High blood pressure, also known as hypertension, is one of the most common yet preventable risk factors for heart disease, stroke and kidney failure. Yet many people don’t realize they have high blood pressure, often because it doesn’t cause any noticeable symptoms.
Half of all American adults have high blood pressure, known as a “silent killer” because it can quietly damage your body for years before any signs appear, in some cases leading to serious health problems. One third of Americans are unaware that they have high blood pressure. And a third of patients with hypertension do not have their blood pressure adequately controlled.
High blood pressure is the most prevalent modifiable risk factor for heart and vascular disease, and is the leading cause of death and disability in the U.S. and worldwide. Some things that put us at risk for heart disease, like age or our genetics, we cannot change. But we can impact blood pressure.
That’s why regular screening and knowing your numbers—including for both blood pressure and cholesterol—is so important, even if you feel perfectly healthy.
Why Blood Pressure Matters
Blood pressure measures the force of blood pushing against the walls of your arteries.
Over time, if your blood pressure is consistently too high, it can damage your blood vessels and vital organs, including your heart, brain and kidneys.
Unchecked high blood pressure increases your risk for:
- Heart attack
- Stroke
- Heart failure
- Chronic kidney disease
- Cognitive decline or dementia
The good news? High blood pressure is treatable and often manageable with early intervention. But first, you need to know your numbers.
What’s Considered Normal Blood Pressure?
Blood pressure is recorded as two numbers:
- Systolic (top number): Measures the pressure in your arteries when your heart beats.
- Diastolic (bottom number): Measures the pressure in your arteries when your heart rests between beats.
Here’s how to interpret your blood pressure reading:
- Normal blood pressure: Your systolic number (the top number) is less than 120 and your diastolic number (the bottom number) is less than 80. This is often described as “120 over 80” or 120/80.
- Elevated blood pressure: Your systolic is between 120 and 129, but your diastolic is still under 80.
- High blood pressure (Stage 1): Your systolic is between 130 and 139 or your diastolic is between 80 and 89.
- High blood pressure (Stage 2): Your systolic is 140 or higher or your diastolic is 90 or higher.
- Hypertensive crisis (considered a medical emergency): Your systolic is over 180 and/or your diastolic is over 120. You should seek immediate medical attention if this happens.
Who’s at Risk for High Blood Pressure?
Anyone can develop high blood pressure, but certain factors increase your risk, including:
- Being over the age of 50+, although high blood pressure can begin in your 20s or 30s
- Family history of hypertension
- Obesity or overweight
- Smoking or heavy alcohol use
- Sedentary lifestyle
- Eating a high-sodium or low-potassium diet
- Having diabetes or chronic kidney disease
- High stress levels
- Sleep apnea
- Black men and women have higher rate of hypertension than other groups
If you fall into any of these categories, get your blood pressure checked regularly by your provider, at least several times per year. You can also check it yourself at home daily to stay on top of your health, even if you feel fine.
Some people may have “white coat hypertension,” where their blood pressure is high when they go into their physician visit. But “masked hypertension” is another important entity where blood pressure in the doctor’s office is lower or normal, but high when measured in other settings. This group is at higher risk than people with normal blood pressure or white coat hypertension. This emphasizes the value in using home blood pressure measurements.
When Should You Check Your Blood Pressure?
Over time, even slightly elevated blood pressure numbers can increase your risk of serious health problems, which is why catching changes early and talking to your doctor about prevention strategies is key for long-term heart health.
Every 20 millimeters of mercury (mm) increase in blood pressure (an increase from 120 to 140 for the top number) doubles your risk for cardiovascular events like heart attack, stroke or cardiac arrest. A 10 mm increase in the bottom number similarly increases this risk.
Routine blood pressure checks should start in early adulthood and continue throughout life.
You should check your blood pressure more frequently if:
- You have a family history of hypertension
- You’ve had elevated numbers in the past
- You’re pregnant or postpartum
- You’ve been told you’re at risk for heart disease or stroke
You can get your blood pressure checked at a primary care visit, a pharmacy kiosk or at home with a reliable monitor.
Silent Signs of High Blood Pressure
Most people with high blood pressure have no symptoms. But in more advanced or crisis situations, you might experience symptoms such as:
- Headaches
- Blurred vision
- Shortness of breath
- Chest pain, pressure, heaviness or tightness
- Dizziness or confusion
- Difficulty speaking, word finding
- Weakness in limb, or facial muscles
If you notice these symptoms and have a history of high blood pressure, heart disease or kidney disease, seek care immediately.
Tips to Maintain Healthy Blood Pressure
If your numbers are high or borderline, there are several things you can do to lower your risk for hypertension and maintain heart health:
- Eat more fruits, vegetables and whole grains (DASH diet)
- Cut back on sodium and processed foods
- Start an exercise routine, aiming for 30 minutes most days of the week, such as taking brisk walks or lifting light weights
- Eliminating alcohol or reducing it
- Quit smoking
- Manage stress with practices like meditation, deep breathing or therapy
In some cases, your provider may also recommend medication. The key is starting early, before complications arise.
Additionally, there is a procedure approved by the FDA nearly two years ago for renal denervation. This is a one-time minimally invasive procedure to treat resistant hypertension (most complicated hypertension). It has been proven to be effective to reduce systolic blood pressure by 9 mm on average.
Get Checked, Stay Informed.
At Stony Brook Medicine, we encourage all adults, especially those with risk factors, to “know your numbers” by getting regular blood pressure screenings. It’s quick, painless and could save your life.
Schedule a visit with a Stony Brook Medicine Primary Care provider or specialist at Stony Brook Cardiology to help you stay informed and empowered about your heart health.
