High Blood Pressure

High Blood Pressure: The Link That Often Leads to Heart Disease and Stroke

One in three Americans has hypertension — commonly known as high blood pressure — and 54 percent of those who have it do not have it under control. Unfortunately, about one in five adults in the U.S. who have high blood pressure do not even know they have it. Because it has no visible symptoms, it’s known as “The Silent Killer.” And certain ethnicities, such as African Americans, are at higher risk than Caucasian or Hispanic populations.

Women are just as likely as men to develop high blood pressure during their lifetime. However, for those under the age of 45, the condition affects more men than women. For people age 65 and older, high blood pressure affects more women than men.

About seven in 10 people who experience their first heart attack also have high blood pressure. Eight in 10 who have their first stroke have high blood pressure. Seven in 10 who have chronic heart failure have high blood pressure.

High blood pressure costs the nation $46 billion each year. This total includes the cost of health care services, medications to treat high blood pressure, and missed days of work.

Learn about high blood pressure, its causes, and what you can do to prevent or treat it.

The risk factors for high blood pressure.

High blood pressure might be hereditary, so you could be genetically predisposed to developing it. But high blood pressure can also be brought on by things you can control:

  • Behaviors consisting of smoking or drinking too much alcohol
  • Poor diet, such as fast foods or processed foods containing trans fats or saturated fats, foods with too much salt or sugar, and foods with not enough potassium
  • Excess weight or obesity
  • Chronic conditions such as diabetes
  • Inactivity, lack of exercise, or other controllable factors

If you haven’t had your blood pressure checked recently, do so. And if it’s borderline or high, talk with a healthcare provider to learn what you can do about it.

Assess your risk of hypertension.

Learn your risk.

The numbers: Blood pressure. Cholesterol. Triglycerides. Hemoglobin. What do they mean?

Blood Pressure

  • Systolic pressure is the pressure in your blood vessels when your heart beats.
  • Diastolic pressure is the pressure in your blood vessels when your heart rests between beats.
  • So if your measurement reads 120 systolic and 80 diastolic, you would say “120 over 80” or write “120/80 mmHg.” The following chart indicates the blood pressure range for normal people, those at risk, and those who have hypertension.

Blood Pressure Levels

  • Systolic: less than 120 mmHg
  • Diastolic: less than 80 mmHg
At risk (prehypertension)
  • Systolic: 120–139 mmHg
  • Diastolic: 80–89 mmHg
High blood pressure
  • Systolic: 140 or higher mmHg
  • Diastolic: 90 or higher mmHg


Cholesterol is a waxy, fat-like substance that helps make vitamin D and hormones in the body. It also travels in the blood stream in small packages of lipoproteins (fat + protein), which contain “good” cholesterol (HDL) made up of high-density lipoproteins and “bad” cholesterol (LDL) made up of low-density lipoproteins.

LDL can lead to cholesterol buildup and plaque in blood vessels, causing narrowing and hardening of the arteries, which triggers a condition called high blood cholesterol and increases the risk of coronary heart disease, heart attack, and stroke. The key is to maintain both types of lipoproteins at healthy levels. Blood glucose tests keep you aware of your cholesterol levels, which are measured in mg/dL (milligrams per deciliter) and show the concentration of a substance in a fluid.


Total Cholesterol
  • Desirable: Less than 200 mg/dL
  • Borderline: 200–239 mg/dL
  • High risk: 240 mg/dL or above
  • Desirable: 60 mg/dL or greater
  • At-risk men: Less than 40 mg/dL
  • At-risk women: Less than 50 mg/dL
  • Optimal: Less than 100 mg/dL
  • Near or above optimal: 100–129 mg/dL
  • Borderline high: 130–159 mg/dL
  • High: 160–189 mg/dL
  • Very high: 190 mg/dL or above

Triglycerides, another fatty substance in the bloodstream, can also contribute to narrowing of the arteries and high blood pressure.

  • Normal: 1490 mg/dL or less
  • Borderline: 150–199 mg/dL
  • High: 200–499 mg/dL
  • Very high: 500 mg/dL or above


The hemoglobin A1c test is also called HbA1c, glycated hemoglobin test, or glycohemoglobin. Hemoglobin is in your red blood cells, which carry oxygen throughout the body. A1c is an important blood test that shows how well your blood sugar is being controlled—critically important for people with diabetes. The higher the hemoglobin A1c, the higher the risks of developing complications related to diabetes.

You should have this test done annually if you are 45 or older, are overweight or obese, inactive, not getting any exercise, or are diagnosed with prediabetes.

Test frequency should increase if:

  • You have type 2 diabetes, but your blood sugar level stays consistently within your target range and you don’t need insulin. Get tested every six months.
  • You have type 2 diabetes, but your blood sugar level stays consistently within your target range and you don’t need insulin. Get You have type 1 diabetes. Get tested three to four times a year.
  • You have type 2 diabetes, but your blood sugar level stays consistently within your target range and you don’t need insulin. Get You have type 2 diabetes and manage it with insulin, but you have difficulty keeping your blood sugar within your target range. Get tested four times a year.

Here’s why. If your blood sugar is persistently high, it can damage small blood vessels (microvascular disease) and nerves. If it damages large blood vessels (macrovascular disease), plaque begins to buildup, which can heighten your risk of coronary heart disease, hypertension, a stroke or a heart attack. Speak with your physician or other health provider about the A1c test. It could save your life.

Here is the range and meaning of A1c numbers:

People without diabetes:
Increased risk of diabetes:
Treatment needed:
6.5% or higher

Preventing, detecting, and treating high blood pressure.

The National Heart, Lung, and Blood Institute has recently published a comprehensive report with the latest findings and recommendations regarding hypertension. Read the report .

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