What Is Hypertension?

Hypertension seems to be common in our community. Of those who participated in our Heart Failure in America survey, 51% said they also had hypertension. So, what is hypertension? What does it have to do with heart failure? Here’s what to know.

What is hypertension?

Hypertension is defined as a high blood pressure (BP). More specifically, it is a blood pressure that is abnormally and chronically elevated. Other names for it are high blood pressure, essential hypertension, and arterial hypertension. The good news is that it can be treated with medicine, though people receiving medicine to control hypertension are considered to have a diagnosis of hypertension.^1-6

We have a series of arteries running throughout our bodies. Arteries are blood vessels that contain freshly oxygenated blood and other nutrients. Your heart (mainly the left side of your heart) is responsible for pumping blood through your arteries.

Your heart relaxes. In this state it is considered to be in diastole. During this time your heart fills with blood. As it fills with blood, the walls of your heart expand. An electrical impulse causes your heart to contract. As this happens, the blood is forced through your arteries. The point at which the heart contracts is called systole. During systole your blood pressure increases.^2-7

The two types of blood pressure

You have two different blood pressures that we measure:⁵

• Systolic: The pressure inside your heart during systole.
• Diastolic: The pressre inside your heart during diastole.

Traditionally, a normal blood pressure was considered as follows:

• Systolic: 120 mmhg
• Diastolic: 80 mmhg

A blood pressure of 120/80 is what we have grown to accept as a normal blood pressure. Higher than this was considered hypertension. However, modern evidence suggests that blood pressure increases with age. This information has caused researchers to update the definition of hypertension as follows:^4,6-9

• Systolic 120 and diastolic 80 (or less) is considered a normal BP.
• Systolic 121-129 and diastolic less than 80 is considered an elevated BP.
• Systolic 130-139 and diastolic 80-89 is considered hypertension (stage 1).
• Systolic 140 and diastolic 90 (or higher) is considered hypertension (stage 2).
• Systolic 180 and diastolic 120 (or higher) is considered hypertensive crisis (seek medical consultation immediately).

What causes hypertension?

In about 3-5% of cases, the cause is kidney or adrenal disease. In about 95-97% of cases, the cause remains unknown.⁹ There are however some theories on what might cause it.

It may be genetic. It may be caused by substances in your environment, such as stress. It may be caused by “behavioral factors”, such as poor diet and lack of exercise. Of course, studies also indicate blood pressure naturally increases with aging. So aging itself can also be put on a list of potential causes.⁶

Arteries are surrounded by smooth muscles. These smooth muscles may constrict and squeeze arteries. They may relax and dilate (open) arteries. By this mechanism, your arteries control blood pressure. Constricting arteries increases it, while dilating arteries lowers it.^7,10

Under normal circumstances, your arteries are constantly increasing and lowering your blood pressure. This is a normal part of life. It is necessary to maintain a sense of normalcy inside your body.^4,9

Constricted arteries

When arteries are constricted, this creates a smaller lumen (opening inside your artery). In other words, the artery becomes narrow. This narrowing increases resistance to the flow of blood. This makes it so your heart has to work harder to pump blood through your arterial system.⁹

Vasoconstriction is important during your day. It is necessary to increase your blood pressure. It’s important when your organs require an increase in nutrients or oxygen. There are are also various other benefits. However, under normal circumstances, your blood pressure returns to normal.¹¹

Sometimes arteries become chronically constricted. This makes it so your heart has to work hard every day to pump blood through them.¹⁰ Over time, this may contribute to kidney disease. It may contribute to heart diseases such as heart failure. It may cause aortic aneurysm, heart attacks, and strokes. It may cause peripheral vascular disease and coronary artery disease. It may cause an arrhythmia called atrial fibrillation.^3-4,6

The good news is that these are all preventable with a proper diagnosis and treatment of hypertension.³ This is why it is so important to address hypertension in its earlier stages.

A global problem

Hypertension is a common medical condition affecting 1 in 2 adults over the age of 20 in the U.S. That comes to about 108 million adults in the U.S. Of those, only 1 in 4 have their hypertension controlled.⁴ Worldwide there are as many as a billion people living with hypertension.³

Still, there are many who have it and have not been diagnosed and there are many who were told they have it and are not receiving treatment. In fact, more adults have hypertension than any other disease.⁶ It's a silent, symptomless disease which may explain why it is so often undiagnosed and untreated.³

The good news is that once diagnosed, hypertension is treatable. Sometimes the treatment may involve an improved diet, weight loss, or a reduction in stress. Although, for most, the treatment involves taking blood pressure medicine every day for the rest of your life. Thankfully, today there are many blood pressure medicines for you and your doctor to choose from.