Hypertension

Hypertension
Other names	Arterial hypertension, high blood pressure
Automated arm blood pressure meter showing arterial hypertension (shown by a systolic blood pressure 158 mmHg, diastolic blood pressure 99 mmHg and heart rate of 80 beats per minute)
Specialty	Cardiology, Nephrology
Symptoms	None[1]
Complications	Coronary artery disease, stroke, heart failure, peripheral arterial disease, vision loss, chronic kidney disease, dementia[2][3][4]
Causes	Usually lifestyle and genetic factors[5]
Risk factors	Lack of sleep, excess salt, excess body weight, smoking, alcohol[1][5]
Diagnostic method	Resting blood pressure in adults ≥ 130/80 mmHg[6] or ≥ 140/90 mmHg[7]
Treatment	Lifestyle changes, medications[8]
Frequency	33% (all adults), 16% (diagnosed) (globally, 2019)[9][10]
Deaths	10.4 million; 19% of deaths (globally, 2019)[9]

Hypertension, also known as high blood pressure, is a long-term medical condition in which the blood pressure in the arteries is persistently elevated.^[11] High blood pressure usually does not cause symptoms itself.^[1] It is, however, a major risk factor for stroke, coronary artery disease, heart failure, atrial fibrillation, peripheral arterial disease, vision loss, chronic kidney disease, and dementia.^{[2][3][4][12]} Hypertension is a major cause of premature death worldwide.^[13]

High blood pressure is classified as primary (essential) hypertension or secondary hypertension.^[5] About 90–95% of cases are primary, defined as high blood pressure due to nonspecific lifestyle and genetic factors.^[5] Lifestyle factors that increase the risk include excess salt in the diet, excess body weight, smoking, physical inactivity and alcohol use.^[1][5] The remaining 5–10% of cases are categorized as secondary hypertension, defined as high blood pressure due to a clearly identifiable cause, such as chronic kidney disease, narrowing of the kidney arteries, an endocrine disorder, or the use of birth control pills.^[5]

Blood pressure is classified by two measurements, the systolic (first number) and diastolic (second number) pressures.^[1] For most adults, normal blood pressure at rest is within the range of 100–140 millimeters mercury (mmHg) systolic and 60–90 mmHg diastolic.^[6][7] For most adults, high blood pressure is present if the resting blood pressure is persistently at or above 130/80 or 140/90 mmHg.^[5][6][7] Different numbers apply to children.^[14] Ambulatory blood pressure monitoring over a 24-hour period appears more accurate than office-based blood pressure measurement.^[5][11]

Lifestyle changes and medications can lower blood pressure and decrease the risk of health complications.^[8] Lifestyle changes include weight loss, physical exercise, decreased salt intake, reducing alcohol intake, and a healthy diet.^[5] If lifestyle changes are not sufficient, blood pressure medications are used.^[8] Up to three medications taken concurrently can control blood pressure in 90% of people.^[5] The treatment of moderately high arterial blood pressure (defined as >160/100 mmHg) with medications is associated with an improved life expectancy.^[15] The effect of treatment of blood pressure between 130/80 mmHg and 160/100 mmHg is less clear, with some reviews finding benefit^[6][16][17] and others finding unclear benefit.^[18][19][20] High blood pressure affects 33% of the population globally.^[9] About half of all people with high blood pressure do not know that they have it.^[9] In 2019, high blood pressure was believed to have been a factor in 19% of all deaths (10.4 million globally).^[9]