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High blood pressure is a common disease in which blood flows through blood vessels (arteries) at higher than normal pressures.
                
Measuring Blood Pressure
                
Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps blood. High blood pressure, sometimes called hypertension, happens when this force is too high. Health care workers check blood pressure readings the same way for children, teens, and adults. They use a gauge, stethoscope or electronic sensor, and a blood pressure cuff. With this equipment, they measure:
                
Systolic Pressure: blood pressure when the heart beats while pumping blood
                
Diastolic Pressure: blood pressure when the heart is at rest between beats
                
Health care workers write blood pressure numbers with the systolic number above the diastolic number. For example:
                

                
118/76 mmHg People read "118 over 76" millimeters of mercury.
                
Normal Blood Pressure
                
Normal blood pressure for adults is defined as a systolic pressure below 120 mmHg and a diastolic pressure below 80 mmHg. It is normal for blood pressures to change when you sleep, wake up, or are excited or nervous. When you are active, it is normal for your blood pressure to increase. However, once the activity stops, your blood pressure returns to your normal baseline range.
                
Blood pressure normally rises with age and body size. Newborn babies often have very low blood pressure numbers that are considered normal for babies, while older teens have numbers similar to adults.
                
Abnormal Blood Pressure
                
Abnormal increases in blood pressure are defined as having blood pressures higher than 120/80 mmHg. The following table outlines and defines high blood pressure severity levels.
                
Stages of High Blood Pressure in Adults
                
The ranges in the table are blood pressure guides for adults who do not have any short-term serious illnesses. People with diabetes or chronic kidney disease should keep their blood pressure below 130/80 mmHg.
                
Although blood pressure increases seen in prehypertension are less than those used to diagnose high blood pressure, prehypertension can progress to high blood pressure and should be taken seriously. Over time, consistently high blood pressure weakens and damages your blood vessels, which can lead to complications.
                
Types of High Blood Pressure
                
There are two main types of high blood pressure: primary and secondary high blood pressure.
                
Primary High Blood Pressure
                
Primary, or essential, high blood pressure is the most common type of high blood pressure. This type of high blood pressure tends to develop over years as a person ages.
                
Secondary High Blood Pressure
                
Secondary high blood pressure is caused by another medical condition or use of certain medicines. This type usually resolves after the cause is treated or removed.
Anyone can develop high blood pressure; however, age, race or ethnicity, being overweight, gender, lifestyle habits, and a family history of high blood pressure can increase your risk for developing high blood pressure.
                
Age
                
Blood pressure tends to rise with age. About 65 percent of Americans age 60 or older have high blood pressure. However, the risk for prehypertension and high blood pressure is increasing for children and teens, possibly due to the rise in the number of overweight children and teens.
                
Race/Ethnicity
                
High blood pressure is more common in African American adults than in Caucasian or Hispanic American adults. Compared with these ethnic groups, African Americans:
                
Tend to get high blood pressure earlier in life.
                
Often, on average, have higher blood pressure numbers.
                
Are less likely to achieve target blood pressure goals with treatment.
                
Overweight
                
You are more likely to develop prehypertension or high blood pressure if youre overweight or obese. The terms overweight and obese refer to body weight thats greater than what is considered healthy for a certain height.
                
Gender
                
Before age 55, men are more likely than women to develop high blood pressure. After age 55, women are more likely than men to develop high blood pressure.
                
Lifestyle Habits
                
Unhealthy lifestyle habits can raise your risk for high blood pressure, and they include:
                
Eating too much sodium or too little potassium
                
Lack of physical activity
                
Drinking too much alcohol
                
Stress
                
Family History
                
A family history of high blood pressure raises the risk of developing prehypertension or high blood pressure. Some people have a high sensitivity to sodium and salt, which may increase their risk for high blood pressure and may run in families. Genetic causes of this condition are why family history is a risk factor for this condition.
Because diagnosis is based on blood pressure readings, this condition can go undetected for years, as symptoms do not usually appear until the body is damaged from chronic high blood pressure.
                

                
Complications of High Blood Pressure
                
When blood pressure stays high over time, it can damage the body and cause complications. Some common complications and their signs and symptoms include:
                
Aneurysms:When an abnormal bulge forms in the wall of an artery. Aneurysms develop and grow for years without causing signs or symptoms until they rupture, grow large enough to press on nearby body parts, or block blood flow. The signs and symptoms that develop depend on the location of the aneurysm.
                
Chronic Kidney Disease: When blood vessels narrow in the kidneys, possibly causing kidney failure.
                
Cognitive Changes: Research shows that over time, higher blood pressure numbers can lead to cognitive changes. Signs and symptoms include memory loss, difficulty finding words, and losing focus during conversations.
                
Eye Damage: When blood vessels in the eyes burst or bleed. Signs and symptoms include vision changes or blindness.
                
Heart Attack: When the flow of oxygen-rich blood to a section of heart muscle suddenly becomes blocked and the heart doesnt get oxygen. The most common warning symptoms of a heart attack are chest pain or discomfort, upper body discomfort, and shortness of breath.
                
Heart Failure: When the heart cant pump enough blood to meet the bodys needs. Common signs and symptoms of heart failure include shortness of breath or trouble breathing; feeling tired; and swelling in the ankles, feet, legs, abdomen, and veins in the neck.
                
Peripheral Artery Disease: A disease in which plaque builds up in leg arteries and affects blood flow in the legs. When people have symptoms, the most common are pain, cramping, numbness, aching, or heaviness in the legs, feet, and buttocks after walking or climbing stairs.
                
Stroke: When the flow of oxygen-rich blood to a portion of the brain is blocked. The symptoms of a stroke include sudden onset of weakness; paralysis or numbness of the face, arms, or legs; trouble speaking or understanding speech; and trouble seeing.
For most patients, health care providers diagnose high blood pressure when blood pressure readings areconsistently 140/90 mmHg or above.
                
Confirming High Blood Pressure
                
A blood pressure test is easy and painless and can be done in a health care providers office or clinic. To prepare for the test:
                
Dont drink coffee or smoke cigarettes for 30 minutes prior to the test.
                
Go to the bathroom before the test.
                
Sit for 5 minutes before the test.
                
To track blood pressure readings over a period of time, the health care provider may ask you to come into the office on different days and at different times to take your blood pressure. The health care provider also may ask you to check readings at home or at other locations that have blood pressure equipment and to keep a written log of all your results.
                
Whenever you have an appointment with the health care provider, be sure to bring your log of blood pressure readings. Every time you visit the health care provider, he or she should tell you what your blood pressure numbers are; if he or she does not, you should ask for your readings.
                
Blood Pressure Severity and Type
                
Your health care provider usually takes 23 readings at several medical appointments to diagnose high blood pressure. Using the results of your blood pressure test, your health care provider will diagnose prehypertension or high blood pressure if:
                
Your systolic or diastolic readings are consistently higher than 120/80 mmHg.
                
Your childs blood pressure numbers are outside average numbers for children of the same age, gender, and height.
                
Once your health care provider determines the severity of your blood pressure, he or she can order additional tests to determine if your blood pressure is due to other conditions or medicines or if you have primary high blood pressure. Health care providers can use this information to develop your treatment plan.
                
Some people have white coat hypertension. This happens when blood pressure readings are only high when taken in a health care providers office compared with readings taken in any other location. Health care providers diagnose this type of high blood pressure by reviewing readings in the office and readings taken anywhere else. Researchers believe stress, which can occur during the medical appointment, causes white coat hypertension.
Healthy lifestyle habits, proper use of medicines, and regular medical care can prevent high blood pressure or its complications.
                
Preventing High Blood Pressure Onset
                
Healthy lifestyle habits can help prevent high blood pressure from developing. It is important to check your blood pressure regularly. Children should have their blood pressure checked starting at 3 years of age. If prehypertension is detected, it should be taken seriously to avoid progressing to high blood pressure. 
                
Preventing Worsening High Blood Pressure or Complications
                
If you have been diagnosed with high blood pressure, it is important to obtain regular medical care and to follow your prescribed treatment plan, which will include healthy lifestyle habit recommendations and possibly medicines. Not only can healthy lifestyle habits prevent high blood pressure from occurring, but they can reverse prehypertension and help control existing high blood pressure or prevent complications and long-term problems associated with this condition, such as coronary heart disease, stroke, or kidney disease.
Metabolic syndrome has several causes that act together. You can control some of the causes, such as overweight and obesity, an inactive lifestyle, and insulin resistance.
                
You can't control other factors that may play a role in causing metabolic syndrome, such as growing older. Your risk for metabolic syndrome increases with age.
                
You also can't control genetics (ethnicity and family history), which may play a role in causing the condition. For example, genetics can increase your risk for insulin resistance, which can lead to metabolic syndrome.
                
People who have metabolic syndrome often have two other conditions: excessive blood clotting and constant, low-grade inflammation throughout the body. Researchers don't know whether these conditions cause metabolic syndrome or worsen it.
                
Researchers continue to study conditions that may play a role in metabolic syndrome, such as:
                
A fatty liver (excess triglycerides and other fats in the liver)
                
Polycystic ovarian syndrome (a tendency to develop cysts on the ovaries)
                
Gallstones
                
Breathing problems during sleep (such as sleep apnea)
People at greatest risk for metabolic syndrome have these underlying causes:
                
Abdominal obesity (a large waistline)
                
An inactive lifestyle
                
Insulin resistance
                
Some people are at risk for metabolic syndrome because they take medicines that cause weight gain or changes in blood pressure, blood cholesterol, and blood sugar levels. These medicines most often are used to treat inflammation, allergies, HIV, and depression and other types of mental illness.
                
Populations Affected
                
Some racial and ethnic groups in the United States are at higher risk for metabolic syndrome than others. Mexican Americans have the highest rate of metabolic syndrome, followed by whites and blacks.
                
Other groups at increased risk for metabolic syndrome include:
                
People who have a personal history of diabetes
                
People who have a sibling or parent who hasdiabetes
                
Women when compared with men
                
Women who have a personal history of polycystic ovarian syndrome (a tendency to develop cysts on the ovaries)
                
Heart Disease Risk
                
Metabolic syndrome increases your risk for coronary heart disease. Other risk factors, besides metabolic syndrome, also increase your risk for heart disease. For example, a high LDL (bad) cholesterol level and smoking are major risk factors for heart disease. For details about all of the risk factors for heart disease, go to the Coronary Heart Disease Risk Factors HealthTopic.
                
Even if you dont have metabolic syndrome, you should find out your short-term risk for heart disease. The National Cholesterol Education Program (NCEP) divides short-term heart disease risk into four categories. Your risk category depends on which risk factors you have and how many you have.
                
Your risk factors are used to calculate your 10-year risk of developing heart disease. The NCEP has an online calculator that you can use to estimate your 10-year risk of having a heart attack.
                
High risk: Youre in this category if you already have heart disease or diabetes, or if your 10-year risk score is more than 20 percent.
                
Moderately high risk: Youre in this category if you have two or more risk factors and your 10-year risk score is 10 percent to 20 percent.
                
Moderate risk: Youre in this category if you have two or more risk factors and your 10-year risk score is less than 10 percent.
                
Lower risk: Youre in this category if you have zero or one risk factor.
                
Even if your 10-year risk score isnt high, metabolic syndrome will increase your risk for coronary heart disease over time.
Metabolic syndrome is a group of risk factors that raises your risk for heart disease and other health problems, such as diabetes and stroke. These risk factors can increase your risk for health problems even if they're only moderately raised (borderline-high risk factors).
                
Most of the metabolic risk factors have no signs or symptoms, although a large waistline is a visible sign.
                
Some people may have symptoms of high blood sugar if diabetesespecially type 2 diabetesis present. Symptoms of high blood sugar often include increased thirst; increased urination, especially at night; fatigue (tiredness); and blurred vision.
                
High blood pressure usually has no signs or symptoms. However, some people in the early stages of high blood pressure may have dull headaches, dizzy spells, or more nosebleeds than usual.
Your doctor will diagnose metabolic syndrome based on the results of a physical exam and blood tests. You must have at least three of the five metabolic risk factors to be diagnosed with metabolic syndrome.
                
Metabolic Risk Factors
                
A Large Waistline
                
Having a large waistline means that you carry excess weight around your waist (abdominal obesity). This is also called having an "apple-shaped" figure. Your doctor will measure your waist to find out whether you have a large waistline.
                
A waist measurement of 35 inches or more for women or 40 inches or more for men is a metabolic risk factor. A large waistline means you're at increased risk for heart disease and other health problems.
                
A High Triglyceride Level
                
Triglycerides are a type of fat found in the blood. A triglyceride level of 150 mg/dL or higher (or being on medicine to treat high triglycerides) is a metabolic risk factor. (The mg/dL is milligrams per deciliterthe units used to measure triglycerides, cholesterol, and blood sugar.)
                
A Low HDL Cholesterol Level
                
HDL cholesterol sometimes is called "good" cholesterol. This is because it helps remove cholesterol from your arteries.
                
An HDL cholesterol level of less than 50 mg/dL for women and less than 40 mg/dL for men (or being on medicine to treat low HDL cholesterol) is a metabolic risk factor.
                
High Blood Pressure
                
A blood pressure of 130/85 mmHg or higher (or being on medicine to treat high blood pressure) is a metabolic risk factor. (The mmHg is millimeters of mercurythe units used to measure blood pressure.)
                
If only one of your two blood pressure numbers is high, you're still at risk for metabolic syndrome.
                
High Fasting Blood Sugar
                
A normal fasting blood sugar level is less than 100 mg/dL. A fasting blood sugar level between 100125 mg/dL is considered prediabetes. A fasting blood sugar level of 126 mg/dL or higher is considered diabetes.
                
A fasting blood sugar level of 100 mg/dL or higher (or being on medicine to treat high blood sugar) is a metabolic risk factor.
                
About 85 percent of people who have type 2 diabetesthe most common type of diabetesalso have metabolic syndrome. These people have a much higher risk for heart disease than the 15 percent of people who have type 2 diabetes without metabolic syndrome.
Making heart-healthy lifestyle choices is the best way to prevent metabolic syndrome by:
                
Being physically active
                
Following a heart-healthy eating plan
                
Knowing your weight, waist measurement, and body mass index
                
Maintaining a healthy weight
                
Make sure to schedule routine doctor visits to keep track of your cholesterol, blood pressure, and blood sugar levels. Speak with your doctor about a blood test called a lipoprotein panel, which shows your levels of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides.
Coronary Heart Disease
                
A heart attack happens if the flow of oxygen-rich blood to a section of heart muscle suddenly becomes blocked and the heart can't get oxygen. Most heart attacks occur as a result of coronary heart disease (CHD).
                
CHD is a condition in which a waxy substance called plaque builds up inside of the coronary arteries. These arteries supply oxygen-rich blood to your heart.
                
When plaque builds up in the arteries, the condition is called atherosclerosis. The buildup of plaque occurs over many years.
                
Eventually, an area of plaque can rupture (break open) inside of an artery. This causes a blood clot to form on the plaque's surface. If the clot becomes large enough, it can mostly or completely block blood flow through a coronary artery.
                
If the blockage isn't treated quickly, the portion of heart muscle fed by the artery begins to die. Healthy heart tissue is replaced with scar tissue. This heart damage may not be obvious, or it may cause severe or long-lasting problems.
                
Coronary Artery Spasm
                
A less common cause of heart attack is a severe spasm (tightening) of a coronary artery. The spasm cuts off blood flow through the artery. Spasms can occur in coronary arteries that aren't affected by atherosclerosis.
                
What causes a coronary artery to spasm isn't always clear. A spasm may be related to:
                
Taking certain drugs, such as cocaine
                
Emotional stress or pain
                
Exposure to extreme cold
                
Cigarette smoking
Certain risk factors make it more likely that you'll develop coronary heart disease (CHD) and have a heart attack. You can control many of these risk factors.
                
Risk Factors You Can Control
                
The major risk factors for a heart attack that you can control include:
                
Smoking
                
High blood pressure
                
High blood cholesterol
                
Overweight and obesity
                
An unhealthy diet (for example, a diet high in saturated fat, trans fat, cholesterol, and sodium)
                
Lack of routine physical activity
                
High blood sugar due to insulin resistance or diabetes
                
Some of these risk factorssuch as obesity, high blood pressure, and high blood sugartend to occur together. When they do, it's called metabolic syndrome.
                
In general, a person who has metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes as someone who doesn't have metabolic syndrome.
                
For more information about the risk factors that are part of metabolic syndrome, go to the Health Topics Metabolic Syndrome article.
                
Risk Factors You Can't Control
                
Risk factors that you can't control include:
                
Age. The risk of heart disease increases for men after age 45 and for women after age 55 (or after menopause).
                
Family history of early heart disease. Your risk increases if your father or a brother was diagnosed with heart disease before 55 years of age, or if your mother or a sister was diagnosed with heart disease before 65 years of age.
                
Preeclampsia (pre-e-KLAMP-se-ah). This condition can develop during pregnancy. The two main signs of preeclampsia are a rise in blood pressure and excess protein in the urine. Preeclampsia is linked to an increased lifetime risk of heart disease, including CHD, heart attack, heart failure, and high blood pressure.