Key takeaways:
High blood pressure happens when blood flows through your arteries at higher-than-normal pressure. Over time, it can lead to damage to your arteries and other organs.
Since high blood pressure usually has no warning signs, many people don’t know they have it. But it affects nearly half of all adults.
Sometimes symptoms include headaches, vision changes, flushing, chest pain, or shortness of breath.
High blood pressure — or hypertension — happens when the force of your blood against your artery walls becomes too high. Almost half of all adults in the U.S. have high blood pressure.
It’s often referred to as “the silent killer” because many people don’t realize they have it.
The most accurate way to detect high blood pressure is by measuring it. When someone does have symptoms, they may report:
Headaches
Changes to their vision
Flushing
Chest pain
Shortness of breath
Here’s how three people describe what it’s like to have high blood pressure.
Anxiety and stress contributed to hypertension
Jamie Bichelman says 10 years of poor stress management led to his high blood pressure. He started feeling anxious and jittery and experiencing tightness in his chest.
“The anxiety was not just mental, but actually visible,” says Jamie, who’s 32 and lives in the Boston area. “There were physiological signs of the stress and anxiety that were contributing to the high blood pressure.”
Two years ago, Jamie’s emotional support cat passed away. He remembers that’s when, “everything in my body just came crashing down.”
Shortly after, during a doctor’s appointment, the physician associate took his blood pressure. Upon noting his blood pressure, they told Jamie that he looked stressed. and immediately suggested he go on medication.
“I tried to explain the environmental aspects of what else is going on in my life, what else is going on emotionally,” Jamie says. “But they weren’t hearing that. All they saw was a number, a readout.”
Jamie, who has a background in clinical psychology, health, and nutrition, wanted a provider willing to investigate the cause of his hypertension.
He says he was dealing with other health conditions — including depression, obsessive-compulsive disorder, post-traumatic stress disorder, and anxiety (exacerbated by high blood pressure). Not only that, but he also had a pituitary tumor, diabetes, sleep apnea, and obesity.
He eventually found a provider who worked with him to adjust his lifestyle factors. Together, they designed a plan that would help Jamie lower his stress level. In turn, this lowered his high blood pressure without medication. Jamie discovered that these changes helped manage his other health conditions as well. In fact, it even improved several of them.
Jamie says he wishes more providers accounted for environmental factors when looking at hypertension. For example, living in Boston means that he sometimes has an hour commute to his appointments with aggressive drivers — which raises his blood pressure. In instances like that, he says, providers should take someone’s blood pressure before and at the end of the exam to see if there’s a difference.
He says it’s vital to keep track of major stressors in your life and share these with your primary care provider. If you don’t feel heard, he recommends finding a different doctor. And he adds that changing your lifestyle can make all the difference.
“People with high blood pressure don’t always lack self-control or have terrible lifestyle habits,” Jamie says. “Sometimes, the stress that is unavoidable in their life is impacting them severely.”
Taking estrogen and learning to relax
Like Jamie, Monica Romano came from a medical background. During the pandemic, Monica, a 56-year-old health journalist (and former nurse) in Bellingham, Washington, was diagnosed with an aortic aneurysm. She learned that hypertension was a contributing factor.
“It was devastating at first, and I constantly worried about my blood pressure,” she says. “I was advised that any extra stress would further jeopardize it.”
At first, Monica’s blood pressure was high — about 150/100.
A blood pressure reading gives two numbers — the pressure in your arteries when your heart beats (systolic pressure) and the pressure in your arteries when your heart rests between beats (diastolic pressure). A normal blood pressure is a systolic pressure of 120 mmHg and a diastolic pressure of 80 mmHg — written as 120/80.
Monica experienced symptoms like dizziness, lightheadedness, anxiety, and shortness of breath.
Based on her provider’s advice, she monitored her hypertension and recorded it daily. She noticed that her blood pressure was often higher while she was working at her desk. But, after a phone call with a friend, it was much lower. This confirmed to her that certain activities had a direct effect.
During this time, Monica took a diuretic (hydrochlorothiazide) and a beta blocker (propranolol). Though these helped lower her high blood pressure, it still remained high. This was on top of weight loss, as well as dietary and lifestyle changes.
Not long after, Monica looked into estrogen to help with her menopausal symptoms. When she brought it up with her provider, her doctor advised against it, saying it would increase her blood pressure. A year later, a different provider told her she could take estrogen without risk. After a few weeks with an estrogen patch, Monica noticed that her blood pressure had lowered significantly. She learned estrogen can relax the blood vessels, decreasing hypertension.
Though stress still affects Monica’s blood pressure, she says it’s much more stable now. She’s found that relaxing hobbies help keep it low. Though she used to endlessly scroll on her phone before bed, she now avoids screens a few hours before sleep.
She also uses humor to relax by watching cute animal videos. She follows several animal Instagram accounts, which help her wind down.
A CPAP machine and staying active help
When Daniel Métraux was 45, he learned during his annual physical that he had high blood pressure. His provider prescribed him medication to help lower it. That brought his blood pressure down to 135/80.
A year ago, Daniel, who’s now 74 and lives in Carlisle, Massachusetts, remembers his wife complaining about his constant snoring. She convinced Daniel to speak to a specialist. He took a sleep test and learned he had severe sleep apnea and began using a CPAP machine to help with the condition. After less than a week, his blood pressure went down to 123/80. Since then, he has never had an issue with hypertension.
Sleep apnea and hypertension are often linked. Daniel recommends getting checked for the condition. Though 30 million people in the U.S. have sleep apnea, only 6 million are usually diagnosed.
Daniel also wonders what role genetics may have played in his condition. Though his parents never had hypertension, his grandmother died from complications of diabetes.
He says it’s important to know that hypertension isn’t always related to a lack of exercise. As a former squash coach, he was always active. “Had I not been so active, my blood pressure might have been worse,” he says.
He continues to stay active, playing squash three times a week and working as a ukulele instructor.
What does the doctor say?
Patricia Pinto-Garcia, MD, MPH
Medical Editor
Having high blood pressure can affect many parts of your body, like your heart, kidneys, and brain. It’s important to understand that there are various factors that can influence your blood pressure. Things such as your health conditions, diet, how active you are, the amount of stress you experience, and even your genetics all play a role. Because everyone is unique, the combination of these factors will be different from person to person. That’s why there isn’t a single solution that works for everyone when it comes to managing blood pressure.
Each person needs a personalized plan that addresses all the factors contributing to their high blood pressure. If you have high blood pressure, it’s important to know that finding the right combination of treatments may take time. You might need to make adjustments to your plan as things change in your life. But always remember: Regardless of what's causing your high blood pressure, there are ways to keep it within a normal range so you stay healthy.
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