Hypertension: The Silent Killer | Johns Hopkins Aramco Healthcare
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Hypertension: The Silent Killer

Hypertension, or high blood pressure, is a common condition that affects 1 out of every 3 adults.

Hypertension is also called the “Silent Killer” because it often has no symptoms.

It is a common condition in which the force of the blood against the artery walls is too high.

Blood pressure varies all the time. It is common for it to differ by 10 to 20 units when it is measured at different times, even minutes apart.

Exercise or emotional stress can increase blood pressure. The increased blood pressure allows more blood to be pumped to the body to help the body cope with increased activity or stress. The body can tolerate a temporary rise in blood pressure.

Because of these normal variations, health care providers do not diagnose a patient with high blood pressure unless repeated measurements show it to be consistently high.

Your health care provider can diagnose high blood pressure based on two or more in-office readings. A blood pressure reading of 120/80 is ideal. Anything above those numbers is considered high blood pressure.

  1. Elevated blood pressure is when your systolic readings are between 120 and 129 AND your diastolic reading is less than 80.
  2. Stage 1 hypertension is more serious than elevated blood pressure. It happens when your systolic readings are between 130 and 139 OR your diastolic readings are between 80 and 89.
  3. Stage 2 hypertension is more serious than stage 1 and means that your systolic readings are at least 140 OR your diastolic readings are at least 90.
  4. Hypertensive crisis is when your systolic readings are over 180 and/or your diastolic readings are over 120. This is very serious. If you have it, you must see your health care provider right away.

If your blood pressure measures high, discuss lifestyle changes with your health care provider. Your health care provider may also prescribe medications.

High blood pressure increases your risk of heart attack, stroke and heart failure.

Causes of Hypertension

The exact causes of hypertension are not known. But certain risk factors are associated with high blood pressure.

Risk factors for high blood pressure include:

  • Being overweight.
  • Eating a diet that is high in salt and saturated and trans fat.
  • Lack of physical activity.
  • Smoking tobacco products and drinking alcohol.
  • Stress.

Certain health conditions increase the risk of hypertension. These include:

  • High cholesterol.
  • Heart disease.
  • Kidney disease.

Though some people are at a higher risk of developing hypertension, anyone at any age can develop high blood pressure.

People who have a family history of hypertension are more likely to develop the condition.


Aneurysms can bleed and cause death, especially when they are located in the blood vessels of the brain or the aorta. The aorta is the largest blood vessel in the body.

Over time, blood vessels become narrower from the buildup of cholesterol and other debris. The muscles of the arteries can thicken due to high blood pressure, which can cause this narrowing.

Narrow blood vessels restrict and may even block the flow of blood. This lack of blood supply can cause damage to the organs in the body.

The blockage of arteries in the brain can lead to a stroke. Strokes can lead to paralysis, speech problems and death.

Blockage of blood vessels in the kidneys can lead to kidney failure. Kidney failure is the inability of the kidneys to remove poisons from the blood.

Kidney failure can lead to death unless patients receive dialysis treatment. During dialysis, patients are hooked up to a machine 3 to 5 times a week for 4 hours at a time to clean their blood.

Blockage of blood vessels in the eye can lead to vision problems and blindness.

The blockage of an artery that supplies the heart with blood may lead to a heart attack. This weakens the heart and may lead to death.

High blood pressure can cause the heart to get tired from pumping blood at such high pressure. This is known as heart failure. It can result in breathing problems and death.

There is a higher chance of developing complications of high blood pressure if the patient has other medical conditions, such as:

  • Diabetes.
  • High cholesterol.
  • Obesity.
  • Previous strokes or heart attacks.

Controlling Hypertension

High blood pressure can be controlled with lifestyle changes and medical treatment.

Controlling hypertension involves a lifelong commitment to healthy eating and lifestyle habits. Medications may also be needed to bring high blood pressure back to normal.

Regular follow-up care with a health care provider is also essential to make sure that hypertension is controlled. A health care provider can also check for signs of complications.

Losing weight, exercising and eating a healthier diet are usually all that patients need to do to bring their blood pressure levels back to normal.

Eating a diet that is low in salt and saturated and trans fat can help control high blood pressure.

The words salt, sodium, and Na on food labels all mean salt. Your health care provider may recommend a reduced sodium diet. Talk with your health care provider about how much sodium is right for you.

Eating less saturated and trans fat not only helps people lose weight and keep blood pressure levels normal, but it also helps prevent heart attacks and strokes not related to hypertension.

Aerobic exercise also helps people reduce blood pressure as well as lose weight. It helps improve heart performance and decreases the chance of having a heart attack.

Walking, biking and swimming are all examples of aerobic exercise. Check with your health care provider before you begin an exercise program.

Quitting smoking if you smoke and avoiding alcohol can help control your blood pressure. Finding ways to control stress can also help. Stress can be managed through exercise and relaxation techniques such as meditation.

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