What is blood pressure?

Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood. This is called systolic pressure. When your heart is at rest, between beats, your blood pressure falls. This is called diastolic pressure.

Your blood pressure reading uses these two numbers. Usually the systolic number comes before or above the diastolic number. For example, 120/80 means a systolic of 120 and a diastolic of 80.

How is high blood pressure diagnosed?

High blood pressure usually has no symptoms. So the only way to find out if you have it is to get regular blood pressure checks from your health care provider. Your provider will use a gauge, a stethoscope or electronic sensor, and a blood pressure cuff. He or she will take two or more readings at separate appointments before making a diagnosis.

For children and teens, the health care provider compares the blood pressure reading to what is normal for other kids who are the same age, height, and sex.

Why do I need to worry about high blood pressure?

When your blood pressure stays high over time, it causes the heart to pump harder and work overtime, possibly leading to serious health problems such as heart attack, stroke, heart failure, and kidney failure.

What are the treatments for high blood pressure?

Treatments for high blood pressure include heart-healthy lifestyle changes and medicines.

You will work with your provider to come up with a treatment plan. It may include only the lifestyle changes. These changes, such as heart-healthy eating and exercise, can be very effective. But sometimes the changes do not control or lower your high blood pressure. Then you may need to take medicine. There are different types of blood pressure medicines. Some people need to take more than one type.

If your high blood pressure is caused by another medical condition or medicine, treating that condition or stopping the medicine may lower your blood pressure.

High blood pressure, also known as hypertension, is a common disease that develops when blood flows through your arteries at higher-than-normal pressures. Your blood pressure is made up of two numbers: systolic and diastolic. Systolic pressure is the pressure when the ventricles pump blood out of the heart. Diastolic pressure is the pressure between heartbeats when the heart is filling with blood.

Your blood pressure changes throughout the day based on your activities. For most adults, a normal blood pressure is less than 120 over 80 millimeters of mercury, which is written as your systolic pressure reading over your diastolic pressure reading—120/80 mm Hg. Your blood pressure is considered high when you have consistent systolic readings of 130 mm Hg or higher or diastolic readings of 80 mm Hg or higher.

Blood Pressure Levels

You usually don’t have symptoms from high blood pressure until it has caused serious health problems. About 1 in 3 U.S. adults with high blood pressure aren’t even aware they have it and are not being treated to control their blood pressure. In fact, that is why it is important to have your blood pressure checked at least once a year.

To control or lower high blood pressure, your doctor may recommend that you adopt a heart-healthy lifestyle. This includes choosing heart-healthy foods such as those in the DASH eating plan. You may also need to take medicines. Controlling or lowering blood pressure can help prevent or delay serious health problems such as chronic kidney disease, heart attack, heart failure, stroke, and possibly vascular dementia.

What is blood pressure?

Blood pressure is the pressure of blood pushing against the walls of your arteries. Arteries carry blood from your heart to other parts of your body.

Your blood pressure normally rises and falls throughout the day.

What do blood pressure numbers mean?

Blood pressure is measured using two numbers:

The first number, called systolic blood pressure, measures the pressure in your arteries when your heart beats.

The second number, called diastolic blood pressure, measures the pressure in your arteries when your heart rests between beats.

If the measurement reads 120 systolic and 80 diastolic, you would say, “120 over 80,” or write, “120/80 mmHg.”

What are normal blood pressure numbers?

A normal blood pressure level is less than 120/80 mmHg.

No matter your age, you can take steps each day to keep your blood pressure in a healthy range.

What is high blood pressure (hypertension)?

High blood pressure, also called hypertension, is blood pressure that is higher than normal. Your blood pressure changes throughout the day based on your activities. Having blood pressure measures consistently above normal may result in a diagnosis of high blood pressure (or hypertension).

The higher your blood pressure levels, the more risk you have for other health problems, such as heart disease, heart attack, and stroke.

Your health care team can diagnose high blood pressure and make treatment decisions by reviewing your systolic and diastolic blood pressure levels and comparing them to levels found in certain guidelines.

The guidelines used to diagnose high blood pressure may differ from health care professional to health care professional:

• Some health care professionals diagnose patients with high blood pressure if their blood pressure is consistently 140/90 mm Hg or higher.² This limit is based on a guideline released in 2003, as seen in the table below.
• Other health care professionals diagnose patients with high blood pressure if their blood pressure is consistently 130/80 mm Hg or higher.¹ This limit is based on a guideline released in 2017, as seen in the table below.

If you are diagnosed with high blood pressure, talk with your health care team about your blood pressure levels and how these levels affect your treatment plan.

What are the signs and symptoms of high blood pressure?

High blood pressure usually has no warning signs or symptoms, and many people do not know they have it. Measuring your blood pressure is the only way to know whether you have high blood pressure.

What causes high blood pressure?

High blood pressure usually develops over time. It can happen because of unhealthy lifestyle choices, such as not getting enough regular physical activity. Certain health conditions, such as diabetes and having obesity, can also increase the risk for developing high blood pressure. High blood pressure can also happen during pregnancy.

What problems does high blood pressure cause?

High blood pressure can damage your health in many ways. It can seriously hurt important organs like your heart, brain, kidneys, and eyes.

The good news is that, in most cases, you can manage your blood pressure to lower your risk for serious health problems.

Heart Attack and Heart Disease

High blood pressure can damage your arteries by making them less elastic, which decreases the flow of blood and oxygen to your heart and leads to heart disease. In addition, decreased blood flow to the heart can cause:

• Chest pain, also called angina.
• Heart attack, which happens when the blood supply to your heart is blocked and heart muscle begins to die without enough oxygen. The longer the blood flow is blocked, the greater the damage to the heart.
• Heart failure, a condition that means your heart can’t pump enough blood and oxygen to your other organs.

Stroke and Brain Problems

High blood pressure can cause the arteries that supply blood and oxygen to the brain to burst or be blocked, causing a stroke. Brain cells die during a stroke because they do not get enough oxygen. Stroke can cause serious disabilities in speech, movement, and other basic activities. A stroke can also kill you.

Having high blood pressure, especially in midlife, is linked to having poorer cognitive function and dementia later in life. Learn more about the link between high blood pressure and dementia from the National Institutes of Health’s Mind Your Risks^®external icon campaign.

Kidney Disease

Adults with diabetes, high blood pressure, or both have a higher risk of developing chronic kidney disease than those without these conditions.

How do I know if I have high blood pressure?

There’s only one way to know if you have high blood pressure: Have a doctor or other health professional measure it. Measuring your blood pressure is quick and painless.

Talk with your health care team about regularly measuring your blood pressure at home, also called self-measured blood pressure (SMBP) monitoring.

High blood pressure is called the “silent killer” because it usually has no warning signs or symptoms, and many people do not know they have it.

What can I do to prevent or manage high blood pressure?

Many people with high blood pressure can lower their blood pressure into a healthy range or keep their numbers in a healthy range by making lifestyle changes. Talk with your health care team about

• Getting at least 150 minutes of physical activity each week (about 30 minutes a day, 5 days a week)
• Not smoking
• Eating a healthy diet, including limiting sodium (salt) and alcohol
• Keeping a healthy weight
• Managing stress

Learn more about ways to manage and prevent high blood pressure.

In addition to making positive lifestyle changes, some people with high blood pressure need to take medicine to manage their blood pressure.

Talk with your health care team right away if you think you have high blood pressure or if you’ve been told you have high blood pressure but do not have it under control.

By taking action to lower your blood pressure, you can help protect yourself against heart disease and stroke, also sometimes called cardiovascular disease (CVD).

There are two main types of high blood pressure: primary and secondary high blood pressure.

• Primary, or essential, high blood pressure is the most common type of high blood pressure. For most people who get this kind of blood pressure, it develops over time as you get older.
• Secondary high blood pressure is caused by another medical condition or use of certain medicines. It usually gets better after you treat that condition or stop taking the medicines that are causing it.

Many factors raise your risk of high blood pressure. Some risk factors, such as unhealthy lifestyle habits, can be changed. Other risk factors, such as age, family history and genetics, race and ethnicity, and sex, cannot be changed. A healthy lifestyle can lower your risk for developing high blood pressure.

Age

Blood pressure tends to increase with age. Our blood vessels naturally thicken and stiffen over time. These changes increase the risk for high blood pressure.

However, the risk of high blood pressure is increasing for children and teens, possibly because of rise in the number of children and teens who are living with overweight or obesity.

Family history and genetics

High blood pressure often runs in families. Much of the understanding of the body systems involved in high blood pressure has come from genetic studies. Many different genes are linked to a small increase in the risk of developing high blood pressure. Research suggests that certain DNA changes as an unborn baby grows in the womb may also lead to high blood pressure later in life.

Some people have a high sensitivity to salt in their diet. This can also run in families.

Lifestyle habits

Lifestyle habits can increase the risk of high blood pressure. These habits include:

• Eating unhealthy foods often, especially those with too much sodium and not enough potassium. Some people, including African Americans, older adults, and people who have chronic kidney disease, diabetes, or metabolic syndrome, are more sensitive to salt in their diet.
• Drinking too much alcohol or caffeine.
• Not getting enough physical activity.
• Smoking or using illegal drugs such as cocaine, “bath salts,” and methamphetamine.
• Not getting enough good-quality sleep.

Medicines

Some prescription and over-the-counter medicines can make it more difficult for your body to control your blood pressure. Medicines that can raise your blood pressure include antidepressants, decongestants (medicines to relieve a stuffy nose), hormonal birth control pills, and non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen.

Other medical conditions

Other medical conditions change the way your body controls fluids, sodium, and hormones in your blood. Other medical causes of high blood pressure include:

• Certain tumors
• Chronic kidney disease
• Metabolic syndrome
• Overweight and obesity
• Sleep apnea
• Thyroid problems

Race or ethnicity

High blood pressure is more common in African American and Hispanic adults than in white or Asian adults. Compared with other racial or ethnic groups, African Americans tend to have higher average blood pressure numbers and get high blood pressure earlier in life. Experiencing discrimination has been tied to high blood pressure. In addition, some high blood pressure medicines may not work as well in African Americans.

During pregnancy, African American women are more likely than white women to develop preeclampsia. Preeclampsia is a pregnancy disorder that causes sudden high blood pressure and problems with the kidneys and liver.

Sex

Men are more likely than women to develop high blood pressure throughout middle age. But in older adults, women are more likely than men to develop high blood pressure.

Women who have high blood pressure during pregnancy are more likely to have high blood pressure later in life.

Social and economic factors

Recent research has shown that factors such as income, your education, where you live, and the type of job you have may contribute to your risk of developing high blood pressure. For example, working early or late shifts can raise your risk.

Experiencing danger or harm as a child has also been tied to a higher risk of developing high blood pressure.

Normal Function

The AGT gene provides instructions for making a protein called angiotensinogen. This protein is part of the renin-angiotensin system, which regulates blood pressure and the balance of fluids and salts in the body. In the first step of this process, angiotensinogen is converted to angiotensin I. Through an additional step, angiotensin I is converted to angiotensin II. Angiotensin II causes blood vessels to narrow (constrict), which results in increased blood pressure. This molecule also stimulates production of the hormone aldosterone, which triggers the absorption of salt and water by the kidneys. The increased amount of fluid in the body also increases blood pressure. Proper blood pressure during fetal growth, which delivers oxygen to the developing tissues, is required for normal development of the kidneys, particularly of structures called the proximal tubules, and other tissues. In addition, angiotensin II may play a more direct role in kidney development, perhaps by affecting growth factors involved in the development of kidney structures.

Health Conditions Related to Genetic Changes

Renal tubular dysgenesis

At least six mutations in the AGT gene have been found to cause a severe kidney disorder called renal tubular dysgenesis. This condition is characterized by abnormal kidney development before birth, the inability to produce urine (anuria), and severe low blood pressure (hypotension). These problems result in a reduction of amniotic fluid (oligohydramnios), which leads to a set of birth defects known as the Potter sequence.

Renal tubular dysgenesis can be caused by mutations in both copies of any of the genes involved in the renin-angiotensin system. Most of the mutations in the AGT gene that cause this disorder change single protein building blocks (amino acids) in the angiotensinogen protein. These changes occur in a region of the protein that is necessary for its conversion to angiotensin I. It is thought that the altered angiotensinogen cannot be converted, leading to a nonfunctional renin-angiotensin system. Without this system, the kidneys cannot control blood pressure. Because of low blood pressure, the flow of blood is reduced (hypoperfusion), and the body does not get enough oxygen during fetal development. As a result, kidney development is impaired, leading to the features of renal tubular dysgenesis.

Hypertension

MedlinePlus Genetics provides information about Hypertension

Other disorders

Variations in the AGT gene are associated with susceptibility to a form of high blood pressure (hypertension) called essential hypertension. Essential hypertension is a complex disorder associated with many genetic and environmental factors. The AGT gene variations associated with this condition affect single DNA building blocks (nucleotides) and likely lead to higher levels of the angiotensinogen protein.

Other Names for This Gene

• angiotensinogen (serpin peptidase inhibitor, clade A, member 8)
• angiotensinogen preproprotein
• ANGT_HUMAN
• ANHU
• pre-angiotensinogen
• serpin A8
• SERPINA8

Genomic Location

Normal Function

The AGTR1 gene provides instructions for making a protein called the angiotensin II receptor type 1 (AT1 receptor). This protein is part of the renin-angiotensin system, which regulates blood pressure and the balance of fluids and salts in the body. Through a series of steps, the renin-angiotensin system produces a molecule called angiotensin II, which attaches (binds) to the AT1 receptor, stimulating chemical signaling. This signaling causes blood vessels to narrow (constrict), which results in increased blood pressure. Binding of angiotensin II to the AT1 receptor also stimulates production of the hormone aldosterone, which triggers the absorption of water and salt by the kidneys. The increased amount of fluid in the body also increases blood pressure. Proper blood pressure during fetal growth, which delivers oxygen to the developing tissues, is required for normal development of the kidneys, particularly of structures called the proximal tubules, and other tissues. In addition, angiotensin II may play a more direct role in kidney development, perhaps by affecting growth factors involved in the development of kidney structures.

Health Conditions Related to Genetic Changes

Renal tubular dysgenesis

At least four mutations in the AGTR1 gene have been found to cause a severe kidney disorder called renal tubular dysgenesis. This condition is characterized by abnormal kidney development before birth, the inability to produce urine (anuria), and severe low blood pressure (hypotension). These problems result in a reduction of amniotic fluid (oligohydramnios), which leads to a set of birth defects known as the Potter sequence.

Renal tubular dysgenesis can be caused by mutations in both copies of any of the genes involved in the renin-angiotensin system. The AGTR1 gene mutations that cause this disorder likely change or block the AT1 receptor's ability to stimulate signaling, which results in a nonfunctional renin-angiotensin system. Without this system, the kidneys cannot control blood pressure. Because of low blood pressure, the flow of blood is reduced (hypoperfusion), and the body does not get enough oxygen during fetal development. As a result, kidney development is impaired, leading to the features of renal tubular dysgenesis.

Hypertension

MedlinePlus Genetics provides information about Hypertension

Other disorders

Variations in the AGTR1 gene have been reported to be associated with an increased risk of a form of high blood pressure (hypertension) called essential hypertension; heart disease; or diabetic nephropathy, a complication of diabetes that affects kidney function. These are complex disorders associated with many genetic and environmental factors. The most studied AGTR1 gene variation associated with these conditions changes a single DNA building block (nucleotide) in the gene. This change switches the nucleotide adenine to cytosine at position 1166 in the gene (written as A1166C). It is unclear how this AGTR1 gene variation contributes to the risk of these conditions.

Other Names for This Gene

• AG2S
• AGTR1_HUMAN
• AGTR1A
• AGTR1B
• angiotensin II receptor, type 1
• AT1
• AT1AR
• AT1B
• AT1BR
• AT1R
• AT2R1
• AT2R1A
• AT2R1B
• HAT1R
• type-1 angiotensin II receptor
• type-1B angiotensin II receptor

Genomic Location

It is important to have regular blood pressure readings taken and to know your numbers, because high blood pressure usually does not cause symptoms until it has caused serious problems.

Undiagnosed or uncontrolled high blood pressure can lead to serious health problems:

• Aneurysms
• Chronic kidney disease
• Eye damage
• Heart attack
• Heart failure
• Peripheral artery disease
• Stroke
• Vascular dementia

High blood pressure in pregnancy can raise the risk of later heart and blood vessel problems for both the mother and her child.

Your doctor may diagnose you with high blood pressure based on your medical history and if your blood pressure readings are consistently at high levels. Your doctor may do more tests to look for medical conditions that could cause high blood pressure, or to see if high blood pressure has affected your kidneys.

Medical history

Your doctor will want to understand your risk factors and get general information about your health—such as your eating patterns, your physical activity level, and your family’s health history to develop a treatment plan for you. Your doctor also will ask questions to see if high blood pressure has caused you any health problems. This will help your doctor determine if you need to undergo any tests.

Confirming high blood pressure

To diagnose high blood pressure, your doctor will take two or more readings at separate medical appointments.

Your doctor may diagnose you with high blood pressure when you have consistent systolic readings of 140 mm Hg or higher or diastolic readings of 90 mm Hg or higher. Based on research, your doctor may also determine you have high blood pressure if you are an adult or child age 13 or older who consistently has systolic readings of 130 to 139 mm Hg or diastolic readings of 80 to 89 mm Hg and you have other risk factors for heart or blood vessel disease. For most adults, healthy blood pressure is usually less than 120/80 mm Hg.

For children younger than 13, blood pressure readings are compared with readings common for children of the same, age, sex, and height.

Talk to your doctor if your blood pressure readings are consistently higher than 120/80 mm Hg. Note that readings above 180/120 mm Hg are dangerously high and require immediate medical attention.

Even after taking these steps, your blood pressure reading may not be accurate for other reasons.

• You are excited or nervous. “White coat hypertension” refers to blood pressure readings that are higher in a doctor’s office than readings at home or in a pharmacy, for example. Doctors can detect this type of high blood pressure by reviewing readings from the office and from other places.
• Your blood pressure tends to be lower when measured at the doctor’s office. This is called masked high blood pressure. Doctors can diagnose this type of high blood pressure by looking at readings taken at the office and at home, especially at night. When this happens, your doctor will have difficulty detecting high blood pressure.
• The wrong blood pressure cuff was used. Your readings can appear different if the cuff is too small or too large. It is important for your healthcare team to track your readings over time and ensure the correct pressure cuff is used for your sex and age.

Diagnostic tests

• Blood tests. Your doctor may recommend blood tests to check for kidney damage, high cholesterol or diabetes that may raise your risk of coronary heart disease, or other problems like thyroid disease that may be causing high blood pressure.
• Blood pressure monitor. To gather more information about your blood pressure, your doctor may recommend wearing a blood pressure monitor to record readings over 24 hours. Your doctor may also teach you how to take blood pressure readings at home.

For most people with high blood pressure, a doctor will develop a treatment plan that may include heart-healthy lifestyle changes alone or with medicines. Heart-healthy lifestyle changes, such as heart-healthy eating, can be highly effective in treating high blood pressure.

If your high blood pressure is caused by another medical condition or medicine, it may improve once the cause is treated or removed.

Risk calculators

Your doctor may use a risk calculator to estimate your risk of having a stroke or heart attack or dying from a heart or blood vessel disease in the next 10 years or throughout your lifetime. This information can help your doctor choose the best treatment to prevent complications.

Healthy lifestyle changes

If you have high blood pressure, your doctor may recommend that you adopt a heart-healthy lifestyle to help lower and control high blood pressure.

• Choose heart-healthy foods such as those in the DASH eating plan. NHLBI-funded research has shown that DASH combined with a low-salt eating plan can be as effective as medicines in lowering high blood pressure.
• Avoid or limit alcohol. Talk to your doctor about how much alcohol you drink. Your doctor may recommend that you limit or stop drinking alcohol.
• Get regular physical activity. Many health benefits result from being physically active and getting the recommended amount of physical activity each week. Studies have shown that physical activity can help lower and control high blood pressure levels. Even modest amounts of physical activity may help. Before starting any exercise program, ask your doctor what level of physical activity is right for you
• Aim for a healthy weight. If you are an adult who is living with overweight or obesity, losing 5% to 10% of your initial weight over about 6 months can improve your health. Even losing just 3% to 5% of your weight can improve blood pressure readings.
• Quit smoking. Although these resources focus on heart health, they include basic information about how to quit smoking.
• Manage stress. Learning how to manage stress and cope with problems can improve your mental and physical health. Learning relaxation techniques, talking to a counselor, and finding a support group can all help.
• Get enough good-quality sleep. The recommended amount for adults is 7 to 9 hours of sleep a day. Develop healthy sleep habits by going to sleep and getting up at regular times, following a calming bedtime routine, and keeping your bedroom cool and dark.

Changing habits can be hard. To help make lifelong heart-healthy changes, try making one change at a time. Add another change when you feel comfortable with the previous one. You’re more likely to manage your blood pressure when you practice several of these healthy lifestyle habits together and can keep them up.

Medicines

When healthy lifestyle changes alone do not control or lower high blood pressure, your doctor may prescribe blood pressure medicines. These medicines act in different ways to lower blood pressure. When prescribing medicines, your doctor will also consider their effect on other conditions you might have, such as heart disease or kidney disease.

Keep up your healthy lifestyle changes while taking these medicines. The combination of the medicines and the heart-healthy lifestyle changes can help control and lower your high blood pressure and prevent heart disease.

Talk to your doctor if you have any concerns about side effects from the medicines. He or she may change the dose or prescribe a new medicine. To manage high blood pressure, many people need to take two or more medicines. This is more likely in African American adults.

Possible high blood pressure medicines include:

• Angiotensin-converting enzyme (ACE) inhibitors to keep your blood vessels from narrowing as much.
• Angiotensin II receptor blockers (ARBs) to keep blood vessels from narrowing.
• Calcium channel blockers to prevent calcium from entering the muscle cells of your heart and blood vessels. This allows blood vessels to relax.
• Diuretics to remove extra water and sodium (salt) from your body, reducing the amount of fluid in your blood. The main diuretic for high blood pressure treatment is thiazide. Diuretics are often used with other high blood pressure medicines, sometimes in one combined pill.
• Beta blockers to help your heart beat slower and with less force. As a result, your heart pumps less blood through your blood vessels. Beta blockers are typically used only as a backup option or if you have other conditions.

Many people need to take medicine in addition to making lifestyle changes to help keep their blood pressure at healthy levels. Read more about blood pressure medicines.

How do blood pressure medicines work?

Blood pressure medicines can work several different ways. Blood pressure medicines can keep blood pressure at a healthy level by:

• Causing your body to get rid of water, which decreases the amount of water and salt in your body to a healthy level
• Relaxing your blood vessels
• Making your heart beat with less force
• Blocking nerve activity that can restrict your blood vessels

Talk with your health care team about the best type of treatment for you. You may need to take more than one type of medicine to control your blood pressure. You can also talk to your health care team about how long it should take your blood pressure medicine to work.

It is important to take your blood pressure medicine exactly as your doctor tells you to. Do not stop taking your current medicine without talking to your doctor or pharmacist first. Stopping your blood pressure medicine without first talking to your health care team could lead to serious health consequences.

What are the benefits and risks of blood pressure medicines?

The benefits of blood pressure medicines are clear: Blood pressure medicines can help you keep your blood pressure at healthy levels and therefore greatly reduce your risk of heart disease, heart attack, and stroke.

In general, the risks of taking blood pressure medicines are low. However, all medicines have risks. Talk with your doctor or health care professional about the risks of high blood pressure medicines.

Do not stop taking your current medicine without talking to your doctor or health care professional first.

What are the side effects of blood pressure medicines?

Most of the time, blood pressure medicines do not cause side effects. Some people have mild side effects, including dizziness, headaches, swelling in the legs or feet, or stomach problems.

Some over-the-counter medicines, such as nasal decongestants, can also raise blood pressure and interact with blood pressure medicines. Tell your doctor about any medicines or supplements you are already taking.

All medicines have risks. Talk with your doctor about the best blood pressure medicines for you, their benefits, risks, and side effects, and any other health problems you may have.

How do I know if I need medicine for high blood pressure?

Your health care team will tell you if you need medicine for high blood pressure, based on your blood pressure readings over a period of time. If you use a home blood pressure monitor, record or write down your readings.

Share your readings with your health care team so that you can make the best decision to manage your blood pressure together.

What are other ways I can lower my blood pressure?

In addition to taking medicine to control your blood pressure, you can take other steps to help keep your blood pressure levels healthy.

• Get regular physical activity. Staying physically active is one of the best things you can do for your health. Physical activity helps keep your heart and blood vessels strong. It also can help you keep a healthy weight.
• Do not smoke. Smoking damages your blood vessels and greatly increases your risk of not only high blood pressure but also heart disease, heart attack, and stroke.
• Eat healthy foods. Choosing healthy meal and snack options can help you avoid high blood pressure and its complications. Be sure to eat plenty of fresh fruits and vegetables.
• Keep a healthy weight. Having overweight or obesity means your heart must work harder to pump blood and oxygen around the body. Staying at a healthy weight reduces the stress on your heart and reduces your risk for heart disease, heart attack, and stroke.

Everyone age 3 or older should have their blood pressure checked by a healthcare provider at least once a year. Your doctor will use a blood pressure test to see whether you have consistently high blood pressure readings. Your doctor will talk to you about heart-healthy lifestyle changes to help prevent or manage your blood pressure.

How to prepare for a blood pressure test

Your doctor will use a blood pressure test to see if you have higher-than-normal blood pressure readings. The reading is made up of two numbers, with the systolic number above the diastolic number. These numbers are measures of pressure in mm Hg. To learn more about systolic and diastolic pressure, visit How the Heart Works.

A blood pressure test is easy and painless and can be done in a doctor's office or clinic. A healthcare provider will use a gauge, stethoscope, or electronic sensor and a blood pressure cuff to measure your blood pressure. To prepare, take the following steps:

• Do not exercise, drink coffee, or smoke cigarettes for 30 minutes before the test.
• Go to the bathroom before the test.
• For at least 5 minutes before the test, sit in a chair and relax.
• Make sure your feet are flat on the floor.
• Do not talk while you are relaxing or during the test.
• Uncover your arm for the cuff.
• Rest your arm on a table so it is supported and at the level of your heart.

If it is the first time your provider has measured your blood pressure, you may have readings taken on both arms.

What the numbers mean

For most adults, healthy blood pressure is usually less than 120/80 mm Hg. Your blood pressure is considered high when you have consistent systolic readings of 140 mm Hg or higher or diastolic readings of 90 mm Hg or higher. Based on research, your doctor may also determine that you have high blood pressure if you are an adult or child age 13 or older who consistently has systolic readings of 130 to 139 mm Hg or diastolic readings of 80 to 89 mm Hg and you have other risk factors for heart or blood vessel disease.

For children younger than 13, blood pressure readings are compared with readings common for children of the same, age, sex, and height.

Talk to your doctor if your blood pressure readings are consistently higher than 120/80 mm Hg. Note that readings above 180/120 mm Hg are dangerously high and require immediate medical attention.

How to prevent high blood pressure

A heart-healthy lifestyle can help prevent high blood pressure from developing. To live a healthy lifestyle:

• Choose heart-healthy foods that are lower in sodium (salt) and are rich in potassium. Fruits and vegetables are high in potassium.
• Avoid or limit alcohol
• Get regular physical activity. Even modest amounts can make a difference.
• Aim for a healthy weight
• Quit smoking
• Manage stress
• Get enough good-quality sleep

Measure your blood pressure regularly to help your health care team diagnose any health problems early. You and your health care team can take steps to control your blood pressure if it is too high.

Why do I need to measure my blood pressure?

Measuring your blood pressure is the only way to know whether you have high blood pressure. High blood pressure usually has no warning signs or symptoms, and many people do not know they have it.

Where can I get my blood pressure checked?

You can get your blood pressure measured

• By a health care team member at a doctor’s office.
• At a pharmacy that has a digital blood pressure measurement machine.
• With a home blood pressure monitor that you can use yourself.

What affects a blood pressure reading?

Many things can affect a blood pressure reading, including:

• Nervousness about having your blood pressure taken. This is called “white coat syndrome.” As many as 1 in 3 people who have a high blood pressure reading at the doctor’s office may have normal blood pressure readings outside of it.
• What you ate, drank, or did before your reading. If you smoked, drank alcohol or caffeine, or exercised within 30 minutes of having your blood pressure measured, your reading might be higher.
• How you are sitting. Crossing your legs and letting your arm droop at your side rather than rest on a table at chest height can make your blood pressure go up.

It’s important to get an accurate blood pressure reading so that you have a clearer picture of your risk for heart disease and stroke.

A reading that says your blood pressure is lower than it actually is may give you a false sense of security about your health. A reading that says your blood pressure is higher than it actually is may lead to treatment you don’t need.

What is the correct way to measure blood pressure?

Learn the correct way to have your blood pressure taken, whether you’re getting it checked at the doctor’s office or checking it yourself at home. Use this checklist:

• Don’t eat or drink anything 30 minutes before you take your blood pressure.
• Empty your bladder before your reading.
• Sit in a comfortable chair with your back supported for at least 5 minutes before your reading.
• Put both feet flat on the ground and keep your legs uncrossed.
• Rest your arm with the cuff on a table at chest height.
• Make sure the blood pressure cuff is snug but not too tight. The cuff should be against your bare skin, not over clothing.
• Do not talk while your blood pressure is being measured.

How do health care professionals measure my blood pressure?

First, a health care professional wraps an inflatable cuff around your arm. The health care professional then inflates the cuff, which gently tightens on your arm. The cuff has a gauge on it that will measure your blood pressure.

The health care professional will slowly let air out of the cuff while listening to your pulse with a stethoscope and watching the gauge. This process is quick and painless. If using a digital or automatic blood pressure cuff, the healthcare professional will not need to use a stethoscope.

The gauge uses a unit of measurement called millimeters of mercury (mmHg) to measure the pressure in your blood vessels. Learn more about blood pressure measurements.

If you have high blood pressure, talk to your healthcare team about steps to take to control your blood pressure to lower your risk for heart disease and stroke.

How can I measure my blood pressure at home?

Talk with your health care team about regularly measuring your blood pressure at home, also called self-measured blood pressure (SMBP) monitoring.

SMBP means you regularly use a personal blood pressure measurement device away from a doctor’s office or hospital—usually at home. These blood pressure monitors are easy and safe to use. A health care team member can show you how to use one if you need help.

Evidence shows that people with high blood pressure are more likely to lower their blood pressure if they use SMBP combined with support from their health care team than if they don’t use SMBP.

Use these additional tips for SMBP:

• Use a blood pressure log to record your blood pressure measurements.
• Take your blood pressure at the same time every day.
• Take at least two readings, 1 or 2 minutes apart.

How often should I measure my blood pressure?

Talk with your health care team about how often you should have your blood pressure measured or when to measure it yourself. People who have high blood pressure may need to measure their blood pressure more often than people who do not have high blood pressure.

What should I do if my blood pressure numbers are high?

If you are concerned about your blood pressure numbers, talk to your health care team. They can help you make a plan to manage high blood pressure.

No matter your age, you also can take steps each day to help keep your blood pressure in a healthy range.

By living a healthy lifestyle, you can help keep your blood pressure in a healthy range. Preventing high blood pressure, which is also called hypertension, can lower your risk for heart disease and stroke. Practice the following healthy living habits:

Eat a Healthy Diet

Choose healthy meal and snack options to help you avoid high blood pressure and its complications. Be sure to eat plenty of fresh fruits and vegetables.

Talk with your health care team about eating a variety of foods rich in potassium, fiber, and protein and lower in salt (sodium) and saturated fat. For many people, making these healthy changes can help keep blood pressure low and protect against heart disease and stroke.

The DASH (Dietary Approaches to Stop Hypertension) eating plan is a healthy diet plan with a proven record of helping people lower their blood pressure.

Keep Yourself at a Healthy Weight

Having overweight or obesity increases your risk for high blood pressure. To determine whether your weight is in a healthy range, doctors often calculate your body mass index (BMI). If you know your weight and height, you can calculate your BMI at CDC’s Assessing Your Weight website. Doctors sometimes also use waist and hip measurements to assess body fat.

Talk with your health care team about ways to reach a healthy weight, including choosing healthy foods and getting regular physical activity.

Be Physically Active

Physical activity can help keep you at a healthy weight and lower your blood pressure. The Physical Activity Guidelines for Americans recommends that adults get at least 2 hours and 30 minutes of moderate-intensity exercise, such as brisk walking or bicycling, every week. That’s about 30 minutes a day, 5 days a week. Children and adolescents should get 1 hour of physical activity every day.

Do Not Smoke

Smoking raises your blood pressure and puts you at higher risk for heart attack and stroke. If you do not smoke, do not start. If you do smoke, quitting will lower your risk for heart disease. Your doctor can suggest ways to help you quit.

For more information about tobacco use and quitting, see CDC’s Smoking and Tobacco Use Web site.

Limit How Much Alcohol You Drink

Do not drink too much alcohol, which can raise your blood pressure. Men should have no more than 2 alcoholic drinks per day, and women should have no more than 1 alcoholic drink per day. Visit the CDC’s Alcohol and Public Health website for more information.

Get Enough Sleep

Getting enough sleep is important to your overall health, and enough sleep is part of keeping your heart and blood vessels healthy. Not getting enough sleep on a regular basis is linked to an increased risk of heart disease, high blood pressure, and stroke.

If you have been diagnosed with high blood pressure, it is important that you continue your treatment plan. You will need regular follow-up care and may want to learn how to monitor your condition at home. Your doctor may need to change or add medicines to your treatment plan over time. Let your healthcare team know if you are planning to become pregnant.

Manage your condition

Keep up your treatment plan, including healthy lifestyle changes, to help control your blood pressure and prevent heart disease. Making lifestyle changes and remembering your medicine every day can be hard, but there are ways to help.

• Ask your doctor, nurse, or pharmacist about apps for monitoring and tracking your blood pressure. They also may know a way to get texts to remind you to take your medicine every day and notify you when it’s time to fill your prescription.
• Get support from loved ones and others in your community.
• Have regular medical checkups and tests, as your doctor advises. Ask questions and discuss your progress. Let your doctor know if you have any new conditions or have been taking new medicines since your last appointment.
• Your doctor may want you to check your blood pressure at home or other locations that have blood pressure equipment. Return to Screening for reminders on how to prepare for blood pressure testing and how to take your blood pressure yourself.

Know when to call for help for complications

Readings above 180/120 mm Hg are dangerously high and require immediate medical attention. Blood pressure this high can damage your organs. Call 9-1-1 if you experience:

• A sudden, severe headache
• Difficulty breathing
• Sudden, severe pain in your abdomen, chest, or back

High blood pressure can also lead to heart attack or stroke. Call 9-1-1 if you suspect this is happening to you or someone else.

Heart attack

The signs and symptoms of a heart attack include:

• Nausea, vomiting, light-headedness or fainting, or breaking out in a cold sweat. These symptoms of a heart attack are more common in women.
• Prolonged or severe chest pain or discomfort not relieved by rest or nitroglycerin. This involves uncomfortable pressure, squeezing, fullness, or pain in the center or left side of the chest that can be mild or strong. This pain or discomfort often lasts more than a few minutes or goes away and comes back.
• Shortness of breath. This may accompany chest discomfort or happen before it.
• Upper body discomfort. This can be felt in one or both arms, the back, neck, jaw, or upper part of the stomach.

Stroke

If you think someone may be having a stroke, act F.A.S.T. and perform the following simple test.

• F—Face: Ask the person to smile. Does one side of the face droop?
• A—Arms: Ask the person to raise both arms. Does one arm drift downward?
• S—Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange?
• T—Time: If you observe any of these signs, call for help immediately. Early treatment is essential.

Too many kids and teens have high blood pressure (hypertension) and other risk factors for heart disease and stroke. Using the updated 2017 American Academy of Pediatrics (AAP) Clinical Practice Guideline, a CDC study shows that about 1 in 25 youth ages 12 to 19 have hypertension, and 1 in 10 has elevated blood pressure (previously called “prehypertension”). High blood pressure is more common in youth with obesity.

High blood pressure in youth is linked to health problems later in life. The good news is that you can both help prevent high blood pressure and manage it.

Study Finds Many Young People Have High Blood Pressure

CDC analyzed data from more than 12,000 participants ages 12 to 19 who responded to the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2016. CDC used these data to find out how the 2017 AAP Clinical Practice Guideline affects hypertension trends in youth over time.

Using the new guideline’s criteria, CDC found that more than 1 in 7 U.S. youth ages 12 to 19 had high blood pressure or elevated blood pressure during 2013 to 2016.

Ask your doctor to measure your child’s blood pressure starting at age 3.

Key findings from the Morbidity and Mortality Weekly Report (MMWR) include:

• High blood pressure in youth has decreased, but youth are still at risk. Between 2001 and 2016, the prevalence of high blood pressure declined as measured by both the new and former guidelines. But there are still many young people with high blood pressure and other cardiovascular disease risk factors, such as obesity and diabetes. Even with this downward trend, under the new guideline more youth are classified as having high blood pressure than 15 years ago under the former guideline.
• The new guideline changes the numbers and uses a lower threshold for high blood pressure. Compared to the former guideline, the updated guideline reclassifies 2.6% of youth in the United States, or nearly 800,000 young people, as having high blood pressure.
  • Nearly half of these newly reclassified young people have obesity. Obesity in youth means having a body mass index (BMI) greater than or equal to the 95th percentile. (Calculate your child’s BMI.)
  • Youth ages 18 to 19 account for about half of the increase, and males account for more than two thirds.

• Read the 2017 AAP Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents.

  Listen to a CDC podcast about hypertension among youth.

  An estimated 1.3 million youth ages 12 to 19 would have high blood pressure according to the new guidelines, or about 1 in 25 children. In a classroom of 30 youth, 1 person would have hypertension, and about 3 more would have elevated blood pressure.

• Risks for cardiovascular disease that start in childhood are more likely to carry over into adulthood. Youth who have cardiovascular disease risk factors, such as high blood pressure, obesity, and diabetes, are more likely to have these risk factors as adults, putting them at greater risk for heart disease and stroke.
• A healthy diet and regular exercise are important to reducing these risk factors. Ensuring that youth are eating a healthy diet and getting enough physical activity is crucial to helping prevent cardiovascular disease.

What can parents do?

Ask your doctor to measure your child’s blood pressure starting at age 3. Helping children keep a healthy weight, eat nutritious foods, and get regular physical activity can lower their blood pressure and reduce their risk for cardiovascular disease later in life. Try these tips to help your child keep a healthy weight and normal blood pressure:

Food and Drinks

• Offer nutritious, lower-calorie foods such as fruits and vegetables in place of foods high in added sugars and solid fats. Try serving more fruits and vegetables at meals and as snacks.
• Provide foods that are low in sodium (salt). Sodium raises blood pressure. Nearly 9 in 10 U.S. children eat more sodium than is recommended. Learn more about sodium.
• Make sure water is always available as a no-calorie alternative to sugary drinks, and limit juice.

Physical Activity

• Help your child get the recommended amount of physical activity each day. Choose from many age-appropriate activities.

Healthy Weight

• Be aware of your child’s growth. Learn how obesity is measured in children, and screen your child for potential weight issues.

Get Involved

• Be a role model! Eat healthy meals and snacks, and get the right amount of physical activity every day.

Your doctor or nurse should look for these conditions before, during, and after pregnancy:

Chronic Hypertension

Chronic hypertension means having high blood pressure before you get pregnant or before 20 weeks of pregnancy. Women who have chronic hypertension can also get preeclampsia in the second or third trimester of pregnancy.

Gestational Hypertension

This condition happens when you only have high blood pressure during pregnancy and do not have protein in your urine or other heart or kidney problems. It is typically diagnosed after 20 weeks of pregnancy or close to delivery. Gestational hypertension usually goes away after you give birth. However, some women with gestational hypertension have a higher risk of developing chronic hypertension in the future.

Preeclampsia/Eclampsia

Preeclampsia happens when a woman who previously had normal blood pressure suddenly develops high blood pressure and protein in her urine or other problems after 20 weeks of pregnancy. Women who have chronic hypertension can also get preeclampsia.

Preeclampsia happens in about 1 in 25 pregnancies in the United States. Some women with preeclampsia can develop seizures. This is called eclampsia, which is a medical emergency.

Symptoms of preeclampsia include:

• A headache that will not go away
• Changes in vision, including blurry vision, seeing spots, or having changes in eyesight
• Pain in the upper stomach area
• Nausea or vomiting
• Swelling of the face or hands
• Sudden weight gain
• Trouble breathing

Some women have no symptoms of preeclampsia, which is why it is important to visit your health care team regularly, especially during pregnancy.

You are more at risk for preeclampsia if:

• This is the first time you have given birth.
• You had preeclampsia during a previous pregnancy.
• You have chronic (long-term) high blood pressure, chronic kidney disease, or both.
• You have a history of thrombophilia (a condition that increases risk of blood clots).
• You are pregnant with multiple babies (such as twins or triplets).
• You became pregnant using in vitro fertilization.
• You have a family history of preeclampsia.
• You have type 1 or type 2 diabetes.
• You have obesity.
• You have lupus (an autoimmune disease).
• You are older than 40.

In rare cases, preeclampsia can happen after you have given birth. This is a serious medical condition known as postpartum preeclampsia. It can happen in women without any history of preeclampsia during pregnancy. The symptoms for postpartum preeclampsia are similar to the symptoms of preeclampsia. Postpartum preeclampsia is typically diagnosed within 48 hours after delivery but can happen up to 6 weeks later.

Tell your health care provider or call 9-1-1 right away if you have symptoms of postpartum preeclampsia. You might need emergency medical care.

What you don’t know about high blood pressure could hurt you. High blood pressure affects nearly half of the adult population in the United States, yet many people who have the condition don’t know they have it.

Uncontrolled high blood pressure raises the risk for heart disease and stroke, which are leading causes of death in the United States. Fortunately, high blood pressure is treatable and preventable.

To lower your risk, get your blood pressure checked regularly and take action to control your blood pressure if it is high.

1. High blood pressure may be linked to dementia.
2. Young people can have high blood pressure, too.
3. High blood pressure usually doesn’t have any symptoms.
4. Many people who have high blood pressure don’t know it.
5. Women and African Americans face unique risks when it comes to high blood pressure.

Recent studies show that high blood pressure is linked to a higher risk for dementia, a loss of cognitive function. Timing seems to matter. Evidence suggests that having uncontrolled high blood pressure during midlife (ages 44 to 66) creates a higher risk for dementia later in life. The takeaway? It’s never too early to start thinking about your blood pressure and taking steps to manage your high blood pressure.

High blood pressure doesn’t just happen to older adults. Nearly 1 in 4 adults aged 20 to 44 have high blood pressure.

High blood pressure is a leading cause of stroke, a condition that is on the rise among younger people. Experts think the increased risk for stroke in this age group is a direct result of the rising rates of obesity, high blood pressure, and type 2 diabetes—conditions that are preventable and treatable.

Ask your health care team how often you should check your blood pressure. You can get your blood pressure checked at a doctor’s office or pharmacy, and you can check it at home if you have a home blood pressure monitor.

High blood pressure is sometimes called the “silent killer.” Most people with high blood pressure don’t have any symptoms. Because many people feel fine, they don’t think they need to get their blood pressure checked.

Even if you feel normal, your health may be at risk. Talk to your doctor about your risk for high blood pressure.

About 1 in 3 U.S. adults with high blood pressure aren’t even aware they have it and are not being treated to control their blood pressure.

Even though most people with uncontrolled high blood pressure have health insurance and visit a health care team member at least twice a year, the condition is often not diagnosed. CDC is working with health care professionals to find patients with high blood pressure who are “hiding in plain sight.”

Ask your health care team what your blood pressure numbers mean and if they are too high. Stick to your treatment plan and follow your provider’s advice if you are diagnosed with high blood pressure.

Women with high blood pressure who become pregnant are more likely to have complications during pregnancy than those with normal blood pressure. High blood pressure during pregnancy can harm a mother’s kidneys and other organs, and it can lead to premature delivery and low birth weight babies.

Some types of birth control can also raise a woman’s risk for high blood pressure. Women with high blood pressure who want to become pregnant should work with their health care team to lower their blood pressure before becoming pregnant.

African American men and women have higher rates of high blood pressure than any other racial or ethnic group.These individuals are also more likely to be hospitalized for high blood pressure. Experts think these health disparities are tied to higher rates of obesity and diabetes.

By living a healthy lifestyle, you can help keep your blood pressure in a healthy range and lower your risk for heart disease and stroke. A healthy lifestyle includes:

• Eating a healthy diet
• Maintaining a healthy weight
• Getting enough physical activity
• Not smoking
• Limiting alcohol use

Lifestyle changes, such as reducing sodium in your diet, being more physically active, and reducing stress, can help lower blood pressure.