Hypertension

1 What is High Blood Pressure (Hypertension)?

High blood pressure, also called hypertension is a common condition in which blood flows in your arteries at a pressure higher than normal. The long-term force of the blood pushing against the walls of your arteries is high enough to cause health problems, such as heart disease.

Blood pressure is determined by the amount of blood pumped by your heart as well as the amount of resistance to the arterial blood flow. The more blood your heart pumps and the narrower your arteries, the higher is your blood pressure.

High blood pressure generally takes several years to develop, during this time, there may be no symptoms at all, but damage to your heart and blood vessels continue and is detectable.

Uncontrolled high blood pressure increases your risk of serious health problems such as heart attack and stroke. Fortunately, it is easy to detect high blood pressure, and once you know you have high blood pressure, your doctor can help to control it.

2 Symptoms

A vast majority of people with high blood pressure may remain asymptomatic, even though their blood pressure readings are high.

Symptoms do not usually appear until long-term blood pressure causes damage to your body. Some people with high blood pressure may have symptoms such as headaches, nosebleeds or shortness of breath, but these signs are non-specific and occur only when high blood pressure reaches a life-threatening stage.

When to see a doctor

You will have your blood pressure measured as part of a routine health check-up. Ask your doctor for a blood pressure reading at least every two years starting at the age of 18.

If you are at 40 or older, or between 18 and 39 with a high risk of high blood pressure, ask your doctor for a blood pressure reading every year. Your doctor will recommend more frequent readings if you have been diagnosed with high blood pressure or have other risk factors for cardiovascular disease.

Children of the age 3 and above will usually have their blood pressure measured as a part of their annual checkups.

If you do not consult your doctor regularly, you may get a free blood pressure reading at a health resource fair or other locations in your community. You can also find machines in some stores that will measure your blood pressure for free.

Public blood pressure machines found in pharmacies may provide helpful information about your blood pressure, but they do have some limitations.  The accuracy of these machines depends on factors, such as a correct cuff size and proper use of the machines. Ask your doctor for advice on using these public blood pressure machines.

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3 Causes

The causes of high blood pressure (hypertension) may vary depending on its type.

There are two types of high blood pressure:

  • Primary (essential) hypertension: The type of high blood pressure in which there is no identifiable cause is called primary (essential) hypertension. It occurs in most adults, and tends to develop slowly over many years.
  • Secondary hypertension: In some people, high blood pressure may be caused by an underlying condition. This type of high blood pressure is called secondary hypertension, and appears suddenly resulting in higher blood pressure than primary hypertension.Various conditions and medications can lead to secondary hypertension, including:
  • Obstructive sleep apnea 
  • Kidney problems
  • Kidney fluid and salt balances: In normal conditions, the kidneys help in regulating our body’s salt balance by allowing retention of sodium and water and excreting potassium. Imbalances occurring in these kidney functions causes expansion of blood volume, which in turn causes high blood pressure.
  • Renin-Angiotensin-Aldosterone System: The renin-angiotensin-aldosterone system is responsible for the production of angiotensin and aldosterone hormones.
  • Angiotensin leads to narrowing or constriction of blood vessels, which causes an increase in blood pressure. Aldosterone controls the way our kidneys maintain a balance in fluid and salt levels.
  • Increased levels or activity of aldosterone may alter this function of kidney, which leads to increased blood volumes and higher blood pressure.
  • Adrenal gland tumors 
  • Thyroid problems 
  • Certain defects in blood vessels present at birth (congenital): Abnormalities in the structure and function of small and large arteries contribute to high blood pressure.

Environmental causes of high blood pressure include unhealthy lifestyle habits, being overweight or obese, and medicines:

  • Unhealthy lifestyle habits include lack of physical activity, high salt intake in food, and drinking excessive amounts of alcohol.
  • Being overweight or obese increases the resistance in your blood vessels, and makes your heart to work hard, which leads to development of high blood pressure.
  • Prescription medications such as asthma, hormone treatments including birth control pills and estrogen, and over-the-counter medicines such as pain relievers, decongestants, and cold remedies may cause this form of high blood pressure. This happens because medicines can change the way your body controls fluid and salt balances, cause your blood vessels to constrict, or impact the renin-angiotensin-aldosterone system leading to high blood pressure.
  • Illegal drugs, such as cocaine and amphetamines

Genetic Causes

High blood pressure often runs in families. Several genetic mutations in the renal salt regulatory and renin-angiotensin-aldosterone pathways have been associated with high blood pressure. But, these genetic factors account for only 2-3 percent of cases.

Recent research studies have suggested that certain DNA changes taking place during fetal development may lead to the development of high blood pressure later in life.

4 Making a Diagnosis

If you think you may have high blood pressure (hypertension) make an appointment with your family physician to have your blood pressure checked and to receive a diagnosis. There are no special preparations required to have your blood pressure checked, but you may wear a short-sleeved shirt for your appointment so that the blood pressure cuff can properly fit around your arm. You should avoid having caffeinated food and drinks before going to your test. As some medications, such as over-the-counter pain medications, cold medicines, antidepressants, birth control pills can cause a raise in your blood pressure, it may be a good idea to list down all your medications and supplements and carry it along to your doctor's appointment. Do not stop taking any prescription medications that you think may affect your blood pressure without your doctor's advice. As appointments could be brief, and there will often be a lot to discuss, it is always a good idea to be prepared for your appointment.

Here is some information that can help you get ready for your appointment.

What you can do?

  • Write down if you have any symptoms. High blood pressure, usually does not have symptoms, but it is a risk factor for heart disease. Inform your doctor if you have symptoms such as chest pain or shortness of breath. It can help your doctor decide on how aggressive your high blood pressure treatment should be. 
  • Write down your key personal information, including family history of high blood pressure, high cholesterol, heart disease, stroke or diabetes, and any major stresses or recent life changes.
  • Make a list of all medications, vitamins or supplements that you take.
  • Ask a family member or a friend to come along, if possible. Sometimes, it can be difficult for you to remember all the information provided during your appointment. Someone who comes with you may remember the things you may have missed or forgotten.
  • Prepare yourself to discuss your diet and exercise habits. If you are not following a diet or exercise routine, ensure that you talk to your doctor about the challenges you might face in getting started.
  • Write down questions to ask your doctor

Preparing a list of questions you may want to ask your doctor will definitely save most of your time. For high blood pressure, some basic questions to ask your doctor include:

  • What kind of tests do I need?
  • Do I need any medications?
  • What foods should I eat or avoid?
  • What is an appropriate level of physical activity?
  • How often will my appointments be scheduled to check my blood pressure?
  • Should my blood pressure be monitored at home?
  • Are there any alternatives to the primary approach that you have suggested?
  • How can I manage my other health conditions together?
  • Are there any restrictions that I need to follow?
  • Are there generic alternatives to the medicine you have prescribed?
  • Are there any brochures or other printed material that can be taken home?
  • What websites do you recommend for further information?

What to expect from your doctor?

Your doctor may ask you a number of questions such as:

  • Do you have a family history of high cholesterol, high blood pressure or heart disease?
  • What is your diet and exercise routine like?
  • Do you smoke or drink alcohol? How many times do you drink in a week?
  • When did you have your blood pressure checked last? What was your reading then?

What you can do in the meantime?

You can adopt healthy lifestyle changes if you are at risk of having high blood pressure, and it is never too early. These changes include stopping smoking cigarettes, eating healthy foods, and becoming more physically active. These are primary defense mechanisms against high blood pressure and its complications, including heart attack and stroke.

To measure your blood pressure, your doctor will place an inflatable arm cuff around your arm and measure your blood pressure using a pressure-measuring gauge. A blood pressure reading is expressed in millimeters of mercury (mm Hg), and has two numbers. The first, or the upper number indicates the pressure in your arteries when your heart beats (systolic pressure). The second, or the lower number is a measure of the pressure in your arteries between beats (diastolic pressure).

Blood pressure measurements fall into four general categories:

  • Normal blood pressure: Your blood pressure is normal if it is below 120/80 mm Hg.
  • Prehypertension: Prehypertension is a systolic pressure, which ranges from 120 to 139 mm Hg or a diastolic pressure ranging from 80 to 89 mm Hg. Prehypertension may become worse over time.
  • Stage 1 hypertension: Stage 1 hypertension is a systolic pressure ranging from 140 to 159 mm Hg or a diastolic pressure ranging from 90 to 99 mm Hg.
  • Stage 2 hypertension: More severe hypertension, stage 2 hypertension is a systolic pressure of 160 mm Hg or higher or a diastolic pressure of 100 mm Hg or higher.

Although both numbers in a blood pressure reading are significant, but after the age of 60, the systolic blood pressure is even more important. Isolated systolic hypertension is a condition in which the systolic pressure is high (greater than 140 mm Hg), and diastolic pressure is normal (less than 90 mm Hg). This is common among people older than 60.

Your doctor will record two to three blood pressure readings each at three or more separate appointments before diagnosing you with high blood pressure.

This is because your blood pressure varies throughout the day, which is normal, and sometimes, particularly during your doctor's appointment, a condition called white coat hypertension. Your blood pressure is measured in both arms to determine if there is a difference. In some cases, your doctor may ask you to record your blood pressure at home or at work so as to get additional information.

Your doctor may also suggest a 24-hour blood pressure monitoring test called ambulatory blood pressure monitoring. The device used in this test can measure your blood pressure at regular intervals during a 24-hour period and can reveal a more accurate picture of blood pressure changes that takes place over an average day and night.

Regardless of the type of your high blood pressure, your doctor will review your medical history and conduct a physical examination.

Your doctor may also order routine tests, such as a urine test (urinalysis), blood tests, a cholesterol test, and an electrocardiogram — a test that measures your heart's electrical activity. Your doctor may also recommend additional tests, such as an echocardiogram, to check for more signs of heart disease.

Taking your blood pressure at home

Home monitoring of blood pressure is a good way to check whether your blood pressure medications are efficient or to diagnose worsening high blood pressure.

A wide range of home blood pressure monitors that are not very expensive are available, and you do not need a prescription to buy one. Your doctor will advise you on how to use home monitoring devices.

However, home blood pressure monitors do have some limitations, and are not a substitute for your doctor's visits. 

5 Treatment

Lifestyle modifications can go a long way in treating high blood pressure.

Your doctor may advise you to eat a healthy diet with less salt, exercise regularly, quit smoking, and maintain a healthy weight. But, in some people, when lifestyle changes alone are not effective, your doctor may recommend medications to lower your blood pressure.

Your blood pressure treatment goal depends on how healthy you are.

Blood pressure treatment goals

Although 120/80 mm Hg or lower is the ideal blood pressure goal, doctors are unsure whether you need treatment (medications) to reach that level.

  •  Less than 150/90 mm Hg: If you are a healthy adult of the age 60 or above.
  •  Less than 140/90 mm Hg: If you are a healthy adult of the age less than 60.
  •  Less than 140/90 mm Hg: If you have chronic kidney disease, diabetes or coronary artery disease or a high risk of coronary artery disease.

If you are of the age 60 or older, and your medications produce lower systolic blood pressure (such as less than 140 mm Hg), your medications need not be changed unless there are negative effects on your health or quality of life.

Also, people above the age of 60 often have isolated systolic hypertension, which means the diastolic pressure remains normal but systolic pressure is high. The type of medications your doctor prescribes depends on your blood pressure readings and your other medical conditions.

Medications to treat high blood pressure

  • Thiazide diuretics: Thiazide diuretics are often the first line treatment, but not the only choice in treating high blood pressure. Diuretics are sometimes called water pills that help your kidneys eliminate sodium and water thereby reducing blood volume. Thiazide diuretics include hydrochlorothiazide (Microzide), chlorthalidone, and others. A common side effect of diuretics is increased urination.
  • Beta blockers: These medications decrease the workload of your heart and open up your blood vessels, making your heart beat slower, and with lesser force. Beta blockers include acebutolol (Sectral), atenolol (Tenormin), and others. These are more effective when prescribed in combination with other blood pressure medications.
  • Angiotensin-converting enzyme (ACE) inhibitors: These medications help in relaxing the blood vessels by inhibiting the formation of a chemical that causes narrowing of blood vessels. These medications include lisinopril (Zestril), benazepril (Lotensin), captopril (Capoten), and others. This medication is beneficial in people with chronic kidney disease.
  • Angiotensin II receptor blockers (ARBs): These medications help in relaxing the blood vessels by blocking the action and not the formation of a natural chemical that narrows blood vessels. ARBs include candesartan (Atacand), losartan (Cozaar), and others. This medication is also helpful in people with chronic kidney disease.
  • Calcium channel blockers: These medications — including amlodipine (Norvasc), diltiazem (Cardizem, Tiazac, others), and others — help in relaxing the muscles of your blood vessels. Some can even slow down your heart rate. Calcium channel blockers are beneficial in older people and blacks than ACE inhibitors alone. Grapefruit juice can interact with some calcium channel blockers, increasing the blood levels of the medication, and putting you at a greater risk of side effects. 
  • Renin inhibitors: Aliskiren (Tekturna) can slow down the production of renin, an enzyme produced by your kidneys, which is required to start a chain of chemical steps that increase your blood pressure. Tekturna acts by reducing the ability of renin to begin this process. Aliskiren should not be taken with ACE inhibitors or ARBs as there is a risk of serious complications, including stroke.

Additional medications used to treat high blood pressure

If you face trouble in reaching your blood pressure goal with combinations of the above medications, your doctor may prescribe:

  • Alpha blockers: These medications can block the nerve impulses to blood vessels, thereby reducing the effects of natural chemicals that cause narrowing of blood vessels. Alpha blockers include doxazosin (Cardura), prazosin (Minipress), and others.
  • Alpha-beta blockers: In addition to blocking nerve impulses to blood vessels, alpha-beta blockers slow down the heartbeat and reduce the amount of blood that must be pumped through the vessels. Alpha-beta blockers include carvedilol (Coreg) and labetalol (Trandate). 
  • Central-acting agents: These medications act on your brain and prevent it from sending signals to your nervous system to increase your heart rate and narrow your blood vessels. Examples include clonidine (Catapres, Kapvay), guanfacine (Intuniv, Tenex), and methyldopa. 
  • Vasodilators: These medications directly act on the muscles of the arterial wall, and prevents muscle tightening and narrowing of your arteries. These include hydralazine and minoxidil.
  • Aldosterone antagonists: These medicines reduce the effect of a natural chemical that leads to salt and fluid retention, which can contribute to high blood pressure. Examples are spironolactone (Aldactone) and eplerenone (Inspra).

In order to reduce the number of daily doses you need, your doctor may advise a combination of low-dose medications rather than prescribing a larger dose of a single drug. Moreover, two or more blood pressure medications are often more effective than one. Sometimes, the most effective medication or combination of drugs can be found out only through trial and error.

Lifestyle changes to treat high blood pressure

Apart from taking the medications your doctor has prescribed, you will need to make certain lifestyle changes to lower your blood pressure.

Your doctor may recommend several lifestyle changes, including:

  • Eating a healthy diet with less salt intake (the Dietary Approaches to Stop Hypertension, or DASH, diet)
  • Exercising regularly 
  • Quitting smoking 
  • Limiting your alcohol consumption
  • Losing your weight if you are overweight or obese

Resistant hypertension (When your blood pressure is hard to control) 

If your blood pressure stays at a higher level stubbornly inspite of taking at least three different types of high blood pressure medications, one of which usually should be a diuretic, you may have resistant hypertension. People who have their high blood pressure in control, but are taking four different types of medications at the same time in order to achieve that control are said to have resistant hypertension. Generally, the possibility of a secondary cause of the high blood pressure is considered.

Resistant hypertension does not mean that your blood pressure will never get lower. There is a good chance to meet your goal by identifying the reason behind your persistently high blood pressure and treating it more effectively.

Your doctor will evaluate whether the medications and the dosage you are taking for your high blood pressure are appropriate. Sometimes, you may have to fine-tune your medications to derive the most effective combinations and doses. Addition of an aldosterone antagonist such as spironolactone (Aldactone) often helps in controlling resistant hypertension.

Some therapies such as catheter-based radio frequency ablation of renal sympathetic nerves (renal denervation) and electrical stimulation of carotid sinus baroreceptors are being experimented.

In addition, your doctor may review medications that you take for other conditions. Some medications, even foods or supplements may make your blood pressure levels high or prevent your blood pressure medications from working effectively. Be honest and inform your doctor about all the medications or supplements that you are taking.

Your blood pressure may rise out of control if you do not take your high blood pressure medications exactly as directed by your physician. If you skip some doses just because you cannot afford the medications or because you have side effects or if you simply forget to take your medications, talk to your doctor about solutions. But, do not change your medication unless your doctor has directed to do so.

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6 Prevention

The development of high blood pressure or its complications can be prevented by adoption of healthy lifestyle habits, taking medications properly, and regular medical care.

Preventing the onset of high blood pressure

Healthy lifestyle habits help in preventing high blood pressure. Get your blood pressure checked regularly. Children may have their blood pressure measured after the age of 3 years. If prehypertension has been detected, take it seriously to avoid progression to high blood pressure.

Preventing Complications or Worsening High Blood Pressure

If you have a high blood pressure, it is very important to have regular medical check-ups and follow your advised treatment plan, which will include healthy lifestyle modifications and medicines.

Adopting healthy lifestyle habits helps prevent high blood pressure from occurring, reverses prehypertension, and helps control existing high blood pressure. It also prevents complications and long-term problems associated with high blood pressure, such as coronary heart disease, stroke, or kidney disease.

7 Alternative and Homeopathic Remedies

A few alternative and homeopathic remedies exist for high blood pressure (hypertension).

There are some supplements that have been found to lower your blood pressure, however, further research is required to establish their potential benefits.

The supplements include:

  • Fiber found in wheat bran and blond psyllium
  • Minerals, such as magnesium, calcium and potassium
  • Omega-3 fatty acids found in fish oil supplements or flaxseed
  • Folic acid 
  • Supplements or products made up of cocoa, coenzyme Q10, L-arginine or garlic can increase nitric oxide or act as vasodilators and widen your blood vessels 

You can take these supplements in the form of pills or capsules, while it is good to include these supplements in your daily diet. Discuss with your doctor before taking any of these supplements as some supplements can have interactions with your blood pressure medications, resulting in serious side effects, such as an increased bleeding risk that could be life-threatening.

You can also relax yourself through techniques such as deep breathing or meditation, which help you relax and manage your stress better. These practices can lower your blood pressure temporarily.

8 Lifestyle and Coping

Lifestyle modifications are necessary in order to cope with high blood pressure (hypertension).

If you have been diagnosed with high blood pressure, it is best to discuss with your doctor about the steps to be taken to control your blood pressure.

Lifestyle changes may be done even if you have been prescribed blood pressure medications.

Be healthy by following your treatment plan closely and here is something you can do:

  • Follow a healthy diet: Try the Dietary Approaches to Stop Hypertension (DASH) diet, which stresses upon including fruits, vegetables, poultry, fish, whole grains, and low-fat dairy foods in your daily diet.Ensure good amounts of potassium in your diet to prevent and control high blood pressure. Eat less amounts of saturated fat and trans fat. Reduce your salt intake.In individuals above the age of 51 years or of any age with hypertension, diabetes, and chronic kidney disease — a sodium level of 1,500 milligrams (mg) a day is recommended. Otherwise healthy people can take about 2,300 mg a day or less. You may also reduce the intake of salt by avoiding the use of the saltshaker. You should also pay attention to the amount of salt present in the processed foods such as canned soups or frozen dinners that you eat.
  • Maintain a healthy weight: If you are overweight or obese, try losing weight to keep your high blood pressure under control, and lower your risk of related health problems. Losing even 5 pounds (2.3 kilograms) can decrease your blood pressure.
  • Increase your physical activity: Regular exercises and physical activity can help in lowering your blood pressure, managing stress, and reducing your risk of several health problems. It also keeps your weight under normal limits.For most healthy adults, the Department of Health and Human Services has recommended at least 150 minutes a week of moderate aerobic activity or 75 minutes a week of vigorous aerobic activity, or a combination or moderate and vigorous activity. Perform muscle-strengthening exercises at least twice a week.
  • Limit intake of alcohol: Alcohol can raise your blood pressure, even if you are healthy. If you want to drink alcohol, do so in moderation.For healthy adults, the limit should be one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men at or below 65. One drink equals 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80-proof liquor.
  • Quit smoking: Tobacco can damage the walls of your blood vessel and speed up the process of hardening of the arteries. Ask your doctor if you need help to stop smoking.
  • Manage your stress properly: Avoid getting stressed as much as possible. Practice healthy coping and relaxation methods, such as muscle relaxation, slow and deep breathing or meditation. Getting plenty of sleep and regular physical exercise can help, too.
  • Monitoring your blood pressure at home: Home blood pressure monitoring helps you keep a closer look on your blood pressure, checks whether your medication is effective, and also alerts you and your doctor about potential complications.Home blood pressure monitoring may have some limitations and cannot be a substitute for visits to your doctor. Do not make any changes in your diet or medications even if you get normal readings, always consult your doctor first.If your blood pressure is under control, you may need fewer visits to your doctor if you perform home blood pressure monitoring.
  • Control blood pressure during pregnancy: High blood pressure may cause problems to both the mother and her baby growing in the womb. It can affect the mother's kidneys and other organs, and can lead to premature labor and birth of low birth weight infants.If you are a woman with high blood pressure and planning to conceive, discuss with your doctor about the steps to be taken to control your blood pressure before and during the pregnancy.Sometimes, women may develop high blood pressure during pregnancy. In such cases, your doctor will closely monitor you and your baby and advise special care to reduce the chances of complications. With appropriate care, most women and babies have favorable outcomes.

Ongoing Care

High blood pressure is not a condition that can be treated and then ignored. It is important to keep track of your blood pressure and manage the condition for the rest of your life.

To maintain your blood pressure under control, take the following steps:

Take your medications regularly, and as directed by your doctor. Do not stop taking your medicines even if side effects or costs pose problems. Ask your doctor about other options.

Have regular medical checkups and tests. Often, a team effort is required for successful treatment of high blood pressure. Work with your doctor to bring your blood pressure back to a safe level, and manage it.

You may also learn to check your blood pressure at home. Every time you check your blood pressure, note down your readings and the date. Take the observed readings with you to your doctor's appointments. During your appointment, inform your doctor about:

  • Blood pressure readings
  • Your general health condition
  • Your treatment plan

Your doctor may make necessary changes or add medicines to your treatment plan.

  • Adopt healthy eating habits: Eat heart healthy foods. Limit consumption of alcohol and if you smoke, stop doing so. 
  • Manage your stress effectively: Avoid performing extra tasks, negative thoughts, maintain good relationships, and always be patient and optimistic.

Making lifestyle modifications can sometimes be difficult, specially if you do not have or feel any symptoms of high blood pressure. Remember the risks associated with uncontrolled high blood pressure if you need motivation to make lifestyle changes. It may be helpful if you derive support from your family and friends as well.

9 Risks and Complications

There are several risks and complications associated with high blood pressure (hypertension).

Any person can get high blood pressure, however, age, gender, race or ethnicity, family history, being overweight or obese, lifestyle habits, and certain chronic conditions can increase your risk of developing high blood pressure.

  • Age: The blood pressure begins to rise with advancing age. The risk of prehypertension and high blood pressure is higher in children and teenagers, probably because of an increase in the number of overweight children and teens. Atleast 65% of the American population of the age 60 or older have high blood pressure.
  • Gender: Men are more likely to develop high blood pressure than women before attaining the age of 55, whereas after the age of 55, women are more likely to develop high blood pressure.
  • Race: High blood pressure is particularly more common African American adults, often developing at an earlier age than in Caucasian or Hispanic American adults. 
  • Family history: High blood pressure tends to run in families. Having a family history of high blood pressure increases the risk of developing prehypertension or high blood pressure. 
  • Being overweight or obese: The term, overweight or obese is used when your body weight is greater than what is considered healthy for a certain height. The more you weigh, the more blood you require to supply oxygen and nutrients to your tissues. As the amount of blood getting circulated through your blood vessels increases, the pressure on your artery walls also increases. 
  • Unhealthy lifestyle habits: Lifestyle habits such as dietary intake of too much amount of salt (sodium) or too little potassium, physical inactivity, use of tobacco, drinking excessive amounts of alcohol, and unusually high levels of stress can raise your risk for high blood pressure.
  • Dietary intake of too much salt (sodium) in your diet: High amounts of sodium in your diet can cause retention of fluid in your body, which increases your blood pressure. 
  • Too less potassium in your diet: Potassium helps in maintaining a balance of the amount of sodium in your cells. If you do not take sufficient amount of potassium in your diet or do not retain enough potassium, excess amounts of sodium gets accumulated in your blood. 
  • Deficiency of vitamin D in your diet: Vitamin D may affect an enzyme released by your kidneys that affects your blood pressure. 
  • Physically inactive people: People who are inactive tend to have a higher heart rate, which makes your heart work harder with each contraction, exerting stronger force on your arteries. Lack of physical activity also increases your risk of being overweight. 
  • Use of tobacco: Smoking or chewing tobacco raises your blood pressure temporarily. The chemicals present in tobacco cause damage to the lining of your artery walls. This leads to narrowing of your arteries, thereby increasing your blood pressure. Secondhand smoke also tends to raise your blood pressure. 
  • Drinking too much alcohol: Heavy drinking causes damage to your heart over a period of time. Having more than two drinks a day for men and more than one drink a day for women may affect your blood pressure. If you drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger. One drink is equal to 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80-proof liquor.
  • Stress: High levels of stress temporarily increases your blood pressure. If you try relaxing by eating more, chewing tobacco or drinking alcohol, you end up increasing your problems with high blood pressure. 
  • Certain chronic conditions: Certain chronic conditions such as kidney disease, diabetes, and sleep apnea may increase your risk of high blood pressure.

Sometimes, pregnancy may also contribute to high blood pressure. Children may be at risk of high blood pressure if they have problems with their kidneys or heart, but in an increasing number of kids, poor lifestyle habits, such as an unhealthy diet, lack of physical exercise, and obesity contributes to high blood pressure.

Complications of High Blood Pressure

If blood pressure remains high over time, the excessive pressure on your artery walls caused by high blood pressure causes damage to your blood vessels and organs in your body. The higher your blood pressure and the longer it goes uncontrolled, the greater is the damage.

Long-term uncontrolled high blood pressure can lead to:

  • Heart attack or stroke: High blood pressure causes atherosclerosis (hardening and thickening of the arteries), which in turn reduces the flow of oxygenated blood to a portion of heart muscle leading to a heart attack. Stroke may also result when the flow of oxygenated blood to a part of the brain gets blocked.
  • Aneurysm: High blood pressure can cause an abnormal bulge in the wall of your blood vessels, which is called an aneurysm. It can be life-threatening if an aneurysm ruptures.
  • Heart failure: Your heart muscle gets thickened when it tries to pump blood against the higher pressure in your vessels. This thickened muscle makes it hard for your heart to pump enough blood to meet your body's needs, which can lead to heart failure. 
  • Chronic kidney disease: The blood vessels in your kidney may become weak and narrow leading to kidney failure or abnormal functioning of kidneys. 
  • Eye problems: Thickened, narrowed or torn blood vessels in the eyes may cause blindness. 
  • Metabolic syndrome: This condition is a cluster of disorders of your body's metabolism, which include increased waist circumference, high triglycerides, low levels of high-density lipoprotein (HDL) cholesterol or ""good"" cholesterol, high blood pressure, and high insulin levels. 
  • Cognitive changes: You may develop trouble with memory or understanding concepts. Uncontrollably high blood pressure may affect your memory, thinking ability, and learning skills. 
  • Peripheral artery disease: In this condition, plaque gets deposited in your leg arteries and affects the blood flow in your legs leading to pain, cramps, feeling of numbness or heaviness in the legs, feet, and buttocks after walking or climbing the stairs.
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