High Blood Pressure

Understanding High Blood Pressure

What is high blood pressure?

High blood pressure ("arterial hypertension") means the force of blood pushing against your artery walls stays too high. It is one of the most common health conditions in the country: nearly half of U.S. adults—well over 120 million people—have it, and it becomes more common with age. High blood pressure is generally defined as a top number (systolic) of 130 mm Hg or higher, or a bottom number (diastolic) of 80 mm Hg or higher.

Why it matters

High blood pressure is often called a "silent killer" because most people feel nothing at all, even when readings are dangerously high. Over time it strains the heart, kidneys, brain, and eyes, and it hardens the arteries (a process called atherosclerosis). This raises the risk of heart attack, heart failure, kidney disease, and stroke (a blockage or bleed in the brain).

What causes it?

For most people there is no single cause—a mix of

Less often, a specific medical problem (such as a hormone or kidney condition) drives blood pressure up. Blood pressure naturally rises and falls throughout the day; some people show high readings only in stressful moments or in the doctor's office.

How it is diagnosed

Diagnosis is based on the average of several accurate readings, not a single measurement. Your clinician may ask you to check your blood pressure at home or wear a 24-hour monitor to confirm it.

How it is treated

The foundation of treatment is healthy lifestyle changes, recommended for everyone with high blood pressure:

• Eating less salt and sodium
• Eating more fruits, vegetables, and potassium-rich foods
• Losing excess weight
• Staying physically active
• Limiting alcohol and managing stress

Lifestyle changes are powerful but do not always bring blood pressure to a normal level. When medication is needed, several proven families of drugs are available, and they are often combined. Examples are:

• Water pills (thiazide diuretics)
• ACE inhibitors and ARBs (which relax blood vessels)
• Calcium channel blockers

Other medication classes exist for specific situations. No single drug is "best" for everyone—your clinician chooses based on your health, other conditions, and how well you tolerate each option.

When blood pressure stays high

If blood pressure remains elevated despite lifestyle changes and several medications, this is called resistant hypertension. A minimally invasive procedure called renal denervation may be an option for some of these patients, usually alongside continued medication.

(Based on the 2025 AHA/ACC High Blood Pressure Guideline and CDC data. Talk with your healthcare provider about your numbers and the plan that fits you best.)