Hypertension

This article is about arterial hypertension. For other forms of hypertension, see Hypertension (disambiguation).

Hypertension
Other namesArterial hypertension, high blood pressure
Automated arm blood pressure meter showing arterial hypertension (shown by a systolic blood pressure 158 mmHg, diastolic blood pressure 99 mmHg and heart rate of 80 beats per minute)
SpecialtyCardiology, Nephrology
SymptomsNone[1]
ComplicationsCoronary artery disease, stroke, heart failure, peripheral arterial disease, vision loss, chronic kidney disease, dementia[2][3][4]
CausesUsually lifestyle and genetic factors[5]
Risk factorsLack of sleep, excess salt, excess body weight, smoking, alcohol[1][5]
Diagnostic methodResting blood pressure in adults
≥ 130/80 mmHg[6] or ≥ 140/90 mmHg[7]
TreatmentLifestyle changes, medications[8]
Frequency33% (all adults), 16% (diagnosed)
(globally, 2019)[9][10]
Deaths10.4 million; 19% of deaths
(globally, 2019)[9]
Part of a series on
Human body weight
General concepts
Medical concepts
Measurements
Related conditions
Obesity-associated morbidity
Management of obesity
Social aspects

Hypertension, also known as high blood pressure, is a long-term medical condition in which the blood pressure in the arteries is persistently elevated.[11] High blood pressure usually does not cause symptoms itself.[1] It is, however, a major risk factor for stroke, coronary artery disease, heart failure, atrial fibrillation, peripheral arterial disease, vision loss, chronic kidney disease, and dementia.[2][3][4][12] Hypertension is a major cause of premature death worldwide.[13]

High blood pressure is classified as primary (essential) hypertension or secondary hypertension.[5] About 90–95% of cases are primary, defined as high blood pressure due to nonspecific lifestyle and genetic factors.[5] Lifestyle factors that increase the risk include excess salt in the diet, excess body weight, smoking, physical inactivity and alcohol use.[1][5] The remaining 5–10% of cases are categorized as secondary hypertension, defined as high blood pressure due to a clearly identifiable cause, such as chronic kidney disease, narrowing of the kidney arteries, an endocrine disorder, or the use of birth control pills.[5]

Blood pressure is classified by two measurements, the systolic (first number) and diastolic (second number) pressures.[1] For most adults, normal blood pressure at rest is within the range of 100–140 millimeters mercury (mmHg) systolic and 60–90 mmHg diastolic.[6][7] For most adults, high blood pressure is present if the resting blood pressure is persistently at or above 130/80 or 140/90 mmHg.[5][6][7] Different numbers apply to children.[14] Ambulatory blood pressure monitoring over a 24-hour period appears more accurate than office-based blood pressure measurement.[5][11]

Lifestyle changes and medications can lower blood pressure and decrease the risk of health complications.[8] Lifestyle changes include weight loss, physical exercise, decreased salt intake, reducing alcohol intake, and a healthy diet.[5] If lifestyle changes are not sufficient, blood pressure medications are used.[8] Up to three medications taken concurrently can control blood pressure in 90% of people.[5] The treatment of moderately high arterial blood pressure (defined as >160/100 mmHg) with medications is associated with an improved life expectancy.[15] The effect of treatment of blood pressure between 130/80 mmHg and 160/100 mmHg is less clear, with some reviews finding benefit[6][16][17] and others finding unclear benefit.[18][19][20] High blood pressure affects 33% of the population globally.[9] About half of all people with high blood pressure do not know that they have it.[9] In 2019, high blood pressure was believed to have been a factor in 19% of all deaths (10.4 million globally).[9]

Video summary (script)
  1. ^ a b c d e "About High Blood Pressure". Centers for Disease Control and Prevention (CDC). 15 May 2024. Archived from the original on 20 May 2024. Retrieved 22 May 2024.
  2. ^ a b Lackland DT, Weber MA (May 2015). "Global burden of cardiovascular disease and stroke: hypertension at the core". The Canadian Journal of Cardiology. 31 (5): 569–571. doi:10.1016/j.cjca.2015.01.009. PMID 25795106.
  3. ^ a b Mendis S, Puska P, Norrving B (2011). Global atlas on cardiovascular disease prevention and control (PDF) (1st ed.). Geneva: World Health Organization in collaboration with the World Heart Federation and the World Stroke Organization. p. 38. ISBN 978-92-4-156437-3. Archived from the original (PDF) on 17 August 2014.
  4. ^ a b Hernandorena I, Duron E, Vidal JS, Hanon O (July 2017). "Treatment options and considerations for hypertensive patients to prevent dementia". Expert Opinion on Pharmacotherapy (Review). 18 (10): 989–1000. doi:10.1080/14656566.2017.1333599. PMID 28532183. S2CID 46601689.
  5. ^ a b c d e f g h i j Poulter NR, Prabhakaran D, Caulfield M (August 2015). "Hypertension". Lancet. 386 (9995): 801–812. doi:10.1016/s0140-6736(14)61468-9. PMID 25832858. S2CID 208792897.
  6. ^ a b c d Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA, Williamson JD, Wright JT (June 2018). "2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines". Hypertension. 71 (6): e13–e115. doi:10.1161/HYP.0000000000000065. PMID 29133356.
  7. ^ a b c Cite error: The named reference ESH2023 was invoked but never defined (see the help page).
  8. ^ a b c "How Is High Blood Pressure Treated?". National Heart, Lung, and Blood Institute. 10 September 2015. Archived from the original on 6 April 2016. Retrieved 6 March 2016.
  9. ^ a b c d e Cite error: The named reference WHOreport2023 was invoked but never defined (see the help page).
  10. ^ Cite error: The named reference NCD2021 was invoked but never defined (see the help page).
  11. ^ a b Naish J, Court DS (2014). Medical sciences (2 ed.). Elsevier Health Sciences. p. 562. ISBN 978-0-7020-5249-1.
  12. ^ Lau DH, Nattel S, Kalman JM, Sanders P (August 2017). "Modifiable Risk Factors and Atrial Fibrillation". Circulation (Review). 136 (6): 583–596. doi:10.1161/CIRCULATIONAHA.116.023163. PMID 28784826.
  13. ^ "Hypertension". World Health Organization (WHO). 16 March 2023. Retrieved 22 May 2024.
  14. ^ James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, Lackland DT, LeFevre ML, MacKenzie TD, Ogedegbe O, Smith SC, Svetkey LP, Taler SJ, Townsend RR, Wright JT, Narva AS, Ortiz E (February 2014). "2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8)". JAMA. 311 (5): 507–520. doi:10.1001/jama.2013.284427. PMID 24352797.
  15. ^ Musini VM, Tejani AM, Bassett K, Puil L, Wright JM (June 2019). "Pharmacotherapy for hypertension in adults 60 years or older". The Cochrane Database of Systematic Reviews. 6 (6): CD000028. doi:10.1002/14651858.CD000028.pub3. PMC 6550717. PMID 31167038.
  16. ^ Sundström J, Arima H, Jackson R, Turnbull F, Rahimi K, Chalmers J, Woodward M, Neal B (February 2015). "Effects of blood pressure reduction in mild hypertension: a systematic review and meta-analysis". Annals of Internal Medicine. 162 (3): 184–191. doi:10.7326/M14-0773. PMID 25531552. S2CID 46553658.
  17. ^ Xie X, Atkins E, Lv J, Bennett A, Neal B, Ninomiya T, Woodward M, MacMahon S, Turnbull F, Hillis GS, Chalmers J, Mant J, Salam A, Rahimi K, Perkovic V, Rodgers A (January 2016). "Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis". Lancet. 387 (10017): 435–443. doi:10.1016/S0140-6736(15)00805-3. PMID 26559744. S2CID 36805676. Archived from the original on 16 April 2019. Retrieved 11 February 2019.
  18. ^ Diao D, Wright JM, Cundiff DK, Gueyffier F (August 2012). "Pharmacotherapy for mild hypertension". The Cochrane Database of Systematic Reviews. 8 (8): CD006742. doi:10.1002/14651858.CD006742.pub2. PMC 8985074. PMID 22895954. S2CID 42363250.
  19. ^ Garrison SR, Kolber MR, Korownyk CS, McCracken RK, Heran BS, Allan GM (August 2017). "Blood pressure targets for hypertension in older adults". The Cochrane Database of Systematic Reviews. 2017 (8): CD011575. doi:10.1002/14651858.CD011575.pub2. PMC 6483478. PMID 28787537.
  20. ^ Musini VM, Gueyffier F, Puil L, Salzwedel DM, Wright JM (August 2017). "Pharmacotherapy for hypertension in adults aged 18 to 59 years". The Cochrane Database of Systematic Reviews. 2017 (8): CD008276. doi:10.1002/14651858.CD008276.pub2. PMC 6483466. PMID 28813123.