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UNIVERSITY STUDENT HEALTH SERVICES ● Fact Sheet
HYPERTENSION
Secondary hypertension is much more rare. In these cases, a
direct cause for high blood pressure can be identified. Causes
include kidney disease, hormonal abnormalities, tumors of the
adrenal gland, medications (such as birth control pills and
decongestants), and pregnancy.
WHAT IS BLOOD PRESSURE &
WHY IS IT IMPORTANT?
Blood pressure readings reflect the force of blood pushing
against the walls of the arteries that transport blood from the
heart to all the body’s organs and tissues.
WHO GETS HYPERTENSION?
Blood pressure is recorded using two numbers:
The upper number (systolic pressure) is the highest pressure
when the heart is contracting to pump blood out to the body.
The bottom number (diastolic pressure) measures the
pressure when the heart is resting between beats and filling
up with blood.
Anyone with the risk factors mentioned earlier is at risk for
developing hypertension. The more risk factors you have, the
higher your probability of developing high blood pressure. One
out of every four adult Americans has high blood pressure, and
more than 50% of Americans over age 65 are hypertensive.
High blood pressure also develops earlier and is more severe
in African Americans.
Systolic blood pressure increases with age. Diastolic blood
pressure increases until age 50 and then declines. Both
numbers do not have to be elevated in order to have high
blood pressure. In people over 50, systolic blood pressure is
more important to control than diastolic blood pressure.
WHAT ARE THE SYMPTOMS?
Hypertension is known as a “silent” disease because it often
has no warning signs or symptoms. That is why it is important
to have your blood pressure checked on a regular basis.
Hypertension is the medical term used to describe the
condition in which blood pressure remains persistently
elevated. Untreated hypertension can become a serious
condition over time because it can lead to life-threatening
complications, such as heart disease, kidney disease, and
stroke.
Frequently, symptoms do not develop until organs begin to
suffer, leading to heart disease, kidney disease, and stroke.
Symptoms may include chest pain, irregular heartbeats,
shortness of breath, fatigue, headache, and changes in vision.
HOW IS HYPERTENSION DIAGNOSED?
WHAT CAUSES HYPERTENSION?
Normal fluctuations in blood pressure are normal. Therefore,
two blood pressure readings of 140/90 or above on two
different days are required before diagnosing someone with
hypertension.
In the vast majority of cases, no specific cause of hypertension
is found. This type of high blood pressure is known as primary
or essential hypertension. Risk factors for essential hypertension include a family history of the disease, smoking, obesity,
high cholesterol, and diabetes. Other risk factors include
excess salt intake, too much alcohol use (more than one to two
drinks per day), and lack of physical activity.
Once hypertension is diagnosed, your health care provider will
check baseline bloodwork and a urine sample to rule out other
causes or complications of high blood pressure. In addition, a
baseline electrocardiogram (a painless test that measures the
electrical activity of your heart) is also recommended.
*CLASSIFICATION OF BLOOD PRESSURE FOR ADULTS
Blood Pressure
Classifications
Normal
**Prehypertension
SBP (mmHg)
DBP (mmHg)
< 120
120-139
and
or
< 80
80-89
Stage 1 Hypertension
140-159
or
90-99
Stage 2 Hypertension
≥ 160
or
≥ 100
* If systolic and diastolic blood pressures fall into different categories, the higher category is used to classify blood
pressure.
** Prehypertension doubles the risk of progression to hypertension compared to those with normal blood pressure.
WHAT ARE THE COMPLICATIONS OF
HYPERTENSION?
If blood pressure is elevated all the time, the constant
abnormal force of blood pushing against the arterial walls
damages the blood vessels and can lead to several conditions:
■ Arteriosclerosis
Elevated blood pressure makes the arteries thick and stiff
while also promoting the build-up of cholesterol and fats inside
the blood vessels. This can cause a blockage of blood flow in
the arteries, leading to problems like a heart attack or stroke.
■ Chest pain (angina) and heart attack
When arteries become damaged by high blood pressure, they
are unable to carry enough blood back to the heart. A
decreased blood supply means a decreased oxygen supply.
When the heart does not get enough oxygen, you can develop
chest pain, called angina. If heart muscle dies because of a
complete lack of oxygen, it is called a heart attack or
myocardial infarction.
■ Enlarged heart
When the heart has to work harder to pump blood against a
higher pressure, the heart muscles will start to enlarge. Over
time, the thickened muscles stretch and become weaker,
decreasing the heart’s ability to pump blood out to the body.
When this condition becomes severe, fluid can start backing up
into the lungs, causing increasing shortness of breath and
cough.
■ Stroke
Elevated blood pressure harms all the arteries, including those
leading to the brain. If a clot blocks the artery and the brain
does not get enough oxygen, a thrombotic stroke can occur. A
hemorrhagic or bleeding stroke can occur when very high
blood pressure causes a weakened artery to break.
■ Kidney damage
Kidneys are particularly prone to damage from high blood
pressure because they are primarily made up of blood vessels
that filter waste products out of the body. Over time, an
elevated blood pressure can narrow and thicken the blood
vessels in the kidneys. As kidney function drops, waste
products build up in the blood and cause a variety of
complications. Eventually, the kidneys can fail completely,
requiring dialysis (mechanical filtering) or transplant.
WHAT CAN BE DONE TO PREVENT AND
TREAT HYPERTENSION?
Individuals whose blood pressure falls between normal and
high readings (from 120/80 to 139/89) have prehypertension.
Prehypertension is not considered an actual disease.
However, individuals with prehypertension are at high risk of
progressing to hypertension; therefore, it is important for these
patients to start implementing healthy lifestyle habits early to
prevent the development of hypertension. In addition, lifestyle
changes should continue to be part of the treatment plan for
those patients already taking medication(s) for hypertension.
■ Maintain a healthy weight.
Being overweight can increase your risk of developing
hypertension by two to six times. Even relatively small
amounts of weight loss can make a huge difference in helping
to decrease or prevent high blood pressure. Remember that
the healthiest and longest-lasting weight loss is very slow –
1/2 to 2 pounds per week. This can be accomplished by
decreasing your intake by 500 calories/day (3,500 calories in 1
week = 1 pound).
■ Be physically active.
Physically active people have a 20-50% lower risk of getting
hypertension. Additionally, aerobic activity for at least 30
minutes four or five times a week helps raise HDL (good
cholesterol) and helps to lower total cholesterol. It is important
to see a health care provider prior to starting a vigorous
exercise program if you have elevated blood pressure, pains or
pressure in the chest or shoulder areas, dizziness or faintness,
breathlessness following a mild workout, or if you are middleaged or older.
■ Stop smoking.
Smoking causes injury to the walls of the blood vessels,
thereby accelerating hardening of the arteries (arteriosclerosis)
already caused by hypertension. Nicotine also increases blood
pressure by causing your arteries to constrict and your heart to
beat faster.
■ Eat foods low in salt or sodium.
Although African Americans and the elderly tend to be more
affected by high sodium foods, it makes sense for everyone to
limit their salt consumption. All Americans should eat no more
than 6 grams of salt per day (which equals 2,400 milligrams of
sodium or one teaspoon of table salt). However, most
Americans eat 4,000-6,000 milligrams of sodium per day! 75%
of this sodium intake comes from processed foods. In addition
to the usual salty foods that come to mind, other foods with
high sodium content include canned vegetables, canned
soups, pre-packaged microwave meals, V8, Gatorade, and
other sports drinks.
■ Adopt a healthy diet.
The DASH (Dietary Approaches to Stop Hypertension) diet is
rich in fruits, vegetables, and low-fat dairy products (with a
reduced content of saturated and total fat). This diet is also
rich in potassium and calcium. Research has shown that
potassium helps to prevent and control high blood pressure.
Many fruits, vegetables, fish, and dairy products are rich
sources of potassium (eg, bananas, spinach, sweet potatoes,
green beans, milk).
■ Limit alcohol consumption.
You should drink no more than one drink per day. A “drink” is
defined as:
1.5 ounces of 80-proof liquor or 1 ounce of 100-proof liquor
5 ounces of wine
12 ounces of beer (regular or light)
While there is some information to suggest that alcohol may
promote a longer life by lowering blood pressure and
preventing the build-up of fats in the arteries, remember that
these benefits are associated with moderate alcohol
consumption only. Increased alcohol use will lead to weight
gain from its high caloric content. In addition, chronic or
excessive alcohol use can lead to diseases of the liver and
pancreas, as well as increased risk of cancers. Given these
and other risks, we recommend against increasing your alcohol
intake or starting to drink if you don’t already do so.
■ Other suggestions
In addition to the above-mentioned steps which are PROVEN
to help prevent and treat hypertension, there are other factors
that MAY be helpful. These include eating foods rich in
calcium, magnesium, and fish oils; decreasing caffeine intake;
cooking with garlic and onions; and engaging in methods of
stress management such as yoga, meditation, or progressive
relaxation.
■ Medications
If hypertension cannot be controlled with the above lifestyle
changes, medication may be necessary. Talk to your medical
provider about which medication is appropriate for you.
RECOMMENDED WEBSITES:
■ www.familydoctor.org
■ www.nhlbi.nih.gov
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Published by VCU Division of Student Affairs and Enrollment Services
University Student Health Services: (804) 828-8828 - Monroe Park
Campus; (804) 828-9220 - MCV Campus
Wellness Resource Center: (804) 828-9355 - 815 S. Cathedral Place
Reviewed 7/11