High blood pressure (known as hypertension) is an incredibly common medical condition. According to the CDC, 47% of American adults suffer from high blood pressure. It was a contributing cause of death for more than half a million Americans last year, and diabetics have a 78% chance of being diagnosed with the condition.

Measuring Blood Pressure

Despite the strong prevalence and dangers associated with hypertension, most people who have it experience no symptoms. This has led to its nickname: “the silent killer.” Fortunately, it’s easy to measure blood pressure, and doing so is part of a routine health checkup.

Blood pressure is typically measured with a device called a blood pressure monitor. Blood pressure monitors include an inflatable piece of fabric that wraps around the arm and outputs a pressure reading. As the fabric fills with air and then collapses, it makes contact with the arteries, and the monitor outputs a pressure measurement.

Because blood pressure isn’t steady, it’s always measured as two numbers in the form of a fraction:

  • Systolic pressure is the top number. It refers to blood pressure right when the heartbeats.
  • Diastolic pressure is the bottom number. It refers to blood pressure when the heart is at rest. Thus, it’s always lower than systolic pressure.

If you received a blood pressure reading of 120/80, your systolic blood pressure is 120 millimeters of mercury (mm Hg) and your diastolic blood pressure is 80 mm Hg.

What are millimeters of mercury?

The first blood pressure monitors displayed results like a thermometer, with higher blood pressure pushing the liquid mercury higher in a vial. For example, a systolic blood pressure of 140 mm Hg would push the mercury up 14 centimeters (140 millimeters).

What Is High Blood Pressure?

Hypertension is a long-term medical condition in which blood pressure is consistently elevated above healthy levels. In a healthy cardiovascular system, the heart pumps blood through the arteries at a manageable rate. In other words, it doesn’t have to pump blood so forcefully that it can damage itself or the blood vessels.

When blood pressure is too high, blood vessels can burst and overwork the heart, potentially causing it to:

  • Become bloated or enlarged (cardiomegaly).
  • Slow down to a fatal BPM (congestive heart failure).
  • Stop beating entirely (cardiac arrest).

High blood pressure is frequently classified into two types:

Primary hypertension: high blood pressure without a known cause. Usually, it affects those over the age of 65, since blood pressure slowly rises with age.

Secondary hypertension: high blood pressure caused by an underlying condition. In adults, the most common causes include renal parenchymal disease, sleep apnea, and coarctation of the aorta. Patients with secondary hypertension usually have a higher blood pressure than those with primary hypertension.

Hypertension is also classified by severity. According to the American Heart Association, blood pressure ranges fall into the following categories:

  • 120/80 or lower: Normal
  • 120/80 – 129/80: This means that your heart is working moderately more and your blood pressure is a bit high when it beats.
  • 130/80 – 139/89: Stage 1 hypertension. Also known as prehypertension, this level is seen as a warning that you may develop consistent high blood pressure in the future.
  • 140/90 or higher: Stage 2 hypertension. If your blood pressure is this high, it means you have severe hypertension that puts you at high risk for stroke or other serious complications.
  • 180/120 or higher: Hypertensive crisis. This is a medical emergency that typically comes with chest/back pain, and trouble breathing. At this level of blood pressure, many people lose the ability to see, hear, feel, or speak. A hypertensive crisis requires immediate treatment to avoid life-threatening complications.

The Connection Between High Blood Pressure & Diabetes

There is a strong scientific consensus that the two conditions are correlated. In addition to the high percentage of diabetics with hypertension, many people that report having high blood pressure also develop a resistance to insulin.

Plus, hypertension and diabetes both affect the cardiovascular system, which means they harm the body in similar ways. This can result in one condition worsening the severity of the other. For example, diabetes can damage arteries, which causes a buildup of atheromatous plaque. As plaque constricts the flow of blood through the arteries, blood pressure rises.

When blood pressure is too high, the body releases nitric oxide to expand blood vessels and decrease pressure on the arteries and heart. The production of nitric oxide is stimulated by insulin, meaning diabetics have a weaker physiological response to high blood pressure.

Diabetes and hypertension are risk factors for a multitude of the same cardiovascular diseases, such as stroke, renal dysfunction, heart disease, peripheral vascular disease, and congestive heart failure.

Risk Factors for High Blood Pressure

There is no one risk for developing high blood pressure, but there are many factors that make a hypertension diagnosis more likely.

As mentioned before, the vast majority of diabetics also have high blood pressure. There are a number of other chronic conditions that are considered risk factors, such as:

  • A family history of hypertension.
  • Being above the age of 65.
  • Ethnic background of African or Caribbean origin.
  • Obesity
  • Living in a low or middle-income country.
  • Kidney disease.
  • Sleep apnea.

Some of these risk factors (like being 65+) are risk factors for diabetes as well, while others (like kidney disease) can be caused or worsened by diabetes.

What Lifestyle Choices Lower the Risk for High Blood Pressure?

Besides taking medication, there are a number of steps you can take to control or prevent hypertension:

Lose Weight

While obesity is considered a chronic disease, it can be stopped with weight loss, which lowers blood pressure; studies have shown that blood pressure can drop by 1 mm Hg with every kilogram of lost weight.

Cut Out Stimulants

The long term effects of caffeine on blood pressure aren’t clear. If you habitually consume caffeine at a healthy rate (400mg per day or less), it’s unlikely to cause an increase in blood pressure. Tobacco is different and is a risk factor for many cardiovascular diseases. The withdrawal effects of nicotine can keep blood pressure high even when a person isn’t actively smoking.

Make Exercise a Daily Habit

At any weight, 30 or more minutes of physical activity per day helps to keep blood pressure down. Strength training (like weight lifting or bodyweight exercise) at least twice a week is listed in national fitness guidelines, and many health professionals recommend it in tandem with aerobic exercise to maintain a healthy blood pressure. Check with your doctor if you have pre-existing conditions (like diabetes) before starting a rigorous exercise routine.

Consume More Potassium and Less Salt

The average person consumes twice as much sodium as they need on a daily basis. Sodium causes blood vessels to constrict and increases the flow of water through the circulatory system. Both of these cause blood pressure to rise. On the other hand, potassium is known to relax blood vessels and reverse the hypertensive effects of sodium.

Minimize Stress

During stressful situations, your body releases hormones like cortisol and adrenaline that keep you focused and alert. Usually, these “fight or flight” responses raise blood pressure for a few minutes before lowering back to normal. Blood pressure could be permanently raised just from experiencing too much stress in your life. Also, stress makes it more difficult to get a good night’s rest, which is a major component of healthy blood pressure.

To minimize stress, focus on feasible actions you can practice every day. Exercise and meditation are both habits that are proven to reduce stress. Stress can also be managed by treating things that make it worse, like being overweight or having anxiety.

Stop Consuming Alcohol

Although alcohol lowers blood pressure in the first few hours of consumption, it has been shown to raise blood pressure by more than 1 mm Hg per daily drink. Abstaining from alcohol also reduces baseline blood pressure in as little as a week, even for heavy drinkers.