Hypertension (High Blood Pressure)

The Centers for Disease Control and Prevention estimates that 67 million American adults (1 out of 3 adults) have high blood pressure, and that less than half have their condition under control.

With high blood pressure, or hypertension, the arteries may face an increased resistance against the flow of blood. This forces the heart to pump harder to circulate the blood, increasing the risk of heart attack and stroke. As it often displays no symptoms, hypertension is often described as “the silent killer.” That is why it is so important that patients get their blood pressure checked regularly and be vigilant about managing their blood pressure.

The Brigham and Women's Hospital (BWH) Division of Cardiovascular Medicine specializes in treating high blood pressure and other risk factors that contribute to the development of heart and vascular disease. For almost a century, our specialists have been delivering innovative and comprehensive care for patients with complex disorders of the heart, blood vessels and circulation. Part of the Heart & Vascular Center, our cardiovascular services span the entire spectrum of patient care, ranging from cardiovascular disease prevention and detection to pharmacologic and interventional treatment. We offer patients personalized care and expertise that includes ongoing communication and education throughout treatment, outpatient care and follow-up.

Hypertension Topics

Risk Factors for Hypertension

There are a number of factors that may contribute to the development of hypertension, including:

  • Diabetesgout, or kidney disease
  • Race (African Americans are most at risk)
  • Age
  • Family history of high blood pressure
  • Obesity
  • Heavy alcohol use
  • Women taking oral contraceptives
  • Stress
Symptoms of Hypertension

In some cases, patients with early-stage hypertension may experience headaches, dizziness or nosebleeds. Usually, however, high blood pressure has no symptoms. That is why it is important for patients to have their blood pressure checked regularly by their health care provider.

Diagnosis of Hypertension

Blood pressure is commonly measured by a nurse or other health care provider by either an automatic blood pressure cuff or a blood pressure cuff and stethoscope.

Two numbers are recorded when measuring blood pressure:

  • The top number, or systolic pressure, refers to the pressure inside the artery when the heart contracts and pumps blood through the body.
  • The bottom number, or diastolic pressure, refers to the pressure inside the artery when the heart is at rest and filling with blood.

Both the systolic and diastolic pressures are recorded as "mm Hg" (millimeters of mercury), which represents how high the mercury column in the blood pressure cuff is raised by the pressure of the blood. The following numbers are used to assess normal blood pressure, prehypertension and high blood pressure in most adults:

  • Normal Less than 120 mm Hg systolic pressure and less than 80 mm Hg diastolic pressure
  • Prehypertension 120-139 mm Hg systolic pressure and 80-89 mm Hg diastolic pressure
  • High blood pressure Stage 1 - 140-159 mm Hg systolic pressure and 90-99 mm Hg diastolic pressure;Stage 2 - 160 mm Hg or higher systolic pressure and 100 mm Hg or higher diastolic pressure

These numbers should only be considered a guide, as a single elevated blood pressure measurement is not necessarily an indication of a problem. A health care provider will want to see multiple blood pressure measurements over several days or weeks before diagnosing high blood pressure and starting treatment.

Everyone should have his or her blood pressure checked at least once a year. People at risk or who have already been diagnosed with hypertension, however, should check their blood pressure more frequently.

Treatment for Hypertension

Left untreated, hypertension can cause heart attacks, stroke, kidney failure or heart failure. High blood pressure can be improved by lifestyle changes, including:

  • Following a low-sodium diet
  • Choosing foods low in calories and fat, specifically opting for foods in their natural state, such as fruits and vegetables, and avoiding processed foods
  • Eating foods high in fiber
  • Maintaining a healthy weight - losing even some weight can improve blood pressure
  • Increasing physical activity to at least 30 minutes of aerobic exercise per day
  • Reducing or stopping alcohol consumption

Sometimes, daily medication is needed to control high blood pressure. A doctor may prescribe:

What You Should Expect

The BWH Heart & Vascular Center is located in the Shapiro Cardiovascular Center, across the street from BWH’s main 75 Francis Street entrance. The Heart & Vascular Center brings together the full range of services in one location, fostering seamless and coordinated care for all cardiovascular patients.

Multidisciplinary Care

Patients benefit from the teamwork of cardiovascular specialists who work alongside nurses, physician assistants, physical therapists, dietitians and social workers to achieve outstanding outcomes for our patients.

Resources

Learn more about hypertension in our health library.

Read questions and answers about high blood pressure.

Visit the Kessler Health Education Library in the Bretholtz Center where patients and families can access computers and knowledgeable staff.

Access a complete directory of patient and family services.

Visit the Brigham and Women’s Hospital HealthHub Blog which features information on a variety of topics, including hypertension.

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