Hypertension — “The Silent Killer”

Joseph R. Anticaglia MD
Medical Advisory Board

People with normal blood pressure generally enjoy a long life. The opposite is true of individuals with chronic, uncontrolled high blood pressure (Hypertension).

Hypertension means high arterial blood pressure. In 2013, hypertension contributed to more than 360,000 American deaths–about one thousand deaths each day. It increases your risk for cardiovascular disease and other worrisome conditions.

Janet is a 47 year old executive secretary with a 15 year history of hypertension first diagnosed when she was pregnant. Her grandmother had a history of heart disease and high blood pressure. Her father, who died of a stroke, also had hypertension.

She complains to her physician that the “blood pressure medications make me feel very tired and listless”.

She hasn’t stopped smoking, doesn’t exercise, is overweight and doesn’t take her medications regularly because of their side effects. Her most recent complaint is recurring headaches.

High Blood Pressure and Other Problems:

  • Those who experience their First stroke: 80% have hypertension
  • People who suffer their First heart attack: 7 out of 10 have hypertension
  • Those with chronic heart failure: 7 out of 10 have hypertension
  • Hypertension increases your risk of kidney disease

What Does Blood Pressure Measure?

The contractions of the heart muscle pumps blood through the arteries to different parts of the body. Blood pressure measures the force or pressure of arterial blood pushing against the walls of your arteries as it circulates throughout the body.

There are two numbers used to measure blood pressure. The first number, systolic blood pressure represents the health of the heart muscle’s ability to contract and pump blood away from the heart (cardiac output) through the arteries and into the tiny capillaries.

The second number, diastolic blood pressure represents the health of the arteries. It measures the pressure, namely, the resistance to the flow of blood in the arteries when the heart is between beats and relaxes. Normal blood pressure is 120 systolic (upper number) and 80 diastolic (lower number) written as a fraction — 120/80.

Blood Pressure Readings


  • Systolic 120 mmHg (or lower)
  • Diastolic 80 mmHg (or lower)


  • Systolic: 120 — 139 mmHg
  • Diastolic: 80 — 89 mmHg

Hypertension Stage 1

  • Systolic 140 — 159 mmHg
  • Diastolic: 90 — 99 mmHg

Hypertension Stage 2

  • Systolic: 160 mmHg or higher
  • Diastolic: 100 mmHg or higher

Hypertensive ‘Crisis’ (Emergency care needed)

  • Systolic: Higher than 180 mmHg
  • Diastolic Higher than 110 mmHg

Who are at Risk of Getting High Blood Pressure?

You have no control over several factors such as age, ethnicity or race. These factors put you at an increased risk of getting hypertension.

  • People above the age of 35
  • Family members with a history of cardiovascular disease, diabetes or hypertension
  • African-Americans

BUT, you can change your behavior to lessen the likelihood of high blood pressure if you are:

  • Overweight
  • Lack of physical exercise
  • Drinking too much alcohol
  • Smoking
  • Eat fatty and salty foods — high cholesterol

What are the Symptoms?

Ordinarily, in the early stages, people with mild to moderate high blood pressure don’t have any symptoms for many years. That’s why it is sometimes called the “silent killer.”

The most frequent symptom, if at all present, is a mild, non-specific headache. Advanced hypertension can be associated with sleepiness, confusion, visual disturbances, nausea and vomiting.

Untreated Blood Pressure can lead to:

  • Heart attacks
  • Heart failure
  • Stroke
  • Kidney/disease
  • Peripheral vascular disease and other problems.

Surprisingly, millions of Americans are unaware that they have hypertension. High blood pressure affects one in three adults or about 75 million Americans. About half of the 75 million Americans have uncontrolled high blood pressure.

There is much one can do to prevent hypertension without the need for medications. The most effective first step anyone can take is to find out if you have high blood pressure.

By maintaining a normal body weight, becoming physically active, drinking alcohol in moderation, not smoking, following a diet low in salty foods, low in saturated fats with little to no trans fats one can keep blood pressure within a normal range. The payoff can be a long and healthy life.


CDC, High Blood Pressure, May 3, 2018

NIH, National, Heart, Lung and Blood Institute; High blood Pressure; May 1, 2018

JNC 8 Guidelines for the Management of Hypertension in Adults. Am Fam Physician.; Oct 1, 2014

EJ Benjamin et al; Heart Disease and Stroke Statistics; Circulation, 2017

This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.