Types of Blood Pressure Problems

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Doctor patient's taking blood pressure

If you’ve ever wondered why healthcare providers check your blood pressure on such a regular basis, it’s because it tells them a lot about your risk for serious illness. High blood pressure was the primary or contributing cause for nearly 1,000 deaths a day in the United States in 2013, and the rate has been rising steadily for years.

Blood pressure measures the force with which blood is pressing against the walls of blood vessels. If the force is too high, it can wear on the arteries, causing damage that can result in blockages and ruptures, which in turn can lead to stroke and heart attack, among other serious medical concerns. Doctors made the connection between blood pressure and risk of death in the early 1900s, and today it is considered one of your vital signs, which measure the body’s basic functions. 

There is more than one kind of high blood pressure problem, though hypertension is the most familiar of them. Here’s a look at different kinds of blood pressure problems and what can be done about them:

High Blood Pressure

Also known as hypertension, high blood pressure affects more than 70 million Americans, or a third of the adult population. Today, experts define high blood pressure as a consistent reading of 130 over 80 or higher. The first number is the force exerted when the heart is beating, and the bottom number is when your heart is at rest, between beats. Because there are no symptoms or warning signs, many people are unaware that they have high blood pressure.

Secondary Hypertension

An underlying medical condition causes high blood pressure in about 5% of cases, including conditions that affect the kidneys, arteries or your hormonal system. Secondary hypertension represents the same health risks as primary hypertension and it can also worsen the primary condition. If the disorder that is causing the high blood pressure is treated, your blood pressure may return to normal, and the same treatments available for primary hypertension can also help get it under control.

Resistant Hypertension

About half the people with hypertension have difficulty getting their blood pressure down to a healthy level, for reasons that are not always clear. If someone has been given three different blood pressure medications, one of which is a diuretic, and their blood pressure hasn’t come down, they have resistant hypertension. Occasionally, it may be due to what is called the “white coat effect,” when people’s blood pressure goes up because they become anxious or nervous in a doctor’s office. Your doctor will be aware of the “white coat effect” and find alternate ways to get an accurate reading.

Pulmonary Hypertension

Pulmonary hypertension affects the vessels that deliver blood to the lungs, which is separate from the rest of your circulatory system. It is a rare condition, usually found in younger women, in which you have high blood pressure specifically in the arteries leading to your lungs. The symptoms may include shortness of breath, a racing heartbeat, chest pain, and reduced appetite. Pulmonary hypertension can make your heart work harder to get blood to your lungs and cause heart failure. Heart failure does not mean your heart stops, but rather that it is not working as well as it should. Though there is no cure for pulmonary hypertension, there are treatments that can help manage the condition.

Low Blood Pressure

Most experts do not consider low blood pressure, or hypotension, to be dangerous, especially if there are no symptoms. Hypotension is defined as having a blood pressure of less than 90 over 60. Some people have naturally low blood pressure. Hypotension can also be caused by dehydration, pregnancy, certain medications, and health conditions. A sudden drop in blood pressure when you abruptly get up from a sitting position is called orthostatic hypotension. It usually lasts for just a few minutes and your body recovers quickly. However, if you experience dizziness, fainting, blurred vision, clammy skin, or shallow breathing on a regular basis, call your healthcare provider, who can assess whether there is an underlying health concern.

You can often lower high blood pressure, regardless of the cause, by making healthy lifestyle changes and working closely with your doctor. You may have heard it before, but three things you can do are to lose weight, stop smoking and get moving. The U.S. Centers for Disease Control and Prevention also estimates that if people simply reduced the salt they eat by one-third, it could mean 11 million fewer cases of high blood pressure a year.

There are many categories of medications your healthcare provider can prescribe to help lower your blood pressure, depending on your age, race, weight and other factors. If your doctor does give you blood pressure medication, it’s important that you take it as prescribed. Be aware of your blood pressure numbers and talk to your healthcare provider about how you can get them to a healthy level and keep them there.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Nov 28

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