GoodRx Guide
What Is High Blood Pressure (Hypertension)? Symptoms, Causes, and Treatments
Comprehensive information for you or a loved one — including treatment options and discounts on popular medications.
What is hypertension?
High blood pressure, also called hypertension, is when the force of the blood pushing against the artery walls is too high. High blood pressure is a very common problem in the U.S. The American Heart Association (AHA) estimates that more than half of adults in the U.S. have the condition. Hypertension is called the “silent killer,” because many people aren’t aware that they have it.
If left untreated, high blood pressure can lead to:
Heart disease
Eye damage
Death
Talk with your healthcare team about your blood pressure readings. This is especially important if you have a family history of high blood pressure or other risk factors (more below).
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What causes hypertension?
For most people with the condition, their high blood pressure is considered “primary” or “essential.” This means it’s not a direct result of another condition. Experts don’t fully understand the cause of primary hypertension. But it’s likely due to a combination of genetic factors and lifestyle habits.
You are more likely to get high blood pressure if you:
Have a relative with high blood pressure
Are older (risk increases with age)
Have a body mass index (BMI) of over 25
Don’t get enough physical activity
Consume a high-sodium diet
Drink more alcohol than is recommended
“Secondary” hypertension is high blood pressure that’s caused by another medical condition or medication. Examples include:
Many prescription and over-the-counter (OTC) medications
Recreational drugs like cocaine and amphetamines
Kidney disease
Narrowing of the large blood vessel that carries blood from the heart (coarctation of the aorta)]
Hormonal conditions like thyroid disease, Cushing’s disease, high aldosterone, or pheochromocytoma
Hypertension symptoms
The majority of people with high blood pressure don’t have symptoms. Even dangerously high levels of blood pressure often don’t cause symptoms.
When people have symptoms with high blood pressure, they report:
Changes to their vision
Flushing
Shortness of breath
Related Health Conditions
How hypertension is diagnosed
Blood pressure is measured using an inflatable arm cuff. A blood pressure reading consists of a systolic blood pressure (top number) and diastolic blood pressure (bottom number). High blood pressure is diagnosed when both numbers are elevated on several occasions.
The current definitions for “normal” and “high” levels of blood pressure are:
Normal blood pressure (considered healthy)
The top number is less than 120 mmHg.
And the bottom number is less than 80 mmHg.
Elevated blood pressure (needs close monitoring)
The top number is between 120 mmHg and 129 mmHg.
And the bottom number is less than 80 mmHg.
Hypertension or high blood pressure (needs treatment)
The top number is above 130 mmHg.
Or the bottom number is above 80 mmHg.
You should have your blood pressure measured at least once per year if you don’t have risk factors for high blood pressure. If you do have risk factors, get your blood pressure checked at least every 6 months, and more often if it’s elevated. It can be helpful to have your own blood pressure cuff to monitor your blood pressure at home.
Lifestyle measures for hypertension
If you have high blood pressure, no matter how mild or severe, a healthcare professional will prescribe lifestyle measures as part of your treatment. These include:
Restricting the amount of salt (sodium) you eat
Weight loss, or maintaining a healthy and balanced weight
Quitting smoking, if you smoke
Reducing alcohol intake
Types of hypertension medications
The decision to start medication for the treatment of high blood pressure is based on a few things. They include how high your blood pressure is, your other health conditions, and your individual circumstances. Sometimes, two or more medications are needed to lower blood pressure to safe levels. You should plan to work closely with your healthcare team to find the right treatment plan for you.
Experts recommend four classes of blood pressure medications as “first-line” treatments. This means these medication types are the most effective medicines used to lower blood pressure.
Thiazide diuretic or thiazide-type diuretic
Thiazide diuretics are a type of “water pill.” These help your kidneys remove excess sodium and fluid from the body. These medications can be used in combination with other medications for control of high blood pressure. Some examples are:
Angiotensin-converting enzyme inhibitor
Angiotensin-converting enzyme (ACE) inhibitors block the production of a hormone called angiotensin II, which the body uses to control blood pressure. They help protect the kidneys in people with kidney disease and diabetes. They’re also recommended for people with heart failure. Some examples are:
Angiotensin receptor blocker
Angiotensin receptor blockers (ARBs) also block angiotensin II. They are similar to ACE inhibitors, and are recommended for similar medical conditions. But they are sometimes more effective at lowering blood pressure. Some examples are:
Calcium channel blocker
Calcium channel blockers prevent calcium from entering muscle cells. Since muscle cells are in blood vessel walls, this causes them to relax. In some cases, they can also slow the heart rate, which can be useful in conditions such as atrial fibrillation (AFib). Examples are:
There are several other classes of medications that can lower blood pressure. They can be used alone and in combination with the medications listed above. These include:
Aldosterone antagonists: aldactone
Alpha blockers: doxazosin
Alpha-beta blockers: carvedilol, labetalol
Beta blockers: metoprolol, atenolol
Central-acting agents: clonidine
Renin inhibitors: aliskiren
Vasodilators: hydralazine, minoxidil
Side effects are possible with any medication. If you think your blood pressure medication is causing side effects, be sure to contact your healthcare team first. It’s not safe to stop your medications suddenly without consulting a medical professional.
Ways to prevent hypertension
The best way to prevent high blood pressure is to make healthy lifestyle changes. These are the same as the ones mentioned above for treatment. They include:
Not smoking or vaping
Limiting alcohol and caffeine
Maintaining a healthy and balanced weight
Frequently asked questions
A reading of 110/70 is a normal blood pressure. A reading of 138/80 is mild hypertension. High blood pressure readings are as follows:
A top number of 120 to 129 and a bottom number of less than 80 is considered elevated blood pressure.
A top number of 130 to 139 or a bottom number of 80 to 89 is stage 1 hypertension.
A blood pressure reading above 140/90 is stage 2 hypertension.
A reading of 180/120 or higher is a hypertensive crisis and requires emergency medical attention.
In some cases, high blood pressure can be lowered to normal levels. There are two main types of high blood pressure: primary and secondary hypertension. Unfortunately, there’s no cure yet for primary hypertension. However, healthy lifestyle habits can help keep your blood pressure under control. They may also be able to reduce the amount of medications that you need to take.
Secondary hypertension is high blood pressure caused by another health condition. In some cases, treating the underlying condition causing the high blood pressure can “cure” the high blood pressure. But this isn’t always possible.
This is a topic of debate. Previously, experts would say high blood pressure doesn’t cause nosebleeds unless it’s very high, like in a hypertensive crisis. But a recent study of over 35,000 people suggested otherwise. It compared people with a history of elevated blood pressure to those without. The people with high blood pressure had an increased risk of nosebleeds that required hospital visits compared with the other group.
Experts agree that anxiety can cause temporary increases in blood pressure. But it’s not clear if it leads to ongoing hypertension. Research suggests a link, but more research is needed to be sure.
Caffeine can raise your blood pressure slightly if you’re not used to it. But a recent review of studies found that drinking coffee doesn’t increase the risk of hypertension in healthy people. If you have hypertension, however, experts recommend limiting caffeine to 300 mg per day (roughly 2 cups of brewed coffee) or less.
References
American Heart Association. (n.d.). Coarctation of the aorta (CoA).
American Heart Association. (2024). American Heart Association recommendations for physical activity in adults and kids.
American Heart Association. (2024). High blood pressure and your kidneys.
American Heart Association. (2024). Know your risk factors for high blood pressure.
American Heart Association. (2025). How to manage high blood pressure.
American Heart Association. (2025). Shaking the salt habit to lower high blood pressure.
American Heart Association. (2025). Types of blood pressure medications.
American Heart Association. (2025). When to call 911 about high blood pressure.
American Heart Association News. (2018). More than 100 million Americans have high blood pressure, AHA says.
Byun, H., et al. (2020). Association of hypertension with the risk and severity of epistaxis. JAMA Otolaryngology Head & Neck Surgery.
Corti, R., et al. (2002). Coffee acutely increases sympathetic nerve activity and blood pressure independently of caffeine content: Role of habitual versus nonhabitual drinking. Circulation.
Han, M., et al. (2022). Coffee intake and risk of hypertension: A meta-analysis of cohort studies. Journal of Korean Medical Science.
Jones, D. W., et al. (2025). 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM guideline for the prevention, detection, evaluation and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association joint committee on clinical practice guidelines. Circulation.
Lim, L., et al. (2021). Association between anxiety and hypertension in adults: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews.
