High blood pressure (HBP) or hypertension means high pressure (tension) in the arteries. Arteries are vessels that carry blood from the pumping heart to all the tissues and organs of the body. High blood pressure does not mean excessive emotional tension, although emotional tension and stress can temporarily increase blood pressure. Normal blood pressure is below 120/80; blood pressure between 120/80 and 139/89 is called "pre-hypertension", and a blood pressure of 140/90 or above is considered high.

The top number, the systolic blood pressure, corresponds to the pressure in the arteries as the heart contracts and pumps blood forward into the arteries. The bottom number, the diastolic pressure, represents the pressure in the arteries as the heart relaxes after the contraction. The diastolic pressure reflects the lowest pressure to which the arteries are exposed.

An elevation of the systolic and/or diastolic blood pressure increases the risk of developing heart (cardiac) disease, kidney (renal) disease, hardening of the arteries (atherosclerosis or arteriosclerosis), eye damage, and stroke (brain damage). These complications of hypertension are often referred to as end-organ damage because damage to these organs is the end result of chronic (long duration) high blood pressure. For that reason, the diagnosis of high blood pressure is important so efforts can be made to normalize blood pressure and prevent complications.

Two forms of high blood pressure have been described: essential (or primary) hypertension and secondary hypertension. Essential hypertension is a far more common condition and accounts for 95% of hypertension. The cause of essential hypertension is multifactorial, that is, there are several factors whose combined effects produce hypertension. In secondary hypertension, which accounts for 5% of hypertension, the high blood pressure is secondary to (caused by) a specific abnormality in one of the organs or systems of the body. (Secondary hypertension is discussed further in a separate section later.)

Genetic factors are thought to play a prominent role in the development of essential hypertension. However, the genes for hypertension have not yet been identified. (Genes are tiny portions of chromosomes that produce the proteins that determine the characteristics of individuals.) The current research in this area is focused on the genetic factors that affect the renin-angiotensin-aldosterone system. This system helps to regulate blood pressure by controlling salt balance and the tone (state of elasticity) of the arteries.

The vast majority of patients with essential hypertension have in common a particular abnormality of the arteries: an increased resistance (stiffness or lack of elasticity) in the tiny arteries that are most distant from the heart (peripheral arteries or arterioles). The arterioles supply oxygen-containing blood and nutrients to all of the tissues of the body. The arterioles are connected by capillaries in the tissues to the veins (the venous system), which returns the blood to the heart and lungs. Just what makes the peripheral arteries become stiff is not known. Yet, this increased peripheral arteriolar stiffness is present in those individuals whose essential hypertension is associated with genetic factors, obesity, lack of exercise, overuse of salt, and aging. Inflammation also may play a role in hypertension since a predictor of the development of hypertension is the presence of an elevated C reactive protein level (a blood test marker of inflammation) in some individuals.

Uncomplicated high blood pressure usually occurs without any symptoms (silently) and so hypertension has been labeled "the silent killer." It is called this because the disease can progress to finally develop any one or more of the several potentially fatal complications of hypertension such as heart attacks or strokes. Uncomplicated hypertension may be present and remain unnoticed for many years, or even decades. This happens when there are no symptoms, and those affected fail to undergo periodic blood pressure screening.

Some people with uncomplicated hypertension, however, may experience symptoms such as headache, dizziness, shortness of breath, and blurred vision. The presence of symptoms can be a good thing in that they can prompt people to consult a doctor for treatment and make them more compliant in taking their medications. Often, however, a person's first contact with a physician may be after significant damage to the end-organs has occurred. In many cases, a person visits or is brought to the doctor or an emergency room with a heart attack, stroke, kidney failure, or impaired vision (due to damage to the back part of the retina). Greater public awareness and frequent blood pressure screening may help to identify patients with undiagnosed high blood pressure before significant complications have developed.

About one out of every 100 (1%) people with hypertension is diagnosed with severe high blood pressure (accelerated or malignant hypertension) at their first visit to the doctor. In these patients, the diastolic blood pressure (the minimum pressure) exceeds 140 mm Hg! Affected persons often experience severe headache, nausea, visual symptoms, dizziness, and sometimes kidney failure. Malignant hypertension is a medical emergency and requires urgent treatment to prevent a stroke (brain damage).

Blood pressure is measured or tested by taking a blood pressure reading. It is measured using two numbers, (i.e.120/80mmHg). The "top" number is called the systolic number, which is a measurement of the pressure on the artery walls when the heart beats. The "bottom" number is the diastolic number, which is a measurement of the pressure on the artery walls when the heart is resting between beats.

The list of diagnostic tests mentioned in various sources as used in the diagnosis of Hypertension includes:

1. Sphygmomanometer (arm cuff blood pressure test)
2. Home blood pressure tests
3. Finger cuff blood pressure test

You and your health care provider have options for treating your high blood pressure.

1. Many people can lower their blood pressure significantly with lifestyle changes, such as weight loss   and exercise, but most still need medication to keep their blood pressure in the healthy range.
2. Whichever therapy you choose, it is important to have your blood pressure checked regularly to make sure that your treatment is working.
3. Uncontrolled high blood pressure is a leading cause of heart disease, heart attacks, heart failure, kidney failure, vision problems, and stroke.
4. You may have wondered whether the blood pressure machines at the pharmacy or supermarket are accurate.
5. A recent study showed that they can be accurate, but sometimes are not.
6. It usually is not possible to tell whether a particular machine is working properly. The cuff should inflate and fit snugly around your arm.
7. Use the machine as directed.
8. Measure your blood pressure three times, two minutes apart. The third measurement is usually the most accurate.
9. If your blood pressure is high on the third reading, even borderline, have it checked by another machine that you know is accurate (for example, at the office of your health care provider).
10. Do not rely on the machines in stores alone to check your blood pressure. Have it checked regularly by a trained medical professional with a machine that is known to be accurate.

1. Healthy weight
2. Lose weight - if you are overweight.
3. Physical activity
4. Exercise
5. Healthy diet
6. Avoid high salt or high sodium diet
7. Avoid excessive alcohol
8. Take anti-hypertension medication as directed

1. Kidney disease
2. Kidney failure (type of Kidney disease) - hypertension is the second most common cause of kidney failure (after diabetes)
3. End-stage renal disease
4. Heart disease
5. Hardened arteries (see Artery symptoms)
6. Cardiovascular disease
7. Angina
8. Heart attack
9. Left ventricular hypertrophy
10. Heart failure
11. Left-side heart failure
12. Stroke
13. Cerebrovascular disease
14. Stroke
15. Cerebral hemorrhage
16. Eye complications (see Eye symptoms)
17. Retinal damage (see Retina symptoms)
18. Impaired vision
19. Death
20. Increased risk of coronary artery disease
21. Increased risk of stroke
22. Increased risk of aneurysm
23. Increased risk of congestive heart failure
24. Increased risk of kidney disease
25. Increased risk of heart attack
26. Increased risk of damage to blood vessels
27. Increased risk of vision loss
28. Premature death (type of Death)