High blood pressure means the force of blood pushing against the walls of your arteries stays too high. It usually causes no symptoms, but over years it damages the heart, brain, kidneys and eyes.
Go to hospital immediately if you notice
- Chest pain or tightness
- Sudden weakness or numbness on one side of the body, or difficulty speaking
- Severe headache with vomiting or confusion
- Sudden difficulty breathing
- Sudden loss of vision
Overview
Blood pressure is written as two numbers, for example 120/80 mmHg. The upper number is the pressure when the heart beats. The lower number is the pressure when the heart rests between beats.
High blood pressure is generally diagnosed when readings stay at 140/90 mmHg or above on more than one occasion, measured properly.
It is often called a silent condition because most people feel completely normal. The damage happens quietly over years.
The good news is that it responds well to treatment. Controlling blood pressure substantially reduces the risk of stroke, heart attack and kidney failure.
Symptoms of High Blood Pressure
- Most people have no symptoms at all — this is the main danger
- Very high readings may cause headache, breathlessness or nosebleeds
- Some people notice blurred vision or a feeling of pressure in the head
- Because symptoms are unreliable, the only way to know is to measure it
What causes it
- In most people there is no single cause — this is called primary or essential hypertension, and it builds up over years
- In a minority it is secondary to another condition: kidney disease, thyroid problems, obstructive sleep apnoea, narrowing of the kidney arteries, or certain medicines
Who is at higher risk
- Age — risk rises steadily after 40
- A family history of high blood pressure
- Eating a lot of salt, pickles, papad and packaged or processed food
- Being overweight and physically inactive
- Regular alcohol use
- Smoking or chewing tobacco
- Diabetes and long-term kidney disease
- Long-term stress and poor sleep
Tests and diagnosis
These are the tests doctors commonly use. Which ones you need depends on your symptoms.
- Repeated blood pressure measurements on separate days, taken after sitting quietly for five minutes
- Home blood pressure monitoring, which avoids falsely high readings caused by anxiety in a clinic
- 24-hour ambulatory blood pressure monitoring in unclear cases
- Blood and urine tests, ECG and sometimes an echocardiogram to check for effects on the organs and to look for a secondary cause
Treatment
- Lifestyle changes come first and continue alongside any medicine.
- Several different types of tablet are used, and they work in different ways — some relax the blood vessels, some help the kidneys remove extra salt and water, and some block the body chemicals that tighten the vessels. You may see them called calcium channel blockers, ACE inhibitors, ARBs or diuretics (water tablets). Many people need more than one, and that is normal rather than a sign things are going badly.
- Blood pressure medicines usually need to be taken long term. Do not stop them because your reading has become normal — the reading is normal because of the medicine.
- Keep a home record of your readings and take it to every appointment.
Prevention
- Keep salt below about 5 grams a day — roughly one level teaspoon, including salt already in packaged food
- Eat more fruit, vegetables, whole grains and dal; cut down fried and processed food
- Walk briskly or do similar activity for 30 minutes on most days
- Reach and hold a healthy weight
- Limit or avoid alcohol
- Stop all forms of tobacco
- Have your blood pressure checked at least once a year from age 30
When should you see a doctor?
Get your blood pressure checked yearly even if you feel fine. See a doctor promptly if home readings are repeatedly above 140/90. Treat chest pain, sudden one-sided weakness, difficulty speaking, severe headache with vomiting or sudden breathlessness as an emergency and go to hospital at once.
Frequently Asked Questions
What is a normal blood pressure reading?
Around 120/80 mmHg is considered normal for most adults. Readings consistently at or above 140/90 mmHg are generally treated as high blood pressure.
Can I stop my BP tablets once my reading is normal?
No — not without your doctor's advice. In most cases the reading is normal precisely because the medicine is working. Stopping it usually allows the pressure to rise again, sometimes sharply.
Does high blood pressure cause headaches?
Usually not. Most people with high blood pressure have no symptoms at all. Headache tends to occur only at very high levels, so you cannot rely on how you feel to judge your blood pressure.
How much salt is safe in a day?
The World Health Organization recommends less than 5 grams of salt a day, about one level teaspoon. Most of it comes hidden in packaged food, pickles, papad, namkeen and restaurant meals rather than from the salt shaker.
Questions to ask your doctor about High Blood Pressure
Pick the three that matter most to you and write them down before your appointment. Consultations are short, and almost everyone forgets at least one.
- What is my target blood pressure?
- Should I measure at home, and how often?
- Why this particular medicine, and will I need more than one?
- What side effects should I tell you about rather than just stopping?
- How much salt is safe for me specifically?
- Do I need my kidneys and cholesterol checked?
- What should make me seek urgent help?
What this costs, and what is free
Government hospitals and health and wellness centres provide screening and treatment for blood pressure, diabetes and common long-term conditions at little or no cost.
Eligible families are covered up to ₹5 lakh per year for hospitalisation under Ayushman Bharat PM-JAY. Day-to-day medicines are not covered by PM-JAY, but Jan Aushadhi Kendras sell them at much lower prices.
Generic versions are sold at Jan Aushadhi Kendras at substantially lower prices than branded packs of the same medicine.
The main long-term cost is medicines taken daily for years, not the consultation. Asking your doctor to write generic names, and buying at a Jan Aushadhi Kendra, is usually the single biggest saving available.
Source: Ayushman Bharat PM-JAY, National Health Authority, Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP)
Prices and scheme rules change. Confirm current details with the hospital or Kendra before you rely on them.