Hypertension (high blood pressure) is a condition in which the force of blood pushing against the walls of the arteries stays too high over time. Nearly half of U.S. adults have high blood pressure, and many do not know it because it usually causes no symptoms. Left uncontrolled, hypertension quietly damages blood vessels throughout the body, raising the risk of stroke, coronary artery disease, heart failure, kidney disease, and vision loss. Causes and Risk Factors: Most people have primary (essential) hypertension, which develops gradually over many years without a single identifiable cause. Several factors raise the risk:

Age and family history: Blood pressure tends to rise with age, and hypertension often runs in families.
Diet high in sodium: Excess salt causes the body to hold on to fluid, which increases the pressure inside the arteries.
Excess weight and inactivity: Carrying extra weight and getting little physical activity both force the heart to work harder.
Alcohol and tobacco: Heavy drinking raises blood pressure, and nicotine temporarily tightens blood vessels while damaging artery walls over time.
Other medical conditions: Kidney disease, sleep apnea, thyroid disorders, and diabetes can cause or worsen high blood pressure; this is called secondary hypertension.

Symptoms: Hypertension is often called the "silent killer" because most people feel completely normal even when their readings are dangerously high. When blood pressure rises to severe levels, it can cause:

Headaches: Particularly with very high readings, though most headaches are not caused by blood pressure.
Vision changes or nosebleeds: Signs that small blood vessels are under strain.
Chest pain or shortness of breath: These symptoms alongside a high reading require emergency evaluation.

Diagnosis: According to the National Heart, Lung, and Blood Institute, normal blood pressure is below 120/80 mmHg. Hypertension is diagnosed when readings are consistently elevated on at least two separate occasions, and home blood pressure monitoring is often used to confirm the pattern and rule out "white coat" elevation from clinic-visit nerves. Your physician will also check kidney function, blood sugar, and cholesterol levels, and may order an electrocardiogram to look for early effects on the heart. Treatment goals are individualized, but most adults benefit from keeping readings below 130/80 mmHg. Treatment: Treatment starts with lifestyle changes and adds medication when readings stay above goal:

Lifestyle changes: A low-sodium eating plan such as the DASH diet, regular aerobic exercise, weight loss, limiting alcohol, and quitting smoking can each lower blood pressure meaningfully.
Thiazide diuretics: Medications such as hydrochlorothiazide help the kidneys remove excess salt and fluid.
ACE inhibitors and ARBs: Medications such as lisinopril, losartan, valsartan, and olmesartan relax blood vessels and help protect the kidneys.
Calcium channel blockers: Medications such as amlodipine relax the muscle within artery walls.
Beta-blockers: Medications such as metoprolol and carvedilol are often chosen when there is coexisting heart disease.
Additional agents: Spironolactone or hydralazine may be added when blood pressure resists standard combinations.

Many people eventually need two or more medications to reach their goal; this is common and does not mean treatment has failed. When to Seek Immediate Care: A reading of 180/120 mmHg or higher accompanied by chest pain, shortness of breath, sudden weakness or numbness, vision loss, confusion, or a severe headache is a hypertensive emergency — call 911. High blood pressure is one of the most treatable causes of heart attack and stroke, but it requires regular follow-up. The primary-care team at Zimmer Medical Group checks blood pressure at every visit and tailors treatment to each patient's overall cardiovascular risk.

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Hypertension (High Blood Pressure)

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