Blood pressure is measured in millimeters of mercury (mm Hg). Hypertension (high blood pressure) is when your blood pressure frequently goes over 140/90 mm Hg.

A patient is considered "pre-hypertensive" if the top (systolic) number of the blood pressure reading is 120-139 mm Hg and if the bottom (diastolic) number is over 80-89 mm Hg on most measurements.

If you have pre-hypertension, you are likely to develop high blood pressure at some point, unless you make lifestyle changes to lower your blood pressure to normal.

High blood pressure can affect all types of people.

About 1 in every 5 adults in the U.S. has high blood pressure. High blood pressure occurs more often in men than in women, and in African Americans almost twice as often as in Caucasians.

Most people feel no symptoms with uncomplicated high blood pressure. Essential hypertension (hypertension with no known cause) is not fully understood, but accounts for between 80-85% of all hypertension cases in people over 45 years of age.

Even though many times high blood pressure does not have a known cause, the condition can still be treated effectively with both lifestyle changes and medications.

Lifestyle changes include following a low sodium diet, exercising, quitting smoking, losing weight, and avoiding excessive alcohol intake. There are dozens of different medications available for the management of high blood pressure.

Most of the time, no cause is identified. This is called essential hypertension. High blood pressure that results from a specific condition, habit, or medication is called secondary hypertension. Some reasons for secondary hypertension include:

• Use of certain medications (such as appetite suppressants, cold preparations, and migraine medications)
• Habitual alcohol use
• Excess sodium (salt) in your diet
• Obesity
• Anxiety or stress
• Arteriosclerosis
• Coarctation of the aorta
• Pain
• Renal artery stenosis
• Diabetes
• Drugs such as alcohol toxicity or cocaine
• Renal disease

Have your blood pressure checked at regular intervals (as recommended by your health care provider) to monitor its condition and response to treatment.

A proper diet, weight loss, exercise, and salt and alcohol reduction are often recommended for patients with hypertension or pre-hypertension.

The goal of treatment is to reduce your blood pressure, which will lower the risk of complications. The goal is blood pressure at least below 140/90 and below 130/80 if you have diabetes or kidney disease.

If your blood pressure reading is consistently above 140/90 mmHg, your doctor may prescribe medication. If you have any other risk factors for heart disease, especially diabetes, your doctor will consider starting medications sooner rather than later.

If you have high blood pressure, you will have regularly scheduled appointments with your doctor.

In between appointments, if you have unexplained and persistent high blood pressure -- this assumes home blood pressure monitoring -- or any of the following symptoms call your health care provider right away:

• Severe headache
• Excessive tiredness
• Confusion
• Visual changes
• Nausea and vomiting
• Chest pain
• Shortness of breath
• Significant sweating

Your health care provider will perform a thorough physical examination. The physical examination will include blood pressure measurement. Your blood pressure may need to be monitored several times over a period of weeks or months.

He or she will also ask questions such as:

• Time pattern
  • Has your blood pressure increased recently?
  • Did it suddenly become high?
• Quality
  • What is your blood pressure reading?
  • When the blood pressure is measured on multiple occasions, what is the average systolic (top number) and diastolic (bottom number)?
  • How much has the blood pressure gone up within the past two weeks?
  • What is the blood pressure now?
  • What was the previous blood pressure?
• What other symptoms are present?

• Blood tests, such as a chem-20
• Urinalysis
• X-rays of the kidneys
• EKG or echocardiogram

In people with hypertension, modification of sodium intake may be recommended. Products containing sodium (e.g., salt, MSG, and baking soda) often have little effect in people without hypertension, but may have a profound effect in those with hypertension.