Elevated blood pressure

If your blood pressure is slightly elevated, eating better and moving more can help prevent prehypertension from becoming high blood pressure.

Elevated blood pressure means that your blood pressure is slightly above what is considered normal. Some doctors refer to slightly elevated blood pressure as prehypertension. Elevated blood pressure will likely turn into high blood pressure (hypertension) unless you make lifestyle changes, such as getting more exercise and eating healthier foods.

Anyone can have elevated blood pressure, even children, especially if they're overweight or obese.

Both elevated blood pressure and high blood pressure increase your risk of a heart attack, stroke and heart failure. Some research suggests that long-term (chronic) elevated blood pressure may contribute to cognitive decline. Weight loss, exercise and other healthy lifestyle changes can often control elevated blood pressure, and set the stage for a lifetime of better health.

Elevated blood pressure doesn't cause symptoms. The only way to detect it is to keep track of your blood pressure readings. Have your blood pressure checked at each doctor's visit — or check it at home with a home blood pressure monitoring device.

When to see a doctor

All people age 3 and older should have their blood pressure checked by a doctor at least once a year. You might need more-frequent readings if you have elevated blood pressure or other risk factors for cardiovascular disease.

Any factor that increases pressure against the artery walls can lead to elevated blood pressure. The buildup of fatty deposits in your arteries (atherosclerosis) can lead to high blood pressure.

Besides atherosclerosis, other conditions that can lead to elevated blood pressure or high blood pressure include:

• Obstructive sleep apnea
• Kidney disease
• Adrenal disease
• Thyroid disease

Certain medications — including birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs — also can cause blood pressure to rise temporarily. Illegal drugs, such as cocaine and amphetamines, can have the same effect.

Risk factors for elevated blood pressure include:

• Being overweight or obese. The greater your body mass, the more blood you need to supply oxygen and nutrients to your tissues. As the amount of blood going through your blood vessels increases, so does the force on your artery walls.
• Sex. Elevated blood pressure is more common in men than in women through about age 55. Women are more likely to develop high blood pressure after age 55.
• Race. Elevated blood pressure is particularly common among people of African heritage, often developing at an earlier age than it does in white people.
• Family history of high blood pressure. If a first-degree relative, such as a parent or sibling, has high blood pressure, you're more likely to develop elevated blood pressure.
• Not being physically active. Not exercising can cause weight gain and increase your risk of elevated blood pressure.
• Diet high in salt (sodium) or low in potassium. Sodium and potassium are two key nutrients in the way your body regulates your blood pressure. If you have too much sodium or too little potassium in your diet, you're more likely to have elevated blood pressure.
• Tobacco use. Smoking cigarettes, chewing tobacco or being around others who smoke (secondhand smoke) can increase your blood pressure.
• Drinking too much alcohol. Alcohol use has been associated with elevated blood pressure, particularly in men.
• Certain chronic conditions. Kidney disease, diabetes and sleep apnea, among others, can increase the risk of elevated blood pressure.

Although elevated blood pressure and high blood pressure are most common in adults, children can be at risk, too. For some children, kidney or heart problems can cause high blood pressure. But for a growing number of kids, poor lifestyle habits, such as an unhealthy diet, obesity and lack of exercise, contribute to elevated blood pressure and high blood pressure.

Elevated blood pressure is likely to worsen and develop into high blood pressure (hypertension). Hypertension can damage your organs and increase the risk of several conditions including a heart attack, heart failure, stroke, aneurysms and kidney failure.

The same healthy lifestyle changes recommended to treat elevated blood pressure also help prevent hypertension. You've heard it before — eat healthy foods, use less salt, exercise regularly, maintain a healthy weight, drink less alcohol, manage stress and quit smoking. But take the advice to heart. Start adopting healthier habits today.

A blood pressure test diagnoses elevated blood pressure. This often involves an inflatable arm cuff placed around your arm and a pressure-measuring gauge.

A blood pressure reading, given in millimeters of mercury (mm Hg), has two numbers. The first, or upper, number measures the pressure in your arteries when your heart beats (systolic pressure). The second, or lower, number measures the pressure in your arteries between beats (diastolic pressure).

According to the American Heart Association, your blood pressure is normal if it is 120/80 mm Hg or lower. Other blood pressure measurements fall into the following categories:

• Elevated blood pressure. Elevated blood pressure is a systolic pressure ranging from 120 to 129 mm Hg and a diastolic pressure below (not above) 80 mm Hg. Elevated blood pressure tends to get worse over time unless steps are taken to control blood pressure.
• Stage 1 hypertension. Stage 1 hypertension is a systolic pressure ranging from 130 to 139 mm Hg or a diastolic pressure ranging from 80 to 89 mm Hg.
• Stage 2 hypertension. Stage 2 hypertension is a systolic pressure of 140 mm Hg or higher or a diastolic pressure of 90 mm Hg or higher.

Because blood pressure tends to vary, a diagnosis of elevated blood pressure is based on the average of two or more blood pressure readings taken on separate occasions in a consistent manner. The first time, your blood pressure generally should be measured in both arms to determine if there's a difference. After that, the arm with the higher reading should be used.

Your doctor might suggest a six-hour or 24-hour blood pressure monitoring test called ambulatory blood pressure monitoring. The device used for this test measures your blood pressure at regular intervals over six or 24 hours and provides a more accurate picture of blood pressure changes over an average day and night (for the 24 hours). However, these devices aren't available in all medical centers, and insurance may not cover them.

Your doctor might also recommend that you use a home blood pressure monitor, preferably one that can store your readings in its memory, to check your blood pressure regularly. If so, he or she should show you how to use it properly.

If you have elevated blood pressure and diabetes, kidney disease or cardiovascular disease, your doctor might recommend blood pressure medication in addition to lifestyle changes.

If you've been diagnosed with elevated blood pressure and don't have any other conditions that raise your heart disease risk, the benefits of medication are less clear.

If you have stage 1 or stage 2 hypertension, your doctor will likely prescribe medications to lower your blood pressure and recommend healthy lifestyle changes.

As your blood pressure increases, so does your risk of cardiovascular disease. That's why it's so important to control elevated blood pressure. The key is a commitment to healthy lifestyle changes.

• Eat healthy foods. Eat a healthy diet. Try the Dietary Approaches to Stop Hypertension (DASH) diet. Choose fruits, vegetables, whole grains, poultry, fish and low-fat dairy foods. Get plenty of potassium from natural sources, which can help lower blood pressure. Eat less saturated fat and trans fat.
• Maintain a healthy weight. Keeping a healthy weight, or losing weight if you're overweight or obese, can help you control your blood pressure and lower your risk of related health problems. In general, you may reduce your blood pressure by about 1 mm Hg with each kilogram (about 2.2 pounds) of weight you lose. In people with high blood pressure, the drop in blood pressure may be even more significant per kilogram of weight lost.
• Use less salt (sodium). Put down the saltshaker. Also reduce your intake of processed meats, canned foods, commercial soups, frozen dinners and certain breads, which can be hidden sources of sodium. Read labels and pay attention to the sodium content. Aim to limit sodium by at least 1,000 milligrams (mg) a day. A lower sodium intake — 1,500 mg a day or less — is ideal for most adults.

• Increase physical activity. Regular physical activity can help lower your blood pressure, manage stress, reduce your risk of other health problems and keep your weight under control.

  For most healthy adults, the Department of Health and Human Services recommends that you get at least 150 minutes a week of moderate aerobic activity or 75 minutes a week of vigorous aerobic activity, or a combination of moderate and vigorous activity. Aim to do muscle-strengthening exercises at least two days a week.

• Limit alcohol. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men. One drink equals 12 ounces (355 milliliters) of beer, 5 ounces (148 milliliters) of wine or 1.5 ounces (44 milliliters) of 80-proof liquor.
• Don't smoke. Tobacco injures blood vessel walls and speeds up the process of hardening of the arteries. If you smoke, ask your doctor to help you quit.
• Manage stress. Reduce stress as much as possible. Practice healthy coping techniques, such as muscle relaxation, deep breathing or meditation. Getting regular physical activity and plenty of sleep can help, too.

If you think you may have elevated blood pressure or high blood pressure, make an appointment with your family doctor to have your blood pressure checked.

No special preparations are necessary. To get an accurate reading, avoid caffeine, exercise and tobacco for at least 30 minutes before your test. You might want to use the toilet before having your blood pressure measured.

Because some medications — such as over-the-counter cold medicines, pain medications, antidepressants, birth control pills and others — can raise your blood pressure, bring a list of all medications, vitamins and other supplements you take and their doses to your doctor's appointment. Don't stop taking any prescription medications that you think might affect your blood pressure without your doctor's advice.

Here's some information to help you get ready for your appointment.

What you can do

Make a list of:

• Your symptoms, if you have any, even if they seem unrelated to the reason you scheduled the appointment, and when they began
• Key personal information, including a family history of high blood pressure, high cholesterol, heart disease, stroke or diabetes, and any major stresses or recent life changes
• Write down questions to ask your doctor.

For elevated blood pressure, questions to ask your doctor include:

• What tests do I need?
• Do I need to take medication?
• What foods should I eat or avoid?
• What's an appropriate level of physical activity?
• How often do I need to have my blood pressure checked?
• Should I monitor my blood pressure at home?
• I have these other health conditions. How can I best manage them together?
• Are there brochures or other printed material that I can have? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, including:

• What are your diet and exercise habits like?
• Do you drink alcohol? How many drinks do you have in a week?
• Do you smoke?
• When did you last have your blood pressure checked? What was your blood pressure measurement then?

Last Updated:

January 14th, 2021