Our hearts pump five to seven liters of blood per minute. When we’re healthy, that blood flows freely through our veins and arteries to the rest of the body, but sometimes, for a variety of reasons, blood flow gets restricted. That’s what it means to have high blood pressure (also called hypertension). 

Like when too much air is pumped into a tire, this condition causes pressure to build up against blood vessel walls. Over time, high blood pressure damages arterial walls and increases the risk of serious health problems such as heart attack, stroke, and peripheral artery disease.

At Yale Medicine, “we are very individualized in our approach,” says cardiologist Arthur Seltzer, MD. “Some people are amenable to taking medication for their condition. Others would rather have lifestyle changes. As long as the patient understands the goal, they are more likely to follow the program.”

Hypertension is often known as the “silent killer” because there are few or no symptoms. 

You should ask your doctor for a blood pressure reading at least every two years. If you are 40 or older, or you’re considered at high risk for high blood pressure, you should ask your doctor for a blood pressure reading every year. You also can take your blood pressure yourself at some grocery stores or with home blood pressure reading kits. However, these options are often less accurate.

According to guidelines from the National Heart, Lung, and Blood Institute (NHLBI), a reading below 120/80 is classified as normal blood pressure. Those with a blood pressure reading anywhere from 120/80 up to 139/89 are classified within a category called "pre-hypertension."

If you are monitoring your own blood pressure and you get a reading above 180 several times in a row, go see a doctor immediately.

• Before age 55, men are more likely than women to develop high blood pressure. After 55, women and men have equal risk of developing the condition.
• Pregnancy may increase risk of high blood pressure.
• People with heart defects, kidney disorders, or sleep apnea may be at higher risk.
• People with family history of high blood pressure may be at risk for developing the condition themselves.

There are several possible causes.

• Kidney disease: The kidneys regulate sodium and water levels in the body. Imbalances in kidney function can increase the volume of blood in the body, which can cause high blood pressure.
• Family history: Since the condition often runs in families, researchers believe that certain genes may predispose some people to high blood pressure.
• Diet: Diets high in sodium, fat and alcohol can lead to high blood pressure.
• Obesity: Research shows that being overweight or obese can increase the resistance in the blood vessels, which forces the heart to work harder and leads to high blood pressure.
• Medication: Certain medications, including certain birth control pills or over-the-counter cold relief medicines, may impact the way your body controls fluid and salt balances. This causes your blood vessels to constrict and can lead to high blood pressure.

Lifestyle changes are the first line of treatment for hypertension. This includes changes in diet, exercise, alcohol intake and stress-management strategies. Sometimes these lifestyle changes are not enough to control high blood pressure, so your doctor may prescribe medications, including beta-blockers, vasodilators, and diuretics. However, even with these medications, it’s important to keep up with healthy lifestyle changes.

Patients who follow their treatment plan consistently are more likely to manage their high blood pressure successfully. At Yale Medicine, our doctors are committed to working with patients to develop an individualized plan that they can commit to.

One of the most common reasons patients have trouble controlling high blood pressure is they are unable or unwilling to follow the treatment plan consistently. People may experience unpleasant side effects from medications, or feel anxiety about their health, which makes it hard to commit to a treatment plan.

Our doctors tease out all these factors to better understand their patients and develop a treatment plan that works for them. "We have had patients with hypertension that was difficult to treat who were successfully treated here,” says Dr. Seltzer. Yale Medicine doctors are also involved in cutting-edge research, which means patients have access to medications that may not be available to the wider public.