Is High Blood Pressure Always Bad?

Blood pressure measures the force placed on your artery wall when the heart pumps blood through your body. The measurement is written in two numbers. The first number is your systolic blood pressure, and the second one is your diastolic blood pressure.

Your systolic blood pressure is the top number and is the measurement of force created as your heart muscles contract and squeeze blood through the arteries. The second number is your diastolic blood pressure. This bottom number measures the force placed on your arteries when your heart is at rest. Blood pressure is normal when measured at 120/80 (or 120 over 80).

Nearly a third of all adults in the United States have high blood pressure.¹ This puts them at an increased risk of heart attack or stroke. However, new research has found that a certain increase in blood pressure may not always be bad. In fact, in some older adults, it may be beneficial. It's also possible to be physically fit and still have a slight increase in blood pressure.

So is higher blood pressure than normal always bad? While it’s important to manage blood pressure, there are circumstances when higher blood pressure may not be a cause for concern. Learn what they are, when you should be concerned, and when to see a doctor. 

What is high blood pressure?

High blood pressure, also known as hypertension, indicates an increase in the force placed on your arteries as your heart pumps blood throughout your body. The higher the force, the more at-risk you are of serious medical problems like heart disease and stroke. Your measurement will put you into one of these blood pressure categories:

• Normal blood pressure

  • Systolic: less than 120

  • Diastolic: less than 80

• Elevated blood pressure

  • Systolic: 120–129

  • Diastolic: less than 80

• High blood pressure (Hypertension Stage 1)

  • Systolic: 130–139

  • Diastolic: 80–89

• High blood pressure (Hypertension Stage 2)

  • Systolic: 140 or above

  • Diastolic: 90 or above

If your blood pressure measures higher than 180 systolic or higher than 120 diastolic, you need to contact your doctor immediately or visit your nearest emergency room. This is a hypertensive crisis and may indicate that you are at serious risk of experiencing a medical emergency such as organ failure, coma, or death.

Most people with high blood pressure experience no signs or symptoms. You may experience some symptoms, particularly if the elevation is high or has been happening for a while. These symptoms could include severe headaches, chest pain, nose bleed, and pounding in the ears, chest, or neck. However, it's impossible to know if you have high blood pressure without testing it.

Fortunately, this is a simple process. Doctors routinely check your blood pressure during office visits. That allows them to monitor your blood pressure over time and catch any increases as early as possible. They'll do this with a blood pressure cuff placed on your arm, then inflated to squeeze your arm and take the reading. While this may be slightly uncomfortable for a moment, it won't hurt.

You can also check your blood pressure without visiting your doctor's office. At-home machines are widely available and allow you to take blood pressure readings in the comfort of your own home. There are also free blood pressure monitors available at many local pharmacies.

If you do monitor your own blood pressure, contact your doctor if you notice your measurements are increasing or if they stay consistently high over three or more occasions at different times. Your doctor will be able to discuss your treatment options with you. 

What are the risks of having high blood pressure?

There is a good reason to monitor your blood pressure. High blood pressure can put you at risk of developing serious health problems. This is primarily due to the effect high blood pressure has on your circulatory system, including your heart and arteries.

High blood pressure puts more strain on this vital system. This can result in your arteries becoming hard and losing their elasticity — a condition called atherosclerosis. High blood pressure also makes your heart work harder to pump blood, putting more strain on it.

These effects can put you at a higher risk of serious health problems, such as:

• Stroke

• Heart attack

• Certain types of dementia

• Aneurysms 

• Kidney disease

• Eye problems

• Other cardiovascular issues

It's important to treat high blood pressure to bring it back into a healthy range. Regularly monitoring your blood pressure can help you and your doctor catch any issues early and start treatment as soon as possible. 

Is high blood pressure preventable?

In the majority of the cases with primary hypertension (not caused by a different condition), the answer is yes. Food and lifestyle are the most important factors contributing to the development of the disease. Some people may be more predisposed to having high blood pressure if it runs in their family. However, even with a family history of hypertension, there are steps you can take to prevent it. You can:

Regularly monitor your blood pressure

While monitoring alone won’t prevent high blood pressure, it can help in the early detection of management of the condition. By detecting it early, you can start to take steps to change your lifestyle before you receive a hypertension diagnosis.

Maintain a healthy diet

Your diet has a big impact on your cardiovascular health. Eating a diet rich in fruits and vegetables,  low in fat and sugar, and high in fiber is best. You should also work to limit your salt intake. Too much salt in your diet is one of the main risk factors for hypertension.²

Exercise daily

Exercise can help improve the function of your heart, making it more efficient, which reduces the strain it's under as it works to pump your blood. Exercise also reduces your bad cholesterol, preventing plaque accumulation in your arteries. It also helps dilate your arteries for longer periods in order to provide enough blood to the muscles, which reduces the pressure in your arteries, and in turn, reduces your blood pressure. Getting at least 30 minutes of exercise a day is best.

Limit your intake of alcohol

Having more than one or two alcoholic drinks a day can increase your blood pressure. The good news is that as soon as you start to limit your alcohol intake, it can positively affect your blood pressure. If you already have high blood pressure, you should consume alcohol very moderately or abstain altogether. Alcohol interferes with the efficacy of some blood pressure medications.

For more tips on preventing high blood pressure, talk to your doctor. 

Is high blood pressure always bad?

Generally, high blood pressure is a medical condition that could be dangerous and should not be neglected. 

However, there are times when higher blood pressure readings may not necessarily be a cause for concern. Your blood pressure can change according to your emotional and physical state.

For example, your blood pressure will fluctuate naturally throughout the day and is often higher when you first wake up in the morning. Your blood pressure may also increase slightly when visiting the doctor or when you are experiencing an emotionally charged situation. It can even go up when you are working out.

These temporary increases in blood pressure are rarely a cause for concern. Aside from these scenarios, a mild or moderate increase in blood pressure that happens a couple of times but stabilizes to normal values shortly after, and continues to stay this way, is usually not a reason to worry.

Our understanding of the impact of high blood pressure continues to develop, too. Some research indicates that traditional blood pressure categories may not be a viable blanket approach for a hypertension diagnosis.

In a study published in the European Heart Journal,³ researchers found that lower blood pressure actually increased the risk of death for some older people. The risk of death increased for those over the age of 80 or those who were elderly and had previous heart-related health conditions and were under treatment for hypertension with blood pressure below 140/90.

A systolic blood pressure of 130 or higher would put you in the range for hypertension and would prompt your doctor to start treatment. What this research suggests, though, is that older people using antihypertensive medications may actually benefit from having slightly higher blood pressure. The next step will be to determine which patients actually benefit from treatment for hypertension.⁴

If you choose to monitor your blood pressure yourself, remember that slight fluctuations are normal. However, if your blood pressure is consistently high after measuring at least three times on three different occasions, talk to your doctor. This may be an early indication of hypertension, and they may recommend treatment options or further testing. 

How is high blood pressure diagnosed?

Your primary healthcare provider can diagnose high blood pressure. They will take your blood pressure with a device called a sphygmomanometer.

Your blood pressure naturally fluctuates throughout the day and is generally highest around midday and lowest at night. Your doctor may want to take a series of blood pressure measurements over time to see how your blood pressure changes.

If your readings are consistently high over time, your doctor may diagnose you with hypertension. They may want to run further tests to determine if any underlying health conditions could be causing the high blood pressure before talking to you about potential treatment options. 

What are the treatment options for hypertension?

High blood pressure is a treatable health condition. Most people can manage their blood pressure with their doctor's help. Your doctor will determine the best treatment plan based on your age, lifestyle, and medical history. Some of the treatment options might include:

Lifestyle changes

Increasing your daily exercise and losing weight can help lower your blood pressure. You can also help yourself by lowering your alcohol and caffeine intake. You should watch the amount of salt in your diet and focus on increasing the number of fruits and vegetables you eat.

Medication

If you cannot control your blood pressure through lifestyle changes, your doctor may recommend medication. Different medications are available, including beta-blockers, calcium channel blockers, Angiotensin-converting enzyme (ACE) inhibitors, and diuretics. Your doctor will look at your medical history to determine which medication is best for you. Some people may need to take a combination of heart and blood pressure medications for the best results.

If an underlying condition is found to be the cause of your hypertension, this means that your hypertension is secondary, and treating that condition will often result in a reduction of high blood pressure.

When to speak to a healthcare professional 

Your doctor will regularly check your blood pressure during routine office visits and annual physical exams.

If you have a history of high blood pressure in your family, you may wish to monitor your blood pressure levels more often. You can buy an at-home blood pressure monitor or have it checked for free at a local pharmacy or wellness fair. If your readings are consistently outside of the normal range, you should meet your doctor to discuss your treatment options.

If your blood pressure ever measures above 180/120, you should seek immediate medical attention. This is a hypertensive crisis and could indicate you are at immediate risk of a serious medical problem.  

The lowdown

Blood pressure is the measurement of force placed on the walls of your arteries as the heart pumps blood through your body. The measurement of your systolic blood pressure and your diastolic blood pressure can give your healthcare provider insight into the health of your cardiovascular system.

When your blood pressure is 130/80 or higher, you are considered to have high blood pressure, also known as hypertension. This can increase your risk of developing serious health problems such as stroke, heart attack, aneurysm, and kidney disease.

Higher blood pressure may not always be a cause for concern, though. Blood pressure naturally fluctuates and may be higher when you first wake up in the morning, when exercising, or when experiencing emotional distress. These temporary changes in blood pressure are rarely a cause for concern, as long as the values return to normal and stabilize a short time later.

Research indicates that slightly elevated blood pressure may benefit some elderly patients. Still, you should always follow your doctor's advice when it comes to treating high blood pressure.

Get your blood pressure checked by your doctor if you're concerned or if it's been a while since you've done so.