High blood pressure (hypertension)

Many people have high blood pressure (hypertension). But they usually don’t notice it – which means that over time it can damage blood vessels. Having blood pressure that is always too high increases the risk of having a heart attack, a stroke or kidney problems.

At a glance

  • Many people have high blood pressure (hypertension).
  • It does not usually cause any symptoms and can therefore remain undetected for a long time.
  • Having blood pressure that is always too high damages blood vessels and increases the likelihood for a heart attack, stroke or kidney problems.
  • Blood pressure is considered to be too high if the systolic value is 140 or higher, or if the diastolic value is 90 or higher – or if both readings are too high.
  • Many people have high blood pressure without there being a specific cause for it.
  • Getting enough exercise, losing weight and eating a low-salt diet can sometimes lower the blood pressure, but if this is not enough, there is the option of medication.

Note: The information in this article cannot and should not replace a medical consultation and must not be used for self-diagnosis or treatment.

High blood pressure: two hands holding a sphygmomanometer. An arm with the blood pressure cuff attached is visible in the background.

What is high blood pressure?

High blood pressure (hypertension) is when someone’s blood pressure is consistently too high. Many people have high blood pressure (hypertension). It does not usually cause any symptoms and can therefore remain undetected for a long time – which means that over time it can damage blood vessels. Having blood pressure that is always too high damages blood vessels and increases the likelihood to have a heart attack, stroke or kidney problems. The higher the blood pressure, the greater is the risk of developing these medical conditions. 

Blood pressure readings have two values: the systolic value and the diastolic value. Both values are always listed together: 128/85 mmHg, for example. The first number represents the pressure in the blood vessels when the heart muscles squeeze (systolic blood pressure). The second represents the pressure in the blood vessels when the heart muscles relax (diastolic blood pressure).

Blood pressure is considered to be too high if the systolic value is 140 or higher or the diastolic value is 90 or higher – or if both readings are too high. These levels are only limit values; they were set for practical reasons and act only as a general guide. Because of this, recommendations about when medication is needed to treat high blood pressure may vary.

What are the symptoms of high blood pressure?

High blood pressure itself usually goes unnoticed. Only if it is extremely high it can sometimes result in symptoms like dizziness or vision problems.

Most people are not aware that they have high blood pressure.

What causes high blood pressure?

The human body is able to regulate blood pressure as needed so it’s normal that there is some variation. It’s typically low during relaxed situations or sleep. It increases with hard physical work when the muscles need more blood. Stress or fear can also cause the blood pressure to go up. It usually naturally increases with age in most people as well.

So it’s normal for blood pressure readings to vary; that’s just a sign of an active life. But if blood pressure is too high for too long, it can damage blood vessels over time and increase the risk of various health problems.

Often no specific cause is found for high blood pressure. Then doctors call it “essential” or “primary” hypertension.

High blood pressure is caused by being overweight, high-salt diets, little exercise, genetic predisposition, certain drugs, advancing age, persistent stress, anxiety, certain diseases such as hyperthyroidism or kidney disease.

Being overweight, eating a lot of salt, drinking too much alcohol and not getting enough exercise can increase your blood pressure. But slim, athletic people who watch what they eat may also develop high blood pressure – for example, because it runs in their family. 

Sometimes medications can increase blood pressure as well.

These include for example:

  • some medicines used to treat psychological illnesses
  • certain plant-based medications like St. John’s wort
  • decongestant nasal sprays or drops
  • birth control pills

How is high blood pressure diagnosed?

To diagnose high blood pressure, it is measured on both arms while you are resting so that the readings can be compared and interpreted more easily. It’s important to measure blood pressure on both arms because the pressures may differ depending on the side of the body. Blood pressure is measured on several days to get a more reliable result than a single reading can offer.

The highest systolic reading and the highest diastolic reading are then taken as the basis for determining the blood pressure. Blood pressure is measured in units of “millimeters of mercury” (mmHg).

An adult’s blood pressure is considered to be normal if it is less than 140 over 90 (140/90). High blood pressure is diagnosed if

  • the systolic reading is 140 mmHg or higher,
  • the diastolic reading is greater 90 mmHg or higher, or
  • both readings are too high.

Sometimes blood pressure is measured over a 24-hour period (ambulatory blood pressure monitoring). This might be done if individual measurements vary a lot. To do that, patients carry a portable instrument with them that measures the blood pressure at regular intervals.

More detailed information on high blood pressure (hypertension) and how it is measured can be found at gesundheitsinformation.de.

Why is high blood pressure dangerous?

The video below explains what happens in the body in the event of high blood pressure. What consequences can high blood pressure have and how can it be lowered?

This and other videos can also be found on YouTube.

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How can high blood pressure be detected early on?

In Germany, statutory health insurers cover the cost of a general health check-up every three years from the age of 35 onwards. The check-up includes taking your blood pressure. The aim of this check-up is to detect early signs of cardiovascular disease, diabetes and kidney problems. So far, though, large studies haven’t proven that regular general health check-ups can protect healthy people from illness or increase their life expectancy. 

How is high blood pressure treated?

There are a number of things people with high blood pressure can do on their own to lower it. Some people manage to keep their blood pressure under control by

  • losing a little weight,
  • eating less salt, and
  • getting more exercise.

If that doesn’t work, medication can also be used to lower blood pressure. Before deciding to take medication to lower high blood pressure, it’s worth considering the pros and cons. That’s because some people benefit less from medication than others, and the medication may have side effects.

More detailed information about high blood pressure medication can be found at gesundheitsinformation.de.

In cooperation with the Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen – IQWiG). As at:

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