High Blood Pressure

Also known as Hypertension 
Overview

High blood pressure, or hypertension, is a common condition that occurs when your blood pressure—the force of the blood on the walls of your arteries—is often too high. Medical Animation Copyright © 2020 Nucleus Medical Media, All rights reserved.

High blood pressure is a common disease that develops when blood flows through your arteries at higher-than-normal pressures. Your blood pressure is made up of two numbers: systolic and diastolic. Systolic pressure is the pressure when the ventricles pump blood out of the heart. Diastolic pressure is the pressure between heartbeats, when the heart is filling with blood. For most adults, a healthy blood pressure is usually less than 120 over 80 millimeters of mercury, which is written as your systolic pressure reading over your diastolic pressure reading—120/80 mm Hg.

You usually don’t have symptoms from high blood pressure until it has caused serious health problems. That is why it is important to have your blood pressure checked regularly. Your doctor will diagnose you with high blood pressure if you have consistently high blood pressure readings.

To control or lower high blood pressure, your doctor may recommend that you adopt a heart-healthy lifestyle. This includes choosing heart-healthy foods such as those in the DASH eating plan. You may also need to take medicines. Controlling or lowering blood pressure can help prevent or delay serious health problems such as chronic kidney disease, heart attack, heart failure, stroke, and possibly vascular dementia.

Explore this Health Topic to learn more about high blood pressure, our role in research and clinical trials to improve health, and where to find more information. During High Blood Pressure Education Month in May and throughout the year, the NHLBI features research findings that help advance our understanding of high blood pressure, materials to share in person or on social media, and resources for managing your condition. Find research studies and get resources on high blood pressure.

Risk Factors - High Blood Pressure

Many factors raise your risk of high blood pressure. Some risk factors, such as unhealthy lifestyle habits, can be changed. Other risk factors, such as age, family history and genetics, race and ethnicity, and sex, cannot be changed. A healthy lifestyle can lower your risk for developing high blood pressure.

Age

Blood pressure tends to increase with age. Our blood vessels naturally thicken and stiffen over time. These changes increase the risk for high blood pressure.

However, the risk of high blood pressure is increasing for children and teens, possibly because of rise in the number of children and teens who are living with overweight or obesity.

Family history and genetics

High blood pressure often runs in families. Much of the understanding of the body systems involved in high blood pressure has come from genetic studies. Many different genes are linked to a small increase in the risk of developing high blood pressure. Research suggests that certain DNA changes as an unborn baby grows in the womb may also lead to high blood pressure later in life.

Some people have a high sensitivity to salt in their diet. This can also run in families.

Lifestyle habits

Lifestyle habits can increase the risk of high blood pressure. These habits include:

  • Eating unhealthy foods often, especially those with too much sodium and not enough potassium. Some people, including African Americans, older adults, and people who have chronic kidney disease, diabetes, or metabolic syndrome, are more sensitive to salt in their diet.
  • Drinking too much alcohol or caffeine.
  • Not getting enough physical activity.
  • Smoking or using illegal drugs such as cocaine, “bath salts,” and methamphetamine.
  • Not getting enough good-quality sleep.

Medicines

Some prescription and over-the-counter medicines can make it more difficult for your body to control your blood pressure. Medicines that can raise your blood pressure include antidepressants, decongestants (medicines to relieve a stuffy nose), hormonal birth control pills, and non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen.

Other medical conditions

Other medical conditions change the way your body controls fluids, sodium, and hormones in your blood. Other medical causes of high blood pressure include:

Race or ethnicity

High blood pressure is more common in African American and Hispanic adults than in white or Asian adults. Compared with other racial or ethnic groups, African Americans tend to have higher average blood pressure numbers and get high blood pressure earlier in life. Experiencing discrimination has been tied to high blood pressure. In addition, some high blood pressure medicines may not work as well in African Americans.

During pregnancy, African American women are more likely than white women to develop preeclampsia. Preeclampsia is a pregnancy disorder that causes sudden high blood pressure and problems with the kidneys and liver.

Sex

Men are more likely than women to develop high blood pressure throughout middle age. But in older adults, women are more likely than men to develop high blood pressure.

Women who have high blood pressure during pregnancy are more likely to have high blood pressure later in life.

Social and economic factors

Recent research has shown that factors such as income, your education, where you live, and the type of job you have may contribute to your risk of developing high blood pressure. For example, working early or late shifts can raise your risk.

Experiencing danger or harm as a child has also been tied to a higher risk of developing high blood pressure.

Screening and Prevention - High Blood Pressure

Everyone age 3 or older should have their blood pressure checked by a healthcare provider at least once a year. Your doctor will use a blood pressure test to see whether you have consistently high blood pressure readings. Your doctor will talk to you about heart-healthy lifestyle changes to help prevent or manage your blood pressure.

Get your blood pressure checked regularly and understand what your numbers mean to better manage your heart disease risk. Watch the video to learn more.

How to prepare for a blood pressure test

Your doctor will use a blood pressure test to see if you have higher-than-normal blood pressure readings. The reading is made up of two numbers, with the systolic number above the diastolic number. These numbers are measures of pressure in mm Hg. To learn more about systolic and diastolic pressure, visit How the Heart Works.

A blood pressure test is easy and painless and can be done in a doctor's office or clinic. A healthcare provider will use a gauge, stethoscope, or electronic sensor and a blood pressure cuff to measure your blood pressure. To prepare, take the following steps:

  • Do not exercise, drink coffee, or smoke cigarettes for 30 minutes before the test.
  • Go to the bathroom before the test.
  • For at least 5 minutes before the test, sit in a chair and relax.
  • Make sure your feet are flat on the floor.
  • Do not talk while you are relaxing or during the test.
  • Uncover your arm for the cuff.
  • Rest your arm on a table so it is supported and at the level of your heart.

If it is the first time your provider has measured your blood pressure, you may have readings taken on both arms.

You can also take your blood pressure at home or at a pharmacy. Visit Measure Your Blood Pressure for more information.

What the numbers mean

For most adults, healthy blood pressure is usually less than 120/80 mm Hg. Your blood pressure is considered high when you have consistent systolic readings of 140 mm Hg or higher or diastolic readings of 90 mm Hg or higher. Based on research, your doctor may also determine that you have high blood pressure if you are an adult or child age 13 or older who consistently has systolic readings of 130 to 139 mm Hg or diastolic readings of 80 to 89 mm Hg and you have other risk factors for heart or blood vessel disease.

For children younger than 13, blood pressure readings are compared with readings common for children of the same, age, sex, and height. Read more about blood pressure readings for children.

Talk to your doctor if your blood pressure readings are consistently higher than 120/80 mm Hg. Note that readings above 180/120 mm Hg are dangerously high and require immediate medical attention.

How to prevent high blood pressure

A heart-healthy lifestyle can help prevent high blood pressure from developing. To live a healthy lifestyle:

Signs, Symptoms, and Complications - High Blood Pressure

It is important to have regular blood pressure readings taken and to know your numbers, because high blood pressure usually does not cause symptoms until it has caused serious problems.

Undiagnosed or uncontrolled high blood pressure can lead to serious health problems:

Watch this video to learn more about why high blood pressure is such a problem.

This video shows how high blood pressure damages the walls of your arteries over time and leads to life-threatening health problems. Medical Animation Copyright © 2020 Nucleus Medical Media, All rights reserved.

High blood pressure in pregnancy can raise the risk of later heart and blood vessel problems for both the mother and her child.

Diagnosis - High Blood Pressure

Your doctor may diagnose you with high blood pressure based on your medical history and if your blood pressure readings are consistently at high levels. Your doctor may do more tests to look for medical conditions that could cause high blood pressure, or to see if high blood pressure has affected your kidneys.

Medical history

Your doctor will want to understand your risk factors and get general information about your health—such as your eating patterns, your physical activity level, and your family’s health history to develop a treatment plan for you. Your doctor also will ask questions to see if high blood pressure has caused you any health problems. This will help your doctor determine if you need to undergo any tests.

Confirming high blood pressure

To diagnose high blood pressure, your doctor will take two or more readings at separate medical appointments. Learn more about screening for high blood pressure, including how to take it yourself.

Your doctor may diagnose you with high blood pressure when you have consistent systolic readings of 140 mm Hg or higher or diastolic readings of 90 mm Hg or higher. Based on research, your doctor may also determine you have high blood pressure if you are an adult or child age 13 or older who consistently has systolic readings of 130 to 139 mm Hg or diastolic readings of 80 to 89 mm Hg and you have other risk factors for heart or blood vessel disease. For most adults, healthy blood pressure is usually less than 120/80 mm Hg.

For children younger than 13, blood pressure readings are compared with readings common for children of the same, age, sex, and height. Read more about blood pressure readings for children.

Talk to your doctor if your blood pressure readings are consistently higher than 120/80 mm Hg. Note that readings above 180/120 mm Hg are dangerously high and require immediate medical attention.

Even after taking these steps, your blood pressure reading may not be accurate for other reasons.

  • You are excited or nervous. “White coat hypertension” refers to blood pressure readings that are higher in a doctor’s office than readings at home or in a pharmacy, for example. Doctors can detect this type of high blood pressure by reviewing readings from the office and from other places.
  • Your blood pressure tends to be lower when measured at the doctor’s office. This is called masked high blood pressure. Doctors can diagnose this type of high blood pressure by looking at readings taken at the office and at home, especially at night. When this happens, your doctor will have difficulty detecting high blood pressure.
  • The wrong blood pressure cuff was used. Your readings can appear different if the cuff is too small or too large. It is important for your healthcare team to track your readings over time and ensure the correct pressure cuff is used for your sex and age.

Diagnostic tests

  • Blood tests. Your doctor may recommend blood tests to check for kidney damage, high cholesterol or diabetes that may raise your risk of coronary heart disease, or other problems like thyroid disease that may be causing high blood pressure.
  • Blood pressure monitor. To gather more information about your blood pressure, your doctor may recommend wearing a blood pressure monitor to record readings over 24 hours. Your doctor may also teach you how to take blood pressure readings at home.

Treatment - High Blood Pressure

For most people with high blood pressure, a doctor will develop a treatment plan that may include heart-healthy lifestyle changes alone or with medicines. A risk calculator can help your doctor estimate your risk of complications and choose the right treatment. A healthcare team can help you best manage your blood pressure and prevent complications. This team may include your doctor, a nutritionist, a pharmacist, and specialists for any conditions you may have, including those related to your heart.

If your high blood pressure is caused by another medical condition or medicine, it may improve once the cause is treated or removed.

Watch this video to learn more about treatments for high blood pressure and how they work. Medical Animation Copyright © 2020 Nucleus Medical Media, All rights reserved.

Risk calculators

Your doctor may use a risk calculator to estimate your risk of having a stroke or heart attack or dying from a heart or blood vessel disease in the next 10 years or throughout your lifetime. This information can help your doctor choose the best treatment to prevent complications.

For example, the Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimator considers your cholesterol levels, age, sex, race, and blood pressure. It also factors in whether you smoke or take medicines to manage high blood pressure or cholesterol.

Healthy lifestyle changes

If you have high blood pressure, your doctor may recommend that you adopt a heart-healthy lifestyle to help lower and control high blood pressure.

  • Choose heart-healthy foods such as those in the DASH eating plan. NHLBI-funded research has shown that DASH combined with a low-salt eating plan can be as effective as medicines in lowering high blood pressure. Visit Living With the DASH Eating Plan or see Tips to Reduce Salt and Sodium.
  • Avoid or limit alcohol. Talk to your doctor about how much alcohol you drink. Your doctor may recommend that you limit or stop drinking alcohol. You can find resources and support at the Alcohol Treatment Navigator from the National Institute on Alcohol Abuse and Alcoholism.
  • Get regular physical activity. Many health benefits result from being physically active and getting the recommended amount of physical activity each week. Studies have shown that physical activity can help lower and control high blood pressure levels. Even modest amounts of physical activity may help. Before starting any exercise program, ask your doctor what level of physical activity is right for you
  • Aim for a healthy weight. If you are an adult who is living with overweight or obesity, losing 5% to 10% of your initial weight over about 6 months can improve your health. Even losing just 3% to 5% of your weight can improve blood pressure readings.
  • Quit smoking. Visit Smoking and Your Heart and our Your Guide to a Healthy Heart. Although these resources focus on heart health, they include basic information about how to quit smoking. For free help and support to quit smoking, you can call the National Cancer Institute’s Smoking Quitline at 1-877-44U-QUIT (1-877-448-7848).
  • Manage stress. Learning how to manage stress and cope with problems can improve your mental and physical health. Learning relaxation techniques, talking to a counselor, and finding a support group can all help.
  • Get enough good-quality sleep. The recommended amount for adults is 7 to 9 hours of sleep a day. Develop healthy sleep habits by going to sleep and getting up at regular times, following a calming bedtime routine, and keeping your bedroom cool and dark.

Changing habits can be hard. To help make lifelong heart-healthy changes, try making one change at a time. Add another change when you feel comfortable with the previous one. You’re more likely to manage your blood pressure when you practice several of these healthy lifestyle habits together and can keep them up.

Medicines

When healthy lifestyle changes alone do not control or lower high blood pressure, your doctor may prescribe blood pressure medicines. These medicines act in different ways to lower blood pressure. When prescribing medicines, your doctor will also consider their effect on other conditions you might have, such as heart disease or kidney disease.

Keep up your healthy lifestyle changes while taking these medicines. The combination of the medicines and the heart-healthy lifestyle changes can help control and lower your high blood pressure and prevent heart disease.

Talk to your doctor if you have any concerns about side effects from the medicines. He or she may change the dose or prescribe a new medicine. To manage high blood pressure, many people need to take two or more medicines. This is more likely in African American adults.

Possible high blood pressure medicines include:

  • Angiotensin-converting enzyme (ACE) inhibitors to keep your blood vessels from narrowing as much.
  • Angiotensin II receptor blockers (ARBs) to keep blood vessels from narrowing.
  • Calcium channel blockers to prevent calcium from entering the muscle cells of your heart and blood vessels. This allows blood vessels to relax.
  • Diuretics to remove extra water and sodium (salt) from your body, reducing the amount of fluid in your blood. The main diuretic for high blood pressure treatment is thiazide. Diuretics are often used with other high blood pressure medicines, sometimes in one combined pill.
  • Beta blockers to help your heart beat slower and with less force. As a result, your heart pumps less blood through your blood vessels. Beta blockers are typically used only as a backup option or if you have other conditions.

Living With - High Blood Pressure

If you have been diagnosed with high blood pressure, it is important that you continue your treatment plan. You will need regular follow-up care and may want to learn how to monitor your condition at home. Your doctor may need to change or add medicines to your treatment plan over time.

Let your healthcare team know if you are planning to become pregnant. Read the High Blood Pressure in Pregnancy section for more information.

Manage your condition

Keep up your treatment plan, including healthy lifestyle changes, to help control your blood pressure and prevent heart disease. Making lifestyle changes and remembering your medicine every day can be hard, but there are ways to help.

  • Ask your doctor, nurse, or pharmacist about apps for monitoring and tracking your blood pressure. They also may know a way to get texts to remind you to take your medicine every day and notify you when it’s time to fill your prescription.
  • Get support from loved ones and others in your community. You can share the Supporting Your Loved One with High Blood Pressure tip sheet with them.
  • Have regular medical checkups and tests, as your doctor advises. Ask questions and discuss your progress. Let your doctor know if you have any new conditions or have been taking new medicines since your last appointment.
  • Your doctor may want you to check your blood pressure at home or other locations that have blood pressure equipment. Return to Screening for reminders on how to prepare for blood pressure testing and how to take your blood pressure yourself.
  • Visit My Blood Pressure Wallet Card to print out and keep a written log of all your results. Take the log to your doctor’s appointments. You may be able to send the readings to your doctor’s office electronically.

Return to Treatment to review possible treatment options for your high blood pressure.

Know when to call for help for complications

Readings above 180/120 mm Hg are dangerously high and require immediate medical attention. Blood pressure this high can damage your organs. Call 9-1-1 if you experience:

  • A sudden, severe headache
  • Difficulty breathing
  • Sudden, severe pain in your abdomen, chest, or back

High blood pressure can also lead to heart attack or stroke. Call 9-1-1 if you suspect this is happening to you or someone else.

Heart attack

The signs and symptoms of a heart attack include:

  • Nausea, vomiting, light-headedness or fainting, or breaking out in a cold sweat. These symptoms of a heart attack are more common in women.
  • Prolonged or severe chest pain or discomfort not relieved by rest or nitroglycerin. This involves uncomfortable pressure, squeezing, fullness, or pain in the center or left side of the chest that can be mild or strong. This pain or discomfort often lasts more than a few minutes or goes away and comes back.
  • Shortness of breath. This may accompany chest discomfort or happen before it.
  • Upper body discomfort. This can be felt in one or both arms, the back, neck, jaw, or upper part of the stomach.

Stroke

If you think someone may be having a stroke, act F.A.S.T. and perform the following simple test.

  • F—Face: Ask the person to smile. Does one side of the face droop?
  • A—Arms: Ask the person to raise both arms. Does one arm drift downward?
  • S—Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange?
  • T—Time: If you observe any of these signs, call for help immediately. Early treatment is essential.

High Blood Pressure in Pregnancy - High Blood Pressure

High blood pressure can cause problems for a mother and her baby. High blood pressure can harm a mother’s kidneys and other organs and can cause early birth (called preterm birth) and low birth weight.

Planning for pregnancy

If you are thinking about having a baby and have high blood pressure, talk with your doctors so you can take steps to lower or control your high blood pressure before and during the pregnancy.

Some medicines used to treat high blood pressure are not recommended during pregnancy. If you are taking medicines to lower or control your high blood pressure, talk with your doctor about your choices for safely managing high blood pressure during pregnancy.

Types of high blood pressure disorders during and after pregnancy

If you have high blood pressure before pregnancy, it will need to continue to be managed during and after pregnancy.

Some women who have a healthy blood pressure develop high blood pressure during or after pregnancy.

  • Gestational hypertension is high blood pressure that develops during pregnancy, usually 20 weeks or more after you become pregnant.
  • Preeclampsia and eclampsia. Preeclampsia is a combination of high blood pressure during pregnancy and signs that your organs are not working well, such as high protein levels in your urine. This can lead to life-threatening seizures or coma, a condition known as eclampsia. Women who have had preeclampsia have a higher risk of developing high blood pressure and heart disease later in life.
  • HELLP syndrome is a more severe type of preeclampsia or eclampsia.
  • High blood pressure disorders after the baby is born. Some women may continue to have high blood pressure problems, including preeclampsia, eclampsia, or HELLP syndrome, after the birth of their child, or their high blood pressure may get worse.
  • A sudden spike in blood pressure (more than 160/110 mm Hg) can also happen during pregnancy or after the baby is born. This is a medical emergency.

Managing high blood pressure during pregnancy

As part of your regular prenatal care, your doctor will measure your blood pressure at each visit. Learn more about how to prepare for a blood pressure test.

If you have high blood pressure, your doctor will closely monitor you and your baby and provide special care to lower the chance of complications. You may need to:

  • Check your blood pressure at home. Visit Measure Your Blood Pressure for more information.
  • Keep track of how many times you feel the baby kicking each day.
  • Limit your physical activity. Talk to your doctor about what level of physical activity is right for you.
  • Take medicine to control your blood pressure. If you do, talk to your doctor about which medicines are safe for your baby. These medicines may include calcium-channel blockers (nifedipine), taken by mouth, or beta blockers (labetalol) or vasodilators (hydralazine), given through an IV.
  • Take aspirin in the second trimester, if you are at risk of preeclampsia and your doctor recommends aspirin.
  • Visit your doctor more often to monitor your condition and your baby’s growth rate and heart rate. He or she may order blood and urine tests to check how well your organs are working, which can help detect preeclampsia.

If your doctor is concerned about you or your baby’s health, they may recommend that you deliver your baby before 39 weeks. You may need to stay in the hospital to get medicine that will help your baby’s lungs develop faster and to be monitored before and after you deliver your baby.

Research for Your Health

The NHLBI is part of the U.S. Department of Health and Human Services’ National Institutes of Health (NIH)—the Nation’s biomedical research agency that makes important scientific discovery to improve health and save lives. We are committed to advancing science and translating discoveries into clinical practice to promote the prevention and treatment of heart, lung, blood, and sleep disorders, including high blood pressure. Learn about the current and future NHLBI efforts to improve health through research and scientific discovery.

Improving health with current research

Learn about the following ways in which we continue to translate current research and science into improved health for people who have high blood pressure. Research on this topic is part of our broader commitment to advancing scientific discovery in heart and vascular disease and health disparities and inequities research.

  • Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). This NHLBI study began in 1994 and lasted eight years. People who had high blood pressure enrolled in one part of the study and people who had high blood cholesterol enrolled in another part of the study. ALLHAT’s findings have informed how we treat high blood pressure and high blood cholesterol. Visit Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial for more information about all research activities and advances from this study.
  • NHLBI Expert Panel on Cardiovascular Health and Risk Reduction in Children and Adolescents. We have supported the development of guidelines based on up-to-date research to evaluate and manage risk of heart disease in children and adolescents, including high blood pressure. Visit Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents for more information.
  • Workshops on Predicting, Preventing, and Treating Preeclampsia. Working with the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), we periodically convene experts to discuss priorities in preeclampsia research. Experts invited in 2010 and 2018 helped identify priorities for future research that could help improve understanding of when and how preeclampsia develops and find better ways to detect and treat it. Visit NHLBI Workshop Predicting, Preventing and Treating Preeclampsia - Executive Summary for more information.
  • NHLBI-funded Research Supports Development of Guidelines for High Blood Pressure Management. The Systolic Blood Pressure Intervention Trial (SPRINT) found that treating to a lower systolic blood pressure target—less than 120 mm Hg—reduced complications from high blood pressure and saved lives. SPRINT results informed the 2017 high blood pressure clinical guidelines that aim to improve treatment for millions of people. A follow-up study found that treating to a systolic blood pressure target of less than 120 mm Hg also reduced mild cognitive impairment, a precursor of dementia. It also reduced white matter lesions in the brain, which are thought to raise the risk of dementia in later life. Visit Intensive blood pressure control may slow age-related brain damage for more information.

Learn about some of the pioneering research contributions we have made over the years that have improved clinical care.

  • Bogalusa Heart Study. We support studies to assess how childhood tobacco use, physical inactivity, and a high-fat, high-calorie eating pattern influence the development of heart and blood vessels diseases, including high blood pressure, later in life. Visit Bogalusa Heart Study for more information.
  • Framingham Heart Study. Our multigenerational landmark study began in 1948 and helped discover that high blood pressure increases the risk of heart disease and stroke. Visit Framingham Heart Study for more information about all research activities and advances from this study.
  • Blood pressure disparities in African Americans. Researchers using data from the NHLBI-funded Coronary Artery Risk Development in Young Adults (CARDIA) study found three in four African American men and women are likely to develop high blood pressure by the age of 55. The NHLBI-supported Jackson Heart Study is looking at genetic and environmental factors to understand how African Americans are disproportionately affected by heart and blood vessel diseases, especially high blood pressure. Using this data, researchers found that high levels of chronic stress are a risk factor for high blood pressure. Another NHLBI-funded study found that high blood pressure in African Americans was linked to living in racially segregated neighborhoods.Visit High blood pressure linked to racial segregation in neighborhoods for more information.
  • Supporting community-based research to lower blood pressure. An NHLBI-funded study showed that a blood pressure program pairing pharmacists with barbers in African American communities lowered customers’ blood pressure to healthy levels. More than a year later, the men’s blood pressure levels were still low. Another study we funded showed that a blood pressure program at African American churches, conducted by trained church members, was also successful at lowering blood pressure. Together, the findings show that community-based programs can help reduce health disparities and inequities in cardiovascular disease. Visit Barbershops provide unusual venue for helping black men lower their blood pressure for more information.
  • Hispanic Community Health Study/Study of Latinos (HCHS/SOL). The NHLBI supports the HCHS/SOL, which is the most comprehensive long-term study of health and disease in Hispanics and Latinos living in the United States. Study data will pave the way for future research into possible causes of health disparities among Hispanic and Latino communities. Visit Hispanic Community Health Study/Study of Latinos for more information.
  • Discovering which genetic patterns contribute to high blood pressure risk. NHLBI-funded researchers identified dozens of new genetic variations that affect blood pressure. Scientists discovered the new genetic regions—and confirmed the role of many previously known ones—by looking specifically at cigarette smoking behavior, one of many lifestyle factors that impact blood pressure. The analysis of the large samples was possible through the work of researchers in the Gene-Lifestyle Interactions Working Group of the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. Visit A Large-Scale Multi-ancestry Genome-wide Study Accounting for Smoking Behavior Identifies Multiple Significant Loci for Blood Pressure for more information.
  • Strong Heart Study (SHS). Since 1988, we have supported SHS, the largest epidemiologic study of American Indians ever conducted. The SHS aims to estimate the impact of heart and blood vessel diseases and to assess how common and significant standard risk factors are in this community. Thirteen tribes and communities in four states participate in the study. Visit Strong Heart Study for more information.
  • Understanding risks of blood pressure in middle age. Researchers pooled data from many NHLBI studies, including CARDIA and the Framingham Heart Study, to understand the risks of high blood pressure or cholesterol during young adulthood (before age 40). The study showed high blood pressure and cholesterol levels in young adults can raise the risk of coronary heart disease in later life, even if they manage to get these levels down when they are older. The researchers recommend implementation of preventive programs targeting young adults that are web-based, patient-centered, and mobile. Read Wake-up call: High blood pressure and cholesterol in young adults associated with later heart disease for more information.
  • Systolic Hypertension in the Elderly Program. From 1984 to 1996, the NHLBI supported the Systolic Hypertension in the Elderly Program (SHEP), which studied high blood pressure treatment in adults age 60 and older who had high blood pressure. The study found that medicines for high blood pressure can reduce the risk of stroke.
  • Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b). The NHLBI is committed to addressing women’s unique health risks, including complications of pregnancy. The nuMoM2b study, funded by the NHLBI and NICHD, found that women who have mild sleep apnea are at higher risk of high blood pressure and preeclampsia during pregnancy. The NHLBI and NICHD are now studying whether treating sleep apnea during pregnancy reduces this risk. In the follow-up nuMoM2b Heart Health Study, researchers found that women who had a complication during their first pregnancy are at higher risk of later developing high blood pressure. Visit First-time pregnancy complications linked to increased risk of hypertension later in life for more information.
  • Investigating the link between high blood pressure and HIV. People living with HIV have a higher risk of developing high blood pressure, whether or not they actively take their HIV medicine. In a recent study, NHLBI-funded researchers documented high blood pressure among more than half of patients who had had AIDS for a long time in Haiti, a higher rate than in the general population. Investigators have also examined how inflammation is linked with high blood pressure among people being treated for HIV in Africa. We also organized a workshop on high blood pressure and other conditions that have distinct effects on patients in this community. Visit HIV-associated Comorbidites, Co-infections, & Complications Workshop to learn more.
  • Improving screening for high blood pressure risk. Understanding who is at the greatest risk of developing high blood pressure could give doctors a head start on helping patients prevent it. Researchers supported by the NHLBI adapted a measure used for economic analysis to determine someone’s risk of developing high blood pressure in the future. One day this measure could be used to improve screening, particularly among individuals who appear to be low-risk. Visit Efficiency score from data envelopment analysis can predict the future onset of hypertension and dyslipidemia: A cohort study for more information.

Advancing research for improved health

In support of our mission, we are committed to advancing high blood pressure research in part through the following ways.

Learn about exciting high blood pressure research we are exploring.

  • Setting our sights on eliminating high blood pressure-related diseases. Our Division of Cardiovascular Sciences has identified the elimination of high blood pressure-related heart and blood vessel diseases as one of six strategic priorities guiding its work. Another aspect of this work will focus on addressing health disparities and social and economic factors that influence health. We are organizing workshops and funding research to better understand blood pressure differences between groups and to develop ways to prevent and treat high blood pressure. Read more in Implementing the National Heart, Lung, and Blood Institute’s Strategic Vision in the Division of Cardiovascular Sciences.
  • Evaluating treatment for high blood pressure during pregnancy. There is a lack of consensus about whether to treat mild high blood pressure during pregnancy, as treatment carries risk for both mother and her unborn baby. The NHLBI-funded Chronic Hypertension and Pregnancy (CHAP) trial will evaluate the effectiveness and safety of treating pregnant women to get their blood pressure below 140/90 mm Hg. The trial is also studying the best point during pregnancy to deliver a baby to minimize complications, such as eclampsia, for both mother and child. Another study we support is testing whether the cholesterol-lowering medicine pravastatin helps prevent preeclampsia from reoccurring in pregnant women who had the condition previously. The trial is being conducted in NICHD’s Maternal Fetal Medicine Units Network. Visit Chronic Hypertension and Pregnancy-CHAP Clinical Coordinating Center for more information.

Participate in NHLBI Clinical Trials

We lead or sponsor many studies relevant to high blood pressure. See if you or someone you know is eligible to participate in our clinical trials.

Trials at the NIH Clinical Center

Causes and risk factors for cardiovascular disease in African Americans

This study will examine how your genes and health behaviors and where you live and work contribute to your risk of heart disease. To participate you must be an African American age 21-65, living in Washington, D.C., or Montgomery or Prince Georges counties in Maryland. This study is located in Bethesda, Maryland.

To learn more about clinical trials at the NIH Clinical Center or to talk to someone about a study that might fit your needs, call the Office of Patient Recruitment 800-411-1222.

Are you living with HIV and high blood cholesterol or high blood pressure?

This study is evaluating a nurse-led reminder system to help people who have HIV stay on track with their heart medicines. Participants will have four visits with a nurse, who will help them manage their medicine schedule with telephone reminders. To participate in this study, you must be at least 18 years old; have HIV, high blood cholesterol, or high blood pressure or be taking medicines to manage these conditions; and have access to a telephone. This study is located in Cleveland, Ohio, and Durham, North Carolina.

Do you live in Iowa and want to work with a pharmacist to manage your high blood pressure?

This study will test a program that uses pharmacists to help people manage high blood pressure. You will be given a blood pressure monitor to take readings at home and text them to a pharmacist. You will then either talk to the pharmacist once or be part of the more intensive program where the pharmacist develops a care plan and monitors you for a year. To participate in this study, you must be older than 21, have had a systolic pressure greater than 145 mm Hg or diastolic pressure greater than 95 mm Hg at your previous clinic visit, and be patient at the Family Medicine, River Crossings, Scott Blvd, or Muscatine University of Iowa Clinics. This study is located in Iowa.

Are you age 18-40 and interested in helping advance science?

This study aims to investigate a component of blood vessels, called endothelin, that causes the blood vessels to narrow and is thought to play a role in high blood pressure. Investigators hope to see if endothelin works differently in people who have obesity. To participate in this study, you must be age 18-40. The study is located in Augusta, Georgia.

Do you want to get better at taking your blood pressure medicine?

This study will test a program aimed at helping motivate people to take their blood pressure medicine. Each day, participants who took their medicine will be eligible to win a prize through a smartphone app that tracks whether they are taking their medicine. To participate in this study, you must be at least 18 years old and have an active prescription for high blood pressure medication. This study is located in New York, New York.

Are you an adult who is curious about how sodium affects your blood pressure?

This study is testing whether limiting sodium can affect individuals with a specific genetic predisposition to high blood pressure. To participate you must be 18 years old or older and not have high blood pressure. Please note that this study is in Charlottesville, Virginia.

Are you an adult whose high blood pressure does not improve with lifestyle changes and medicines?

This study will assess whether minocycline, an antibiotic with anti-inflammatory effects, can improve blood pressure control in patients who do not respond to medicines in combination with lifestyle changes, such as physical activity, weight loss, and healthy eating patterns. To participate you must be at least 18 years old and have high blood pressure that does not respond to treatment with three different high blood pressure medicines even when used at the maximum doses. Please note that this study is in Gainesville, Florida.

Do you work at a desk and want to improve your health?

This study will investigate whether reducing the amount of time that participants spend sitting results in lower blood pressure. Participants will reduce their sitting by 2 to 4 hours a day for three months by using a sit-stand desk attachment and receiving alerts though text messages and an activity watch. They will also receive in-person and phone counselling on setting goals, overcoming barriers, self-monitoring, and social support. To participate in this study, you must be between 21 and 65 years old, get less than 150 minutes of physical activity per week, and have a stable desk job that is within 25 miles of the University of Pennsylvania. This study is located in Pittsburgh, Pennsylvania.

Are you an adult under age 50 interested in helping researchers understand blood pressure?

This study will explore endothelin, a molecule found in blood vessels, to better understand its role in blood pressure. For the study, you will take either a medicine that blocks this molecule or a placebo. Your blood pressure and heart and blood vessel functions will be measured with ultrasound, blood tests, and other tests. This will happen while you exercise and while you hold your hand in ice water. To participate in this study, you must be between 18 and 50 years old and identify as African American or white. You also must have a BMI between either 16 and 24 or 31 and 40. Women who are pregnant, menopausal, or post-menopausal cannot participate. This study is located in Augusta, Georgia.

Are you a healthy adult who regularly sleeps for 6.5 or fewer hours?

This study is examining whether getting enough sleep can lower your risk of high blood pressure. To participate in this study, you must be between 18 and 65 years old, regularly sleep for 6.5 or fewer hours, and be able to adjust your sleep schedule for the study. This study is located in Rochester, Minnesota.

Do you have high blood pressure, and do you receive care at a community-based clinic in the South?

This study will explore an intensive high blood pressure management approach at participating community-based clinics. The approach aims to lower participants’ systolic blood pressure to 120 mm Hg. To participate in this study, you must be at least 40 years old, understand English, and not be pregnant. The study is located in Louisiana, Alabama, and Mississippi.

Do you want to take part in a supervised exercise program and help science?

This study will see how aerobic and resistance exercise affect blood pressure. In the study you will take part in one of these exercise programs for two months. You will be supervised by a physical therapist or an exercise physiologist during the exercises. To participate in this study, you must be between 18 and 55 years old, and not be taking medicine for high blood pressure. This study is located in Chicago, Illinois.

Are you at least 35 years old, and do you have resistant high blood pressure?

This study aims to test the effectiveness of using lifestyle changes, such as healthy eating and physical activity, in addition to medicines to help treat high blood pressure. To participate in this study, you must be at least 35 years old, be overweight, and have high blood pressure that has not been successfully treated with medicines. This study is located in Durham, North Carolina.

Is your high blood pressure resistant to medicines?

Some people have high blood pressure despite taking medicines, putting those individuals at risk of heart disease or stroke. This study will see whether the DASH heart-healthy eating plan and a special exercise program can help lower your blood pressure. To participate in this study, you must be at least 35 years old and be taking three or more medicines for high blood pressure. This study is located in Durham, North Carolina.

Do you take medicine for high blood pressure or high blood cholesterol?

This study will test a program that asks pharmacists to reach out to patients who have high blood pressure, high blood cholesterol, or diabetes and help them stick to their plans for taking and refilling their medicines as prescribed. To participate in this study, you must be between 18 and 75 years old. The study location is in Bloomington, Minnesota.

Are you an adult who has uncontrolled high blood pressure?

This study will see whether an early notification system for health professionals can help manage patients’ high blood pressure, especially among those who have had a stroke or have an increased risk of stroke. To participate in this study, you must be between 18 and 85 years old and have high blood pressure that is not controlled by medicine and lifestyle changes. This study is enrolling native English, Spanish, or Hmong speakers. The study is located in Minneapolis, Minnesota.

Are you an African American near Detroit who wants to better manage your blood pressure?

This study will test a mobile phone app for people with high blood pressure. The app helps people monitor their blood pressure, physical activity, and sodium (salt) intake; set goals; and remember to take their medicine. During the study you will learn how to use the app, which could help you improve your health. To participate in this study, you must be an African American adult age 25 to 70 who has high blood pressure. This study is located in Detroit, Michigan.

Are you being treated for a chronic health condition in Wisconsin?

This study assesses an online program for people 65 and older who have some combination of diabetes, high blood pressure, high blood cholesterol, COPD, obesity, congestive heart failure, chronic kidney disease, arrhythmia, pulmonary heart or vascular disease, chronic pain, and arthritis. Follow-up surveys will help researchers evaluate the effectiveness of the care and support offered through the online program and determine if it decreases the use of health care services and improves health measures. To participate in this study, you must be at least 65 years old and be receiving treatment for at least three chronic conditions at a University of Wisconsin health clinic. This study is located in Madison, Wisconsin.

Are you an adult whose high blood pressure has not improved with medicines?

This study is assessing whether a low-sodium and low-calorie eating pattern, along with aerobic exercise, can improve blood pressure in patients who do not respond to high blood pressure medicines. To participate you must be at least 35 years and have high blood pressure that does not respond to medicines. Please note that this study is in Durham, North Carolina.

Do you want help remembering to refill your medicine prescriptions?

In this study, you will receive text messages to remind you to take your medicines and refill your prescriptions before they run out. To participate in this study, you must be between 18 and 89 years old and taking medicines for high blood pressure, high blood fats, diabetes, or atrial fibrillation. This study is located in Aurora and Denver, Colorado.

Are you a Hispanic/Latino adult who wants to improve your mental and emotional well-being?

This study aims to test the effect of improving mental and emotional well-being on blood pressure. Over the course of eight weeks, you will take part in activities that are designed to help you be more mindful, relaxed, and optimistic. Participants will take part in a program that encourages optimism, gratitude, mindfulness, and resilience for three months. To participate in this study, you must be Hispanic/Latino adult over age 18 and have high blood pressure. This study is located in Chicago, Illinois.

Are you an adult who does not have high blood pressure?

Circadian rhythms control daytime and nighttime changes in blood pressure. This study is examining the links between stress, loss of sodium through urine, and circadian rhythms in controlling blood pressure. To participate in this study, you must be at least 21 years old and not have high blood pressure. This study is located in New York, New York.

Have you been diagnosed with high blood pressure while pregnant?

This study is investigating whether a mother’s blood pressure during pregnancy affects her newborn’s lung development. To participate in this study, your newborn must have been born either prematurely at more than 25 weeks’ gestation or at full term to a healthy mother or a mother who was diagnosed with high blood pressure during pregnancy. This study is located in Indianapolis, Indiana.

Do you struggle to take your blood pressure medicine as prescribed?

This study will investigate whether exercises that affirm one’s values help adults with high blood pressure take their medicine regularly. Stereotypes about race or ethnicity can affect your attitudes and behaviors about your health, which can prevent you from being as healthy as possible. The researchers think that the exercises in this study could help people overcome the negative influences of stereotypes and take better care of their health. To participate in this study, you must be a white or African American adult over age 21 who is currently taking blood pressure medicine. This study is located in Denver, Colorado, and Rockville, Maryland.

Do you want to help researchers understand the link between gut bacteria and high blood pressure?

This study aims to explore the relationship between gut microbiota (tiny organisms that live in the digestive system) and high blood pressure. The researchers will compare gut microbiota in participants with normal blood pressure, controlled high blood pressure, uncontrolled high blood pressure, and high blood pressure that is resistant to treatment. To participate in this study, you must be between 18 and 80 years old and not be pregnant or taking an antibiotic. This study is located in Gainesville, Florida.

More Information

After reading our High Blood Pressure Health Topic, you may be interested in additional information found in the following resources.

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