As blood is pumped through your body, it exerts pressure on the walls of your arteries. The systolic blood pressure is the pressure against these walls when the heart contracts, and the diastolic blood pressure is the pressure when the heart relaxes.

High blood pressure, also called hypertension, occurs when the systolic pressure is consistently over 140 mm Hg, or the diastolic blood pressure is consistently over 90 mm Hg. "Essential hypertension" refers to high blood pressure with no identifiable cause.

Blood pressure is determined by the amount of blood pumped, by the actions of the heart, and by the size and condition of the arteries. Many other factors can affect blood pressure including the water volume in the body; salt content of the body; condition of the kidneys, nervous system, or blood vessels; and various hormone levels in the body.

African Americans of both sexes and Caucasian males have a higher incidence of significant hypertension. While essential hypertension has no correctable cause, some genetic factors have been identified.

• Occasionally, headache

• Tiredness
• Confusion
• Visual changes
• Nausea, vomiting
• Anxiety
• Perspiration
• Pale skin, or redness
• An angina-like pain, crushing substernal chest pain

Note: There are usually no symptoms.

Blood pressure measurements are repeated over time. Blood pressure consistently elevated over 140/90, or diastolic blood pressure consistently over 90, is considered hypertension. There may be signs of complications.

Tests for suspected causes (i.e., secondary hypertension) may be performed. Essential hypertension is diagnosed when NO causes can be found.

• Diuretics
• Potassium supplements
• Beta-blockers
• Calcium channel blockers
• Angiotensin-converting enzyme (ACE) inhibitors, Angiotensin receptor blockers (ARBs)
• Hydralazine, diazoxide, and nitroprusside (if acute)

Essential hypertension is controllable with proper treatment. It requires lifelong monitoring, and treatment may require periodic adjustments.

• Heart attacks (myocardial infarction)
• Congestive heart failure
• Other heart damage
• Blood vessel damage (arteriosclerosis)
• Kidney damage
• Stroke
• Loss of vision

Call your health care provider if you suspect you may have hypertension.

Call your health care provider if you have hypertension and new or returning symptoms occur.

• Weight loss, if the person is overweight. Excess weight adds to heart strain. In some cases, weight loss may be the only treatment needed.
• Exercise to improve cardiac fitness.
• Dietary adjustments to modify sodium in the diet (sodium intake may have little effect in people without hypertension, but may have a profound effect in those with hypertension). Salt, MSG, and baking soda all contain sodium.