Hypertension, or high blood pressure, is a serious but common medical condition. Close to half of American adults (47% or 116 million) have hypertension. Globally, it’s estimated that 1.28 billion adults between the ages of 30 and 79 have the condition. Hypertension significantly increases the risk of other diseases, including in the heart, kidneys, and brain.
To understand hypertension, we must first discuss blood flow and blood pressure. Your arteries bring blood from your heart to the rest of your body. Blood pressure is how we describe the force of blood as it pushes against the walls of the arteries. It’s normal for blood pressure to fluctuate up and down during the day. With hypertension, you experience continuously high levels of blood pressure which can be damaging to your heart and overall health.
Triad Clinical Trials put together this resource page to provide an overview of hypertension and answer any questions you have about this condition.
Symptoms of hypertension
Hypertension doesn’t always have signs or symptoms. This is why it’s called a “silent killer.” Sometimes, the only indication of high blood pressure is an elevated blood pressure reading, so it’s important to have your blood pressure checked frequently.
Still, there are some symptoms that people with elevated blood pressure may experience. It’s important to note that these aren’t specific and generally only appear when blood pressure is extremely high. They include:
- Shortness of breath
- Pounding chest, ears, or neck
- Chest pain
- Vision problems
- Irregular heartbeat
- Blood in the urine
What causes hypertension?
There are two kinds of hypertension: primary (essential) hypertension and secondary hypertension. Primary hypertension is most common and has no obvious cause. It typically develops slowly over time.
Secondary hypertension occurs when high blood pressure is caused by an underlying condition. Secondary hypertension can result in even higher blood pressure than primary hypertension and often appears suddenly.
A wide variety of medications and conditions can cause secondary hypertension, such as:
- Thyroid problems
- Obstructive sleep apnea
- Adrenal gland tumors
- Birth defects in the blood vessels
- Kidney disease
- Certain medications, including cold remedies, over-the-counter pain relievers, decongestants, birth control pills, and other prescription medications
- Illegal drugs, like amphetamines and cocaine
Who’s at risk?
Hypertension has many risk factors, some of which you can modify and some you cannot.
Non-modifiable risk factors include:
- Family history: Hypertension typically runs in families.
- Age: Your risk increases with age.
- Sex: High blood pressure is more typical in men under age 64. However, it’s more common in women over the age of 65.
- Race: Hypertension tends to be more common and develops earlier in people who are of African heritage.
- Chronic conditions: Certain conditions like diabetes, sleep apnea, and kidney disease can increase the risk of hypertension.
Modifiable risk factors include:
- Weight: People who are overweight or obese are more likely to develop high blood pressure because they need more blood to supply nutrients and oxygen to the body. As blood flow increases, the artery walls experience more pressure.
- Salt intake: Having too much salt or sodium in the diet causes the body to retain fluid which then increases blood pressure.
- Potassium intake: Potassium plays a role in balancing the sodium in your cells. Eating enough potassium is important for heart health.
- Activity levels: People who are not physically active typically have higher heart rates, meaning their hearts work harder to pump blood. This creates additional pressure on the arteries.
- Tobacco use: Smoking and chewing tobacco contain chemicals that can damage the lining of the walls of the arteries. Over time, this narrows your arteries and increases the chances of heart disease. Plus, tobacco use immediately (although temporarily) raises blood pressure.
- Alcohol use: Heavy alcohol use can affect blood pressure and damage the heart.
- Stress: Increased levels of stress can raise your blood pressure. Plus, many people turn to food, alcohol, and tobacco to cope with stress, which can lead to higher blood pressure.
You can prevent or greatly reduce your chances of getting hypertension by maintaining a healthy weight, exercising regularly, limiting stress, eating healthily, drinking in moderation, and avoiding smoking entirely.
You can determine whether you need to lose weight by using a BMI calculator or talking with your doctor. It’s worth noting that even losing a few pounds can make a big difference in lowering your blood pressure.
A healthy diet includes plenty of vegetables and fruits, as well as fiber and whole grains. A good rule of thumb is to eat five servings of fruit and vegetables each day. Additionally, lower your salt intake to less than five grams per day and eat plenty of foods that contain potassium, like bananas.
To avoid high blood pressure, you should also limit your drinking and avoid tobacco completely. The recommended levels of alcohol are:
- No more than one drink per day for women
- No more than two drinks per day for men
Regular exercise keeps your blood vessels and heart in good condition which can help lower your blood pressure. It can also help you maintain a healthy weight. Aim for a minimum of 150 minutes of moderate-intensity activity, like fast walking or cycling, each week.
Doctors often recommend lifestyle changes to address high blood pressure. This includes eating a healthy diet, lowering salt intake, increasing physical activity, limiting alcohol, and losing weight if you’re overweight.
When diet and exercise don’t lower blood pressure, doctors typically recommend medication. Medications vary depending on overall health and blood pressure readings, but two or more medications typically yield better results than one.
A doctor may prescribe any of the following medications:
- Angiotensin-converting enzyme (ACE) inhibitors
- Angiotensin II receptor blockers (ARBs)
- Calcium channel blockers
- Alpha blockers
- Alpha-beta blockers
- Beta blockers
- Aldosterone antagonists
- Renin inhibitors
- Central-acting agents
Clinical trials for hypertension
There are several new treatments for hypertension that are being studied at Triad Clinical Trials. This includes catheter-based ultrasounds as well as radiofrequency ablation of the sympathetic nerves of the kidneys for resistant hypertension. These may be especially helpful for women over 65, as they have a higher risk of developing high blood pressure. If you or someone in your life has high blood pressure and would like to learn more about paid research studies, sign up with Triad Clinicals.