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Core Knowledge


All About Hypertension


For a condition that's so common, hypertension (or high blood pressure) remains somewhat of a mystery. In most cases, there isn't a single identifiable cause and the symptoms are rarely apparent. But it's a condition that affects about a third of American adults, and a third of those affected don’t even know they have it.

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If left untreated, hypertension can slowly lead to heart, kidney, and brain damage, which is why some experts call hypertension the “silent killer.” The good news: In many cases it can be prevented, and, in all cases, it can be treated.

Hypertension by the Numbers

The percentage of adults in the U.S. with high blood pressure.

The percentage of adults who have high blood pressure and don’t know it.

The percentage of adults in which there's no recognizable cause of high blood pressure.

The percentage of adults with high blood pressure that's caused by a serious underlying condition.

How Hypertension Works

Blood is pumped out of the heart through arteries, then to arterioles (small arteries), and finally to capillaries, which supply nutrients and oxygen to tissues and organs throughout the body. As long as the network of blood vessels is healthy, free of obstructions, and pliable, blood can flow through the system easily and efficiently. When those vessels narrow or become clogged, the heart has to work harder to push blood through the arteries and the vessels become weak and damaged.

The whole vascular system is put under added pressure with every heartbeat, which is why it's called high blood pressure. The combination of events presents a triple threat: 

  1. A damaged heart muscle because it’s being overworked.
  2. Damaged arteries and arterioles trying to take care of the extra pressure.
  3. Damaged organs throughout the body because they aren't getting enough oxygen and nutrients. Hypertension becomes a major risk factor for kidney failure, heart attack, and stroke. It can even damage the blood vessels in the eyes, causing loss of vision, and vessels in the brain, which could result in problems with memory and understanding.

Types of Hypertension

There are two kinds of hypertension. Primary hypertension, also called essential hypertension, develops over a period of years without a known cause and usually without symptoms. Between 90 and 95 percent of hypertension in adults is due to primary hypertension.

Secondary hypertension is involved in 10 percent or less of all high blood pressure cases. It tends to develop suddenly and with significantly higher blood pressure readings than primary hypertension. Among the organs affected are the kidneys, adrenal glands, and heart. Certain medications used for colds, pain, lung congestion, and birth control, in addition to cocaine and amphetamines, can trigger secondary hypertension.

Some of the possible symptoms of extremely high blood pressure are severe headaches, chest pain, difficulty breathing, irregular heartbeat, blood in the urine, fatigue, confusion, a pounding sensation in your ears, neck, or chest, and blood in the urine. All of these are considered serious, potentially life-threatening conditions. If you experience these symptoms, seek medical attention as soon as possible.

Hypertension Risk Factors

Below is a list of 10 risk factors that can contribute to hypertension.

  1. Salt – Too much salt in the diet can cause fluid retention, which increases blood pressure. Potassium is needed to balance sodium (salt) intake. Too little potassium means too much sodium in the bloodstream.
  2. Alcohol – Too much alcohol over a long period damages the heart, which can’t be good for an organ trying to push blood through the system. More than two or three drinks in a short period of time can cause a temporary rise in blood pressure.
  3. Age – The risk of developing hypertension increases with age.
  4. Race – Hypertension is more prevalent among African-Americans.
  5. Family history – People with a family history of hypertension are at an increased risk of developing it themselves.
  6. Weight – People who being overweight or obese are more likely to suffer from hypertension.
  7. Lack of exercise – People who don't regularly exercise are more likely to develop hypertension.
  8. Smoking – Tobacco damages artery walls and causes increased spikes in blood pressure, which increase hypertension risk.
  9. Stress – Too much stress can increase a person's risk of hypertension.
  10. Chronic conditions – People who suffer from chronic conditions such as diabetes, sleep apnea, elevated cholesterol levels, and kidney disease are more likely to develop hypertension.

Testing for Hypertension

Blood pressure kits are relatively inexpensive and easy to use at home, but a health professional who has better equipment and more experience should periodically measure your blood pressure. Normal blood pressure is considered to be 120/80 or less. Lower is better. The first number is the systolic blood pressure, that is, the amount of pressure exerted against arterial walls when the heart beats. The second number is called diastolic and is the reading between heartbeats when the blood vessels relax.

Some cardiologists prefer your blood pressure be at 115/75. A condition called pre-hypertension exists when the top number is between 120 and 139, and the bottom number is between 80 and 89. Within a period of four years, almost a third of adults between the ages of 35 and 64 who have pre-hypertension develop clinically-diagnosed high blood pressure. Among those 65 and older, about half progress to hypertension.

Low blood pressure isn't a problem unless other symptoms or conditions exist. Symptoms of low blood pressure include dizziness, light-headedness, or fainting.

3 Keys to Hypertension Prevention and Treatment

The first line of defense against hypertension lies within changes you can make to your lifestyle.  Let the following tips guide you down a path to blood pressure reduction and management.

Key #1: Eat Clean 

This first key to hypertension reduction/management involves the foods you eat. The DASH (Dietary Approaches to Stop Hypertension) diet has been researched extensively throughout the years and proven effective. It emphasizes many of the same goals we set on a daily basis for our athletes and clients at Athletes' Performance and Core Performance. Use the tips below to improve your eating habits.

  1. Eat plenty of fiber. Diets high in fiber-rich foods have been associated with improvements in blood pressure, as well as blood lipid profiles and blood glucose levels. Many fiber-rich foods pack a one-two-punch because they are also great sources of calcium and magnesium, which are associated with blood pressure reduction. 

    Some great choices include:1/2 cup black beans (~7 g fiber, ~23 mg calcium, and ~60 mg magnesium), 1/2 cup white beans(~7g fiber, ~80 mg calcium, and ~56 mg magnesium), 1/4 cup raw almonds (~4 g fiber, ~78 mg calcium, and ~99 mg magnesium).
  2. Color your plate. This is a catch phrase we use a lot at Athletes’ Performance and Core Performance to remind our athletes/clients to incorporate more micronutrient-rich fruits and vegetables into their daily diet. All fruits and vegetables are great additions to your diet, but for blood pressure reduction, focus on those rich in potassium, calcium, and magnesium.

    These particular micronutrients all have the potential to reduce your blood pressure. Some great choices for each micronutrient include:

    - Potassium (1 banana: ~486 mg, 1 small baked potato: ~738 mg, 1 medium orange: ~333mg)
    - Calcium (1/2 cup cooked spinach: ~120 mg, 1/2 cup cooked kale: ~90 mg, 1/2 cup cooked turnip greens: ~99 mg)
    - Magnesium (1/2 cup cooked spinach: ~75 mg, 1 small baked potato: ~48 mg).
  3. Choose healthy fats. Replacing foods loaded with saturated and trans fats with foods rich in poly and monounsaturated fats has also been associated with blood pressure reduction. Nuts and seeds are great sources of these healthy fats and can also be high in magnesium (benefits stated earlier). Be sure to choose raw and unsalted varieties, and also be aware of portion sizes because these foods are calorie dense. Try a small handful of the following as a healthy snack: almonds, cashews, and pumpkin seeds.
  4. Reduce sodium intake. Diets containing between 1,500 and 2,300 mg of sodium per day have been shown to reduce blood pressure. Some great tips to reduce your sodium intake include choosing spices and herbs over table salt, reducing your condiment use by asking for these on the side, and replacing salty snacks with fruits, vegetables, and unsalted nuts and seeds.  

Key #2: Live Clean 

Now that we’ve addressed your food choices, let’s clean up your habits away from the table to help reduce blood pressure.

  1. Move more. Yes, this means training. Increased physical activity has been shown to positively influence your blood pressure. Utilize the training portion of Core Performance and begin to train for life. Make it your goal to break a sweat every day.
  2. Take time to recover.  Now that you've increased your physical activity and started training for the game of life, you must incorporate recovery techniques to maximize the benefits. Incorporating recovery techniques into your daily routine can be a great way to reduce stress, and guess what…stress reduction has been associated with blood pressure reduction. Remember, WORK + REST = SUCCESS. 
  3. Manage your weight. If you start to eat cleantrain, and recover, then you're well on your way to managing your weight.
  4. Stop smoking and drinking alcohol. As mentioned earlier, tobacco and alcohol use is associated with elevated blood pressure.  If you use these substances, stop. 

Key 3: Think Clean

The final key to reducing your blood pressure lies within your mindset

  1. Stay current with the research. You should always strive to not only keep your body in top condition, but your mind. By staying current with the research, you can begin to incorporate the latest research-supported techniques for blood pressure reduction. Always be a savvy consumer of information, look for reputable sources, and be sure to consult your physician for his or her approval.
  2. Monitor your progress. Don’t shy away from monitoring your blood pressure. The only way to know if your new lifestyle changes are effective is to monitor your numbers. Remember, ignoring the facts won't make them disappear.   

Tags: Health, Disease


  1. American Heart Association
  2. American Society of Hypertension
  3. Archives of Internal Medicine
  4. Hypertension (publication of the American Heart Association)
  5. MayoClinic.com
  6. National Institutes of Health
  7. New England Journal of Medicine
  8. WebMD