


Since there is a strong connection between environmental factors and blood pressure, healthcare professionals have been promoting hypertension prevention.

The American Hospital Association, AHA recommend:

  • eating a healthful diet low in salt
  • limiting alcohol intake
  • enjoying regular physical activity
  • managing stress
  • maintaining a healthy weight
  • quitting tobacco smoking

A healthful diet for the heart consists of eating:

  • fruits
  • vegetables
  • whole grains
  • low fat dairy products
  • skinless poultry and fish
  • nuts and legumes
  • non-tropical vegetable oils

People who follow a healthful diet to prevent hypertension and cardiovascular disease should also avoid or limit:

  • saturated and trans fats
  • sodium
  • red meat
  • sweets and sugar-sweetened beverages

People who eat well, stop smoking, lower their stress, and exercise regularly may see benefits in their general health.

The DASH diet (Dietary Approaches to Stop Hypertension) may be beneficial in helping to prevent or treat high blood pressure.

Learn more about the DASH diet here.


There is a range of blood pressure medications that have various effects on the body. The following are different classes of drugs, how they work, and their potential side effects:

  • Diuretics: These drugs help the body remove excess salt and water. Some also reduce potassium, which may result in weakness. An example is chlorothiazide (Diuril).
  • Beta-blockers: These drugs lower the heart’s workload. Side effects may include slow heartbeat and fatigue. An example is metoprolol.
  • Angiotensin converting enzyme (ACE) inhibitors: These drugs enable the body to produce less angiotensin, a chemical that narrows the arteries. Side effects may include a rash and loss of taste. An example is captopril (Capoten).
  • Angiotensin II receptor blockers (ARBs): These block the effects of angiotensin, enabling blood vessels to stay open. They may sometimes cause dizziness. An example is candesartan (Atacand). Doctors do not prescribe ACE inhibitors and ARBs together because they have similar effects.
  • Calcium channel blockers: These drugs prevent calcium from entering the cells of the blood vessels and heart, an effect that relaxes narrowed blood vessels. They may cause swollen ankles and palpitations, which is an irregular heartbeat. Examples are amlodipine and bepridil (Vasocor).
  • Alpha blockers: These drugs relax the muscle tone in the artery walls. Side effects may include dizziness and a fast heart rate. An example is doxazosin mesylate (Cardura).
  • Alpha-2 receptor agonists: These drugs reduce the activity of the part of the nervous system that produces adrenaline, a hormone that strengthens the force of the heart’s contractions. Side effects may include drowsiness or dizziness. An example is methyldopa (Aldomet).
  • Combined alpha and beta blockers: Doctors may order the administration of these drugs via a person’s vein if they are undergoing a hypertensive crisis. They may cause a drop in blood pressure when an individual stands up from a seated position. Examples are labetalol and carvedilol (Coreg).
  • Central agonists: These drugs decrease the ability of a blood vessel to contract. Side effects vary with the medication, but they may include dry mouth and drowsiness. An example is clonidine hydrochloride (Catapres).
  • Peripheral adrenergic inhibitors: These drugs block chemicals in the brain that send a message to the blood vessels to constrict. Side effects may include heartburn and a stuffy nose. An example is guanadrel (Hylorel).
  • Blood vessel dilators: These drugs relax the muscles in the walls of blood vessels. Side effects may include palpitations and headaches. An example is hydralazine hydrochloride (Apresoline).

Treatment for resistant hypertension

Doctors define resistant hypertension as blood pressure higher than 140/90 mm Hg after treatment with three or more medications. The medications should include optimal doses of the following:

  • an ACE inhibitor or angiotensin receptor blockers
  • calcium channel blockers
  • diuretics

While scientists do not fully understand the causes of resistant hypertension, they theorize that it involves excessive sodium retention in the kidneys. For this reason, the ACC advises one of these additional treatments:

  • Spironolactone: For a person with a potassium level below 4.5 millimoles per liter (mmol/L) if they are likely to respond to this type of medication.
  • Other potassium-sparing diuretics: For individuals with a potassium level of less than 4.5 mmol/L who cannot tolerate spironolactone. An example is eplerenone (Inspra), which acts similarly to spironolactone but has fewer side effects.
  • A double dose of diuretic: For people with a potassium level higher than 4.5 mmol/L.

Alternative medicine

Research suggests some types of alternative medicine can produce small decreases in blood pressure in individuals with hypertension. These include tai chi, meditation, yoga, and qigong.

Tai Chi

Tai chi is an exercise that combines deep diaphragmatic breathing with graceful body movements. An older 2013 study reviewed 18 clinical trials investigating its effects on hypertension. Researchers found weak but encouraging evidence that it may help reduce hypertension.


Meditation involves focusing the mind on a particular thought or object. A 2017 review evaluated the effects of meditation on the risk of heart and blood vessel diseases. It found a potential benefit but could not draw definite conclusions.


Yoga involves poses and slow, gentle movements. An older 2014 review of 120 studies assessed the benefit of yoga on hypertension in 6,693 participants. Most of the studies reported that yoga could reduce hypertension and suggested that clinical guidelines should include yoga as a therapy.


Qigong is an exercise that involves coordinating breathing patterns with meditation and rhythmic movements.

An older 2015 meta-analysis reviewed 20 clinical trials evaluating the effects of qigong on 2,349 people with hypertension. The results suggested it was an effective therapy, but the findings warrant further research.

Emergency treatment

A hypertensive crisis is when an individual has a systolic blood pressure higher than 180 mm Hg or diastolic blood pressure higher than 120 mm Hg. A hypertensive emergency is when those readings are also accompanied by signs of organ damage.

Systolic is the top blood pressure reading, which shows the force on the arteries during a contraction of the heart during a heartbeat. Diastolic is the bottom reading, which indicates the force on the arteries as the heart relaxes between beats.

People with a hypertensive emergency need rapid-acting medications that a health care provider administers through a vein. Different conditions can cause this serious issue, and the drug of choice depends on the cause. A doctor treating the person will need to attempt to reduce their blood pressure slowly, to avoid dangerous side effects if the person’s blood pressure drops too fast.

Living with hypertension

Since hypertension often does not produce symptoms, it has the name “the silent killer.” In addition to the lifestyle changes mentioned above, it is helpful for someone to take their medications precisely according to their doctor’s directions.

This includes not skipping a dose or cutting a pill in half. Doctors also recommend taking medications at the same time every day.


The American Heart Association (AHA) notes that the risk of death from a heart attack or stroke doubles with every 10 mm Hg diastolic increase or 20 mm Hg systolic blood pressure increase in individuals aged 40–89.

A person’s outlook depends on how well they can control their hypertension. People should visit their doctor regularly to find out their blood pressure measurements and take appropriate action according to their doctor’s advice.


Hypertension, or high blood pressure, is fairly common in the U.S. It can cause heart attacks, strokes, heart failure, or kidney disease because of the damage it can have on organs in the body.

Treatment for hypertension may include medications such as beta-blockers. However, other treatment options exist, including lifestyle adjustments such as eating a balanced diet, and avoiding alcohol and smoking. Other approaches, such as meditation and certain breathing techniques, may also help.

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