Hypertension, or high blood pressure, affects millions of people — but without outward signs or symptoms, many don’t even know they have it. Because of this, hypertension is often known as the “silent killer.”

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Hypertension, or high blood pressure, affects almost 50% of all adults in the United States, according to the Centers for Disease Control and Prevention (CDC). Hypertension is a risk factor for heart disease, one of the leading causes of death. Yet only 24% of adults living with hypertension have it under control.

Because hypertension doesn’t usually cause any obvious symptoms, especially not in the early stages, it’s often known as the “silent killer.” In fact, many people with high blood pressure don’t even know they have it until they receive a diagnosis.

Learn more about hypertension.

Most people who have hypertension aren’t even aware that they have it because it doesn’t usually cause any symptoms.

But high blood pressure is one of the leading risk factors in many chronic conditions, including heart attack and stroke, two of the most common causes of death worldwide.

Given that people can live with hypertension for years without knowing it, it makes sense that it’s often referred to as the “silent killer.”

Blood pressure refers to the pressure that your blood puts on our arteries as it travels throughout your body to your organs and tissues. Hypertension happens when your blood pressure is higher than what’s considered normal.

We measure blood pressure using two different measurements: systolic and diastolic. Systolic blood pressure is your blood pressure during a heartbeat. Diastolic blood pressure is your blood pressure between heartbeats.

Current clinical guidelines for blood pressure ranges and hypertension

Blood pressure diagnosisBlood pressure range
Normal blood pressuresystolic less than 120 millimeters of mercury (mm Hg) and diastolic less than 80 mm Hg (120/80)
Elevated blood pressuresystolic 120–129 mm Hg and diastolic less than 80 mm Hg (120–129/80)
Hypertension stage 1systolic 130–139 mm Hg or diastolic 80–89 mm Hg (130–139/80–89)
Hypertension stage 2systolic 140 mm Hg or higher or diastolic 90 mm Hg or higher (140/90+)

If a healthcare professional is using older guidelines from 2003, you might notice that these ranges are different. But if you’re confused about which guidelines are being used, don’t hesitate to ask for clarity — especially if you’ve received a diagnosis of hypertension.

Several different factors increase the risk of developing hypertension, including:

Recent research also suggests that certain factors are more likely to lead to uncontrolled hypertension. There are two groups of people that these factors tend to overly affect.

Black people

Hypertension complications, like increased risk of death from stroke or cardiovascular disease, affect Black communities more than any other racial or ethnic group.

While there are multiple reasons for this, one of the largest reasons is healthcare inequities. Inequities that frequently affect Black communities — like racial bias from healthcare professionals and lack of access to treatment — can make it hard for Black people to receive a diagnosis and get the treatment they need.

Older adults

Not only are older adults at a higher risk of developing hypertension as they age, but several other risk factors that increase with age can further increase their risk.

For example, conditions like diabetes and coronary artery disease, which commonly affect older adults, increase their risk of having uncontrolled hypertension. Other factors that increase with age, like financial barriers and even forgetfulness, can also increase your risk of uncontrolled hypertension.

In order for a doctor or healthcare professional to accurately diagnose hypertension, they must collect at least two or more readings on two separate occasions and find the average of these readings.

It’s important that a doctor or nurse checks your blood pressure the right way so that your readings are as accurate as possible. Before your reading, you’ll want to avoid caffeine, exercise, and smoking for at least 30 minutes. During your reading, a doctor might decide to use both of your arms to take readings so that they can get a more accurate picture of your levels.

Whether you have hypertension or just elevated blood pressure, it’s important to lower it so that you can reduce your risk of complications. Treatment options for high blood pressure typically include lifestyle changes and medications.

Lifestyle changes

One of the best ways to lower your blood pressure is by making lifestyle changes. Some of the lifestyle changes that are helpful for managing blood pressure include:


For some people, lifestyle changes aren’t enough, and medication is required to help lower their levels. Many different medications exist for high blood pressure. Each type of medication works to reduce your blood pressure in different ways.

Some common examples include:

  • diuretics
  • angiotensin converting enzyme (ACE) inhibitors
  • angiotensin II receptor blockers (ARBs)
  • calcium channel blockers
  • beta-blockers
  • alpha-beta-blockers
  • alpha-2 receptor agonists (central agonists)
  • vasodilators

Even if you don’t have high blood pressure, following these heart-healthy steps can help keep your blood pressure low and your heart strong.

  • Eat a balanced diet: A heart-healthy diet includes plenty of foods that are low in sodium and saturated fat and that are high in potassium and fiber. Try to fill your plate with fruits and vegetables, lean proteins, and heart-healthy fats. Enjoy treats in moderation.
  • Keep your body moving: Exercise is crucial to keep your blood pressure low because regular exercise helps strengthen your heart. When your heart is stronger, it pumps more efficiently, which means less pressure and stress on your arteries.
  • Watch your intake: Both drinking alcohol and smoking can raise your blood pressure. Try to limit yourself to no more than one to two alcoholic drinks a day (for women and men, respectively). If you smoke, work on quitting.
  • Know your numbers: Hypertension is known as the “silent killer” because many people don’t know they have it. Protect yourself and your heart by having your blood pressure checked regularly and knowing your own numbers.

According to the American Heart Association (AHA), uncontrolled high blood pressure can lead to a number of health complications, including:

If you or someone you love received a diagnosis of elevated or high blood pressure, it’s never too late to address it. With healthy lifestyle changes and medications, you can lower your blood pressure and reduce your risk of complications.

If you’re still worried that you might not be doing enough to get your blood pressure under control, here are a few more commonly asked questions that may be helpful.

How can I lower my blood pressure quickly?

Lowering your blood pressure with lifestyle changes takes time. Although most people start to notice small changes within weeks, sometimes it can take upwards of 6 months to see significant changes, according to the AHA. Medications, on the other hand, can start to lower your blood pressure levels more quickly — usually within a few days.

What foods are good for lowering blood pressure?

While there are no specific foods that can lower your blood pressure by themselves, there are certain foods that can help keep your blood pressure low when eaten regularly as part of a balanced diet. Some of the best foods for high blood pressure include citrus fruits, berries, fatty fish, seeds and nuts, leafy greens, and Greek yogurt, just to name a few.

For some people, limiting their salt intake may also be beneficial.

When is blood pressure high enough to go to the hospital?

For most people, high blood pressure doesn’t usually cause symptoms. But people with very high blood pressure may experience symptoms like headaches, dizziness, chest pain, or even blurred vision. If you have hypertension and are experiencing any of these symptoms, it’s important to get medical care right away.

It can sometimes seem like a Herculean task to keep your heart healthy. But when it comes to your heart health, it’s all about small, consistent steps.

Lifestyle changes like eating a balanced diet, being active regularly, and limiting your alcohol consumption can all help reduce your risk of hypertension — or sometimes even treat it. But if these changes aren’t making enough of an impact on your blood pressure levels, medications can help you get your levels under control.