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Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood. This is called systolic pressure. When your heart is at rest, between beats, your blood pressure falls. This is called diastolic pressure.

Your blood pressure reading uses these two numbers. Usually the systolic number comes before or above the diastolic number. For example, 120/80 means a systolic of 120 and a diastolic of 80.

High blood pressure usually has no symptoms. So the only way to find out if you have it is to get regular blood pressure checks from your health care provider. Your provider will use a gauge, a stethoscope or electronic sensor, and a blood pressure cuff. They will take two or more readings at separate appointments before making a diagnosis.

For children and teens, the health care provider compares the blood pressure reading to what is normal for other kids who are the same age, height, and sex.

There are two main types of high blood pressure: primary and secondary high blood pressure.:

• Primary, or essential, high blood pressure is the most common type of high blood pressure. For most people who get this kind of blood pressure, it develops over time as you get older.
• Secondary high blood pressure is caused by another medical condition or use of certain medicines. It usually gets better after you treat that condition or stop taking the medicines that are causing it.

When your blood pressure stays high over time, it causes the heart to pump harder and work overtime, possibly leading to serious health problems such as heart attack, stroke, heart failure, and kidney failure.

Treatments for high blood pressure include heart-healthy lifestyle changes and medicines.

You will work with your provider to come up with a treatment plan. It may include only the lifestyle changes. These changes, such as heart-healthy eating and exercise, can be very effective. But sometimes the changes do not control or lower your high blood pressure. Then you may need to take medicine. There are different types of blood pressure medicines. Some people need to take more than one type.

If your high blood pressure is caused by another medical condition or medicine, treating that condition or stopping the medicine may lower your blood pressure.

NIH: National Heart, Lung, and Blood Institute

Coronary artery disease (CAD) is the most common type of heart disease. It is the leading cause of death in the United States in both men and women.

CAD happens when the arteries that supply blood to heart muscle become hardened and narrowed. This is due to the buildup of cholesterol and other material, called plaque, on their inner walls. This buildup is called atherosclerosis. As it grows, less blood can flow through the arteries. As a result, the heart muscle can't get the blood or oxygen it needs. This can lead to chest pain (angina) or a heart attack. Most heart attacks happen when a blood clot suddenly cuts off the hearts' blood supply, causing permanent heart damage.

Over time, CAD can also weaken the heart muscle and contribute to heart failure and arrhythmias. Heart failure means the heart can't pump blood well to the rest of the body. Arrhythmias are changes in the normal beating rhythm of the heart.

NIH: National Heart, Lung, and Blood Institute

Heart failure means that your heart can't pump enough oxygen-rich blood to meet your body's needs. Heart failure doesn't mean that your heart has stopped or is about to stop beating. But without enough blood flow, your organs may not work well, which can cause serious problems.

Heart failure can affect one or both sides of your heart:

• With right-sided heart failure, your heart is too weak to pump enough blood to your lungs to get oxygen.
• With left-sided heart failure, your heart can't pump enough oxygen-rich blood out to your body. This happens when the left side of your heart becomes either:
  • Too weak to pump enough blood.
  • Too thick or stiff to relax and fill with enough blood.

Left-sided heart failure is more common than right-sided heart failure.

Heart failure can start suddenly after a medical condition or injury damages your heart muscle. But in most cases, heart failure develops slowly from long-term medical conditions.

Conditions that can cause heart failure include:

• Arrhythmia (a problem with the rate or rhythm of your heartbeat)
• Cardiomyopathy
• Congenital heart defects or other types of heart diseases that you are born with
• Coronary artery disease
• Endocarditis
• Heart attack
• Heart valve diseases
• High blood pressure
• A blood clot in your lung
• Diabetes
• Certain severe lung diseases, such as COPD (chronic obstructive pulmonary disease)
• Obesity

Over time, left-sided heart failure can lead to right-sided heart failure.

Heart failure can happen at any age. It happens to both men and women, but men often develop it at a younger age than women. Your chance of developing heart failure increases if:

• You're 65 years old or older. Aging can weaken and stiffen your heart muscle.
• Your family health history includes relatives who have or have had heart failure.
• You have changes in your genes that affect your heart tissue.
• You have habits that can harm your heart, including:
  • Smoking
  • Eating foods high in fat, cholesterol, and sodium (salt)
  • Having an inactive lifestyle
  • Alcohol use disorder (AUD)
  • Illegal drug use
• You have other medical conditions that can affect your heart, including:
  • Any heart or blood vessel conditions, including high blood pressure
  • Serious lung diseases
  • Infection, such as HIV or COVID-19
  • Obesity
  • Diabetes
  • Sleep apnea
  • Chronic kidney disease
  • Anemia
  • Iron overload disease
  • Cancer treatments that can harm your heart, such as radiation and chemotherapy
• You are African American. African Americans are more likely to develop heart failure and have more serious cases at younger ages than people of other races. Factors such as stigma, discrimination, income, education, and geographic region can also affect their risk of heart failure.

The symptoms of heart failure depend on which side of your heart is affected and how serious your condition has become. Most symptoms are caused by reduced blood flow to your organs and fluid buildup in your body.

Fluid buildup happens because the flow of blood through your heart is too slow. As a result, blood backs up in the vessels that return the blood to your heart. Fluid may leak from the blood vessels and collect in the tissues of your body, causing swelling (edema) and other problems.

Symptoms of heart failure may include:

• Feeling short of breath (like you can't get enough air) when you do things like climbing stairs. This may be one of the first symptoms you notice.
• Fatigue or weakness even after rest.
• Coughing.
• Swelling and weight gain from fluid in your ankles, lower legs, or abdomen (belly).
• Difficulty sleeping when lying flat.
• Nausea and loss of appetite.
• Swelling in the veins of your neck.
• Needing to urinate (pee) often.

At first you may have no symptoms or mild symptoms. As the disease gets worse, your symptoms will usually bother you more.

Fluid buildup and reduced blood flow to your organs can lead to serious problems, including:

• Breathing problems from fluid in and around your lungs (also called congestive heart failure)
• Kidney or liver damage including cirrhosis
• Malnutrition if fluid buildup makes eating uncomfortable or if your stomach doesn't get enough blood flow to digest food properly
• Other heart conditions, such as irregular heartbeat and sudden cardiac arrest
• Pulmonary hypertension

To find out if you have heart failure, your doctor will:

• Ask about your medical history, including your symptoms
• Ask about your family health history, including relatives who have had heart failure
• Do a physical exam
• Will likely order heart tests and blood tests, including a brain natriuretic peptide (BNP) test

In some cases, your doctor may refer you to a cardiologist (a doctor who specializes in heart diseases) for tests, diagnosis, and care.

Your treatment will depend on the type of heart failure you have and how serious it is. There's no cure for heart failure. But treatment can help you live longer with fewer symptoms.

Even with treatment, heart failure usually gets worse over time, so you'll likely need treatment for the rest of your life.

Most treatment plans include:

• Taking medicine
• Eating less sodium and drinking less liquid to control fluid buildup
• Making other changes, such as quitting smoking, managing stress, and getting as much physical activity as your health care provider recommends
• Treating any conditions that may make heart failure worse

You may need heart surgery if:

• You have a congenital heart defect or damage to your heart that can be fixed.
• The left side of your heart is getting weaker and putting a device in your chest could help. Devices include:
  • An implantable cardioverter defibrillator.
  • A biventricular pacemaker (cardiac resynchronization therapy).
  • A mechanical heart pump (a ventricular assist device (VAD) or a total artificial heart).
• Your heart doctor recommends a heart transplant because your heart failure is life-threatening and nothing else is helping.

As part of your treatment, you'll need to pay close attention to your symptoms, because heart failure can worsen suddenly. Your provider may suggest a cardiac rehabilitation program to help you learn how to manage your condition.

You may be able to prevent or delay heart failure if you:

• Work with your provider to manage any health conditions that increase your risk of developing heart failure
• Make healthy changes in your eating, exercise, and other daily habits to help prevent heart disease

NIH: National Heart, Lung, and Blood Institute

Around half of American adults have high blood pressure (hypertension). Many of those people don't know they have it because there are usually no warning signs. This can be dangerous, because high blood pressure can lead to life-threatening conditions like heart attack or stroke. The good news is that you can often prevent or treat high blood pressure. Early diagnosis and heart-healthy lifestyle changes can keep high blood pressure from seriously damaging your health.

Each time your heart beats, it pumps blood into your arteries (the blood vessels that carry blood from your heart to the tissues and organs in your body). Blood pressure is the force of your blood pushing against the walls of your arteries. Blood pressure is measured as two numbers:

• Systolic pressure (the first and higher number) measures pressure inside your arteries when your heart beats
• Diastolic pressure (the second and lower number) measures the pressure inside your arteries when your heart rests between beats

As an example, a blood pressure reading of 120/80 means a systolic of 120 and a diastolic of 80.

High blood pressure usually has no symptoms. So the only way to find out if you have it is to get regular blood pressure checks from your health care provider. Your provider will use a gauge, a stethoscope or electronic sensor, and a blood pressure cuff. They will take two or more readings at separate appointments before making a diagnosis:

For children and teens, the provider compares the blood pressure reading to what is normal for other kids who are the same age, height, and gender.

Anyone can develop high blood pressure, but there are certain factors that can increase your risk:

• Age. Blood pressure tends to rise with age.
• Race/Ethnicity. High blood pressure is more common in Black adults. They also tend to have higher average blood pressure numbers and get high blood pressure earlier in life.
• Sex. Men are more likely than women to develop high blood pressure throughout middle age. But in older adults, women are more likely than men to develop high blood pressure.
• Lifestyle. Certain lifestyle habits can raise your risk for high blood pressure, such as eating too much sodium (salt) or not enough potassium, lack of exercise, drinking too much alcohol, and smoking.
• Family history and genetics. High blood pressure often runs in families. Many genes are linked to small increases in high blood pressure risk.
• Social and economic factors:
  • Research shows that factors such as income, education level, where you live, and the type of job you have may raise your risk of high blood pressure. For example, working early or late shifts can raise your risk.
  • Experiencing discrimination and poverty has been linked to high blood pressure. Also, some research has shown that trauma in childhood may raise the risk of high blood pressure.
• Certain medicines. Some medicines can raise your blood pressure, including:
  • Certain antidepressants
  • Decongestants (medicines to relieve a stuffy nose)
  • Hormonal birth control pills
  • Non-steroidal anti-inflammatory drugs (NSAIDs), which are a type of pain reliever
• Having certain other medical conditions, such as:
  • Some tumors
  • Chronic kidney disease
  • Diabetes
  • Metabolic syndrome
  • Overweight and obesity
  • Sleep apnea
  • Thyroid problems

You can help prevent high blood pressure by having a healthy lifestyle. This means:

• Eating a healthy diet. To help manage your blood pressure, you should limit the amount of sodium (salt) that you eat and increase the amount of potassium in your diet. It is also important to eat foods that are lower in fat, as well as plenty of fruits, vegetables, and whole grains. The DASH eating plan is an example of an eating plan that can help you to lower your blood pressure.
• Getting regular physical activity. Regular physical activity can help you maintain a healthy weight and lower your blood pressure.
• Being at a healthy weight. Being overweight or having obesity increases your risk for high blood pressure. Maintaining a healthy weight can help you control high blood pressure and reduce your risk for other health problems.
• Limiting alcohol. Drinking too much alcohol can raise your blood pressure. It also adds extra calories, which may cause weight gain.
• Not smoking. Cigarette smoking raises your blood pressure and puts you at higher risk for heart attack and stroke. If you do not smoke, don't start. If you do smoke, talk to yourprovider for help in finding the best way for you to quit.
• Managing stress. Learning how to relax and manage stress can improve your emotional and physical health and lower high blood pressure. Stress management techniques include exercising, listening to music, focusing on something calm or peaceful, and meditating.
• Getting enough high-quality sleep.

If you already have high blood pressure, it is important to prevent it from getting worse or causing complications. You need to get regular medical care and follow your treatment plan. Your plan will include healthy lifestyle habit recommendations and possibly medicines.

NIH: National Heart, Lung, and Blood Institute