Blood pressure is the force of blood pressing against your artery walls. Chronic high blood pressure (also called hypertension) can harm the arteries over time. This can lead to other conditions like heart disease, heart attacks, and strokes. This guide will help you understand what you can do to maintain a healthy blood pressure throughout your life.

What the Numbers Say

Blood pressure monitor, fruits with vegetables and medical pills

When you visit your doctor, he or she will likely take your blood pressure and read off two numbers, one over the other (such as 120/75). But what do these numbers mean? The top number is your systolic blood pressure, meaning the pressure in the arteries when the heart beats. The bottom number is diastolic blood pressure, which is the pressure in the arteries when the heart rests between beats.

Normal blood pressure is measured as anything 120/80 or under. Elevated blood pressure (also called pre-hypertension) is 120-129 / less than 80. High blood pressure is at or over 130/80. Blood pressure can fluctuate depending on physical activity, emotional state, and stress levels, so get at least two consistent readings for accuracy. Understanding these numbers will help you manage your blood pressure.

Blood Pressure Systolic Diastolic
Low ≤ 90 ≤ 60
Normal ≤ 120 ≤ 80
Elevated (Pre-hypertension) 120 – 129 ≤ 80
High ≥ 130 ≥ 80


Symptoms of the “Silent Killer”

The American Heart Association estimates that nearly half of all Americans have high blood pressure, accounting for those who likely have high blood pressure but don’t know it. High blood pressure, unfortunately, has very few outward symptoms. That is why it is known as the “silent killer.”

The best way to know if you have high blood pressure is to simply get your blood pressure checked regularly. This can be done with your regular checkups with your doctor. And you can even learn to check your blood pressure at home with the right equipment.

There are a few reported symptoms that may indicate you have high blood pressure. However, do not wait for these symptoms to talk with your doctor. You can still have high blood pressure without experiencing the following:

  • Blood spots in the eyes due to nerve damage caused by high blood pressure.
  • Frequent facial flushing, which occurs with the blood vessels in the face dilate.
  • High blood pressure can cause other conditions that lead to dizziness; dizziness can also be a sign of a stroke.

Risk Factors

Hereditary or Physical Risk Factors

  • Family history. If you have a parent or close relative with high blood pressure, it is more likely you will have it as well.
  • Your chances for having high blood pressure will increase as your artery walls thicken and harden as you age. However, that doesn’t mean children and adolescents do not develop high blood pressure.
  • Men are more likely than women to have high blood pressure until about 65; women are more likely to develop it after menopause.
  • African-Americans are more likely to have high blood pressure, and their blood pressure can be more severe.

Diseases and Conditions

  • Chronic Kidney Disease
  • Diabetes
  • Sleep apnea
  • Pregnancy can cause preeclampsia or gestational hypertension

Lifestyle Risk Factors

  • Unhealthy diet
  • Too much sodium intake
  • Being overweight or obese
  • Excessive alcohol intake
  • High cholesterol
  • Smoking / tobacco use
  • Stress


  • Birth control pills cause high blood pressure in some women
  • Decongestants
  • Frequent use of NSAIDs (non-steroidal anti-inflammatory drugs like ibuprofen or aspirin)


Close up of elderly man having a heart attack

Heart Attack. Over time, buildup of fat and cholesterol causes buildup in the arteries (known as plaque). The plaque hardens and causes the arteries to narrow, and the heart must work harder to get blood through. This means higher blood pressure. Chronic high blood pressure damages artery walls; eventually, plaque breaks away from the wall and forms a blood clot. This prevents blood flow to the heart and causes a heart attack.

Heart failure. Heart failure is not the heart stopping; it means that the heart isn’t pumping enough blood to the body. High blood pressure makes the heart beat harder. That causes the heart to enlarge and fail to supply blood to the body.

Stroke. Like heart attacks, strokes often occur because of limited blood flow in the brain. High blood pressure can cause blood vessels to clog or even burst.

Vision loss. Cells in the eye can be damaged by untreated high blood pressure.

Sexual dysfunction. High blood pressure can cause erectile dysfunction in men or lower libido in women.

Microvascular disease (MVD). This is a heart disease that damages the inner lining of the artery walls, which can decrease blood flow to the heart.

Angina. Chest pain (also known as angina) is a common symptom of MVD.

Peripheral artery disease (PAD). High blood pressure can cause atherosclerosis, which is the buildup up of fats and plaque in the artery walls. This leads to the narrowing of the arteries in the legs, arms, stomach, and head. This causes pain and fatigue.

Metabolic Syndrome. High blood pressure is one risk factor that leads to metabolic syndrome (or insulin resistance syndrome). Other factors include high blood glucose, low levels of HDL (“good”) cholesterol, high levels of triglycerides in the blood, and being overweight.


couple running outdoors

  • Get to know your family history to understand your risk for high blood pressure.
  • Eat a healthy diet, especially one that is low in sodium and high in potassium, calcium, and magnesium.
  • Manage your cholesterol. Avoid foods with LDL (“bad”) cholesterol trans fats—deep-fried foods or packaged pastries with preservatives. Stick with foods with HDL (“good”) cholesterol, like olive oil, nuts, legumes, and fatty fish.
  • Get regular physical exercise.
  • Maintain a healthy weight.
  • Quit smoking or tobacco use.
  • Limit alcohol intake.
  • Manage stress.

When to See a Doctor

If your blood pressure exceeds 180/120 after two readings (five minutes apart), get medical attention immediately. You could be experiencing hypertensive crisis.

Work to have a normal blood pressure level before you think you may become pregnant, then work closely with your doctor and have your blood pressure checked regularly.

Get regular checkups with your doctor to have your blood pressure measured and make a plan with your doctor if you have high blood pressure.