High Blood Pressure

High Blood Pressure: What You Can Do to Protect Your Heart, Kidneys, and Brain


Photo credit: Pavel Danilyuk

May is National High Blood Pressure Education Month, a United States observance founded by the National Heart, Lung, and Blood Institute to raise awareness about hypertension, one of the most common and most preventable chronic conditions affecting adults today [1]. May is also when the International Society of Hypertension and the World Hypertension League run May Measurement Month, a global campaign that encourages people everywhere to have their blood pressure checked and to understand what their numbers mean [2]. High blood pressure is often called the “silent killer” because it usually causes no symptoms, yet it quietly raises the risk of heart attack, stroke, kidney disease, and premature death [3]. This month is an opportunity to understand what blood pressure is, recognize the risk factors, learn your numbers, and take practical steps to protect your health.

What Is High Blood Pressure?

Blood pressure is the force of blood pushing against the walls of your arteries as your heart pumps. It is written as two numbers and measured in millimeters of mercury (mmHg). The first, or top, number is the systolic pressure, which is the force in your arteries when your heart beats. The second, or bottom, number is the diastolic pressure, which is the force when your heart rests between beats [4].

A healthy blood pressure reading is below 120/80 mmHg. High blood pressure, or hypertension, is generally defined as a reading that is consistently at or above 130/80 mmHg, based on the 2017 clinical practice guideline from the American College of Cardiology and the American Heart Association [5].

What makes hypertension so dangerous is that it rarely causes warning signs. A person can have high blood pressure for years without feeling unwell, while the elevated pressure quietly damages blood vessels and organs throughout the body [3]. This is why measuring your blood pressure, rather than waiting for symptoms, is the only reliable way to know where you stand.

A Growing Global and National Crisis

Hypertension is one of the most widespread health conditions in the world. According to the World Health Organization, an estimated 1.4 billion adults aged 30 to 79 were living with high blood pressure as of 2024, a number that has more than doubled since 1990 [3]. Nearly half of them, about 44 percent, are unaware that they have the condition, and only about 23 percent have it under control [3]. Hypertension is a major cause of premature death worldwide [3]. These global figures are based on the World Health Organization’s threshold for hypertension of 140/90 mmHg or higher, which is higher than the 130/80 mmHg threshold used in current United States guidelines. The World Health Organization also notes that blood pressure can begin to raise the risk of heart and kidney disease even below 140/90 mmHg [3].

In the United States, the numbers are equally striking. Nearly half of American adults, about 48 percent or 119.9 million people, have high blood pressure [4]. Only about one in four adults with hypertension have it under control [4]. In 2023, high blood pressure was a primary or contributing cause of 664,470 deaths in the United States [4]. It is also one of the nation’s costliest health conditions, with an estimated 219 billion dollars in annual costs [9]. High blood pressure is more common in men than in women and is more prevalent among non-Hispanic Black adults than other groups [4].

High blood pressure does not act alone. The Global Burden of Disease (GBD) 2023 study on chronic kidney disease identified high systolic blood pressure as one of the three leading drivers of kidney disease burden worldwide, alongside high fasting plasma glucose and high body-mass index [6]. In clinical terms, these correspond to hypertension, diabetes, and excess body weight, three closely connected conditions that together account for a large share of preventable chronic disease. This is why high blood pressure cannot be understood in isolation from the diabetes and kidney disease covered in my earlier articles.

The encouraging news is that high blood pressure is largely preventable, and when detected, it is highly treatable. The remainder of this article explains how hypertension develops, who is most at risk, how it harms the body, and the practical steps you can take to protect yourself.

How High Blood Pressure Develops

There are two main types of high blood pressure. The most common is primary, or essential, hypertension, which develops gradually over many years and has no single identifiable cause [8]. It results from a combination of factors, including age, genetics, and lifestyle. The second type is secondary hypertension, which is caused by an underlying condition such as kidney disease, thyroid disorders, obstructive sleep apnea, or the use of certain medications [8].

The relationship between high blood pressure and other chronic diseases often works in both directions. Conditions such as diabetes and chronic kidney disease can raise blood pressure, and sustained high blood pressure in turn damages the organs they affect, particularly the kidneys [7]. This creates a cycle in which one condition accelerates another, which is one reason managing blood pressure early matters so much.

Risk Factors for High Blood Pressure

Several factors influence your risk of developing hypertension. Some can be changed, while others cannot. Knowing both helps you understand your personal risk and take action where you can.

Modifiable Risk Factors (Risk Factors You Can Change) 

  • A diet high in sodium: Consuming too much salt causes the body to retain fluid, which raises blood pressure. Diets high in processed and packaged foods are a common source of excess sodium [8].
  • Physical inactivity: A sedentary lifestyle contributes to weight gain and reduces the flexibility of blood vessels. Regular physical activity helps keep blood pressure within a healthy range [8].
  • Being overweight or obese: Excess body weight increases the workload on the heart and is closely linked to high blood pressure, insulin resistance, and type 2 diabetes [8].
  • Excessive alcohol intake: Drinking too much alcohol can raise blood pressure over time and reduce the effectiveness of blood pressure medications [8].
  • Tobacco use: Smoking damages blood vessels and temporarily raises blood pressure with each cigarette. Quitting improves blood pressure and lowers the risk of heart disease, stroke, and kidney disease [8].
  • Chronic stress and poor sleep: Ongoing stress and inadequate sleep can contribute to elevated blood pressure and to habits that raise it further [8].

Non-Modifiable Risk Factors (Risk Factors You Cannot Change)

  • Age: The risk of high blood pressure increases as you get older, as arteries naturally become stiffer over time [8].
  • Family history: Having a parent or close relative with high blood pressure raises your own risk. Knowing your family history allows you to be proactive about monitoring and prevention [8].
  • Race and ethnicity: In the United States, high blood pressure is more common among non-Hispanic Black adults, in whom it also tends to develop earlier in life [4].
  • Other chronic conditions: Diabetes and chronic kidney disease both increase the likelihood of developing high blood pressure [7].

How High Blood Pressure Harms the Body

When blood pressure stays high over time, the constant force strains the heart and damages blood vessels throughout the body. The effects can reach nearly every major organ system [3].

  • The heart and blood vessels: High blood pressure is a leading risk factor for heart attack, heart failure, and coronary artery disease. The heart must work harder to pump blood against elevated pressure, which over time can enlarge and weaken the heart muscle [8].
  • The brain: Hypertension is one of the most important risk factors for stroke, which occurs when blood flow to part of the brain is blocked or a blood vessel bursts. Over the long term, high blood pressure also contributes to cognitive decline and vascular dementia. Fittingly, May is also recognized as National Stroke Awareness Month, a reminder of how closely blood pressure and brain health are linked [10].
  • The kidneys: High blood pressure damages the small blood vessels that allow the kidneys to filter waste from the blood. As discussed in my article on chronic kidney disease, this damage can lead to chronic kidney disease, and damaged kidneys in turn raise blood pressure further, creating a harmful cycle [7].
  • The eyes: Elevated blood pressure can damage the tiny blood vessels in the retina, a condition known as hypertensive retinopathy, which can lead to vision problems and, in severe cases, vision loss [8].

These complications are not inevitable. With consistent blood pressure control, the risk of developing them can be significantly reduced [3].

Know Your Numbers: Measurement and Screening

The central message of May Measurement Month is a simple one: know your numbers. Because high blood pressure has no symptoms, measurement is the only way to detect it, and an accurate reading is the foundation of good management.

For the most accurate reading, sit quietly for about five minutes beforehand, keep both feet flat on the floor, support your arm at heart level, and avoid caffeine, exercise, and tobacco for at least 30 minutes before measuring [5]. Taking more than one reading and recording the average gives a more reliable picture than a single measurement.

Blood pressure readings fall into the following categories, based on the 2017 American College of Cardiology and American Heart Association guideline [5]:

  • Normal: below 120/80 mmHg
  • Elevated: 120 to 129 systolic and below 80 diastolic
  • Stage 1 hypertension: 130 to 139 systolic or 80 to 89 diastolic
  • Stage 2 hypertension: 140/90 mmHg or higher

Home blood pressure monitoring, also called self-measured blood pressure monitoring, is a valuable tool that allows you and your healthcare provider to track your readings over time outside the clinic [8]. If you are not sure how often to check your blood pressure, or what your target should be, your healthcare provider can guide you based on your individual risk.

Protect Yourself: Key Takeaways

  • Know your numbers: High blood pressure has no symptoms. A simple, painless measurement is the only way to know whether yours is in a healthy range.
  • Watch your sodium: The Dietary Guidelines for Americans recommend limiting sodium to less than 2,300 milligrams per day [11], and many people with high blood pressure benefit from eating patterns such as the DASH diet, which emphasizes fruits, vegetables, whole grains, and lean protein [8].
  • Stay physically active: The Physical Activity Guidelines for Americans recommend at least 150 minutes of moderate-intensity activity per week, such as brisk walking, cycling, or swimming [12].
  • Maintain a healthy weight: Even modest weight loss can meaningfully lower blood pressure and reduce the risk of diabetes and kidney disease [8].
  • Limit alcohol and avoid tobacco: Both raise blood pressure and increase cardiovascular risk. Quitting smoking is one of the most impactful steps you can take [8].
  • Take medications as prescribed: If your provider has prescribed blood pressure medication, take it as directed. Controlling your blood pressure protects your heart, brain, and kidneys [8].
  • Manage related conditions: If you have diabetes or kidney disease, work with your healthcare team to manage them together, since each affects the others [7].
  • Get screened regularly: Knowing your blood pressure, and acting early if it is high, is one of the simplest and most powerful things you can do for your long-term health.

This May, take a few minutes to know your numbers. Blood pressure is one of the easiest things to measure and one of the most important to control. Awareness, regular measurement, and early action today can protect your heart, kidneys, and brain for years to come. If you are unsure about your blood pressure or your risk, a conversation with your healthcare provider is the best place to start.

References 

1.         National Heart, Lung, and Blood Institute (NHLBI). High Blood Pressure Education Month. Available at: https://www.nhlbi.nih.gov/education/high-blood-pressure/high-blood-pressure-education-month Accessed May 25, 2026.

2.         International Society of Hypertension and World Hypertension League. May Measurement Month. Available at: https://www.maymeasure.org Accessed May 25, 2026.

3.         World Health Organization. Hypertension Fact Sheet. Available at: https://www.who.int/news-room/fact-sheets/detail/hypertension Accessed May 25, 2026.

4.         Centers for Disease Control and Prevention. High Blood Pressure Facts. Available at: https://www.cdc.gov/high-blood-pressure/data-research/facts-stats/index.html Accessed May 25, 2026.

5.         Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. Hypertension. 2018;71(6):e13-e115. https://doi.org/10.1161/HYP.0000000000000065.

6.         GBD 2023 Chronic Kidney Disease Collaborators. Global, regional, and national burden of chronic kidney disease in adults, 1990-2023, and its attributable risk factors: a systematic analysis for the Global Burden of Disease Study 2023. The Lancet. 2025;406(10518):2461-2482. https://doi.org/10.1016/S0140-6736(25)01853-7.

7.         National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). High Blood Pressure and Kidney Disease. Available at: https://www.niddk.nih.gov/health-information/kidney-disease/high-blood-pressure Accessed May 26, 2026.

8.         National Heart, Lung, and Blood Institute (NHLBI). High Blood Pressure. Available at: https://www.nhlbi.nih.gov/health/high-blood-pressure Accessed May 26, 2026.

9.         Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. High Blood Pressure. Available at: https://www.cdc.gov/nccdphp/priorities/high-blood-pressure.html Accessed May 26, 2026.

10.     American Stroke Association (a division of the American Heart Association). American Stroke Month. Available at: https://www.stroke.org/en/about-the-american-stroke-association/stroke-awareness-month Accessed May 26, 2026.

11.     U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. Available at: https://www.dietaryguidelines.gov Accessed May 26, 2026.

12.     U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd Edition. Washington, DC: U.S. Department of Health and Human Services; 2018. Available at: https://odphp.health.gov/our-work/nutrition-physical-activity/physical-activity-guidelines/current-guidelines Accessed May 26, 2026.


Cynthia Chisom Edeh is a physician-scientist with years of clinical and research experience focused on evidence-based research for health promotion, disease prevention, diagnosis, and treatment.