High Blood Pressure
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Try one of these related symptoms.
Blood pressure is high
Episode of high blood pressure
Possible Causes
Generally, High blood pressure can be related to:
- Hypertension
Hypertension is high blood pressure (increased pressure of blood against blood vessel walls). It's classified into primary and secondary. Primary is when the cause is unknown. Secondary is due to underlying conditions, such as kidney or thyroid disease. Risk factors include smoking, being overweight, lack of physical activity, unhealthy diet, excessive alcohol consumption, stress, genetics, etc. There are often no symptoms. If untreated, it can cause health problems, such as heart disease and stroke.
- Subcortical Hemorrhage
Subcortical hemorrhage refers to bleeding in the subcortical region of the brain. Causes include hereditary abnormalities of blood vessels in the brain, hypertension, and trauma. It is a type of stroke and is a life-threatening emergency that requires immediate medical attention.
- Pheochromocytoma
Pheochromocytoma is a rare and typically benign tumor that grows in your adrenal gland. Your adrenal glands are small triangular organs, located above your kidneys, responsible for producing hormones that regulate your blood pressure, metabolism, and body reactions in stressful states. Pheochromocytomas are usually caused by genetic mutations and are associated with hereditary syndromes. Some symptoms include These symptoms can include: high blood pressure, headaches, irregular heartbeat, and sweating.
- Benign Paroxysmal Positional Vertigo (BPPV)
- Hypertrophic Cardiomyopathy
Related Serious Diseases
Sometimes, High blood pressure may be related to these serious diseases:
- Gestational Hypertension
High blood pressure can be a side effect of pregnancy. In some cases, this can be severe and harmful to both mother and child. The causes are varied, but risk is higher in obese, older, and first-time mothers.
- Preeclampsia
- HELLP Syndrome
- Eclampsia
- Placental Abruption
Doctor's Diagnostic Questions
Your doctor may ask these questions to check for this symptom:
- Is your blood pressure 140mmHg or higher?
- How long have you had high blood pressure (above 140mmHg)?
Reviewed By:
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Yoshinori Abe, MD (Internal Medicine)
Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.
Content updated on Feb 6, 2025
Following the Medical Content Editorial Policy
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FAQs
Q.
Amlodipine Side Effects? Why Your Ankles Swell and Medically Approved Next Steps
A.
Amlodipine can cause ankle swelling because it relaxes arteries more than veins, letting fluid shift into the tissues; it is usually not dangerous, but the risk rises with higher doses and any new, one-sided, painful swelling or shortness of breath needs prompt medical attention. Do not stop amlodipine on your own; talk to your doctor about dose changes, switching medications, adding an ACE inhibitor or ARB, and supportive steps like leg elevation or, if appropriate, compression stockings. There are several factors to consider, including other medications and red flags, so see the complete guidance below for medically approved next steps.
References:
* Chelliah, D., & Nissen, S. E. (2010). Amlodipine-induced peripheral edema: mechanisms and management. *Journal of Clinical Hypertension (Greenwich, Conn.)*, *12*(4), 284–290.
* Messerli, F. H., & Grossman, E. (2005). Mechanism of peripheral edema caused by calcium channel blockers. *Current Hypertension Reports*, *7*(5), 374–378.
* Makani, H., Bangalore, S., Romero, J., Messerli, F. H., & Wasan, S. K. (2012). Management of peripheral oedema with dihydropyridine calcium channel blockers: a practical approach. *Journal of Human Hypertension*, *26*(2), 118–125.
* Sica, D. A. (2005). Strategies for the management of peripheral edema with calcium channel blockers. *Journal of Clinical Hypertension (Greenwich, Conn.)*, *7*(12), 706–710.
* Li, H., & Huang, Y. (2021). Amlodipine in treatment of hypertension and ischemic heart disease: a review. *Current Pharmaceutical Design*, *27*(26), 2883–2892.
Q.
Silent Pounding? Why Your Heart Is Racing: Blood Pressure Chart & Medical Steps
A.
A racing or pounding heart is often harmless but can overlap with high blood pressure or other conditions; compare your numbers to the blood pressure chart (normal under 120/80, Stage 1 is 130 to 139 over 80 to 89, Stage 2 is 140 or higher over 90 or higher, and 180/120 or higher with red flag symptoms is an emergency). Check your pulse and blood pressure after resting, address triggers like caffeine, anxiety, dehydration, or poor sleep, and seek care for repeated Stage 1 or 2 readings, a resting heart rate over 100, or any emergency signs such as chest pain or vision changes. There are several factors to consider. See complete details below for the full chart, risks, home monitoring steps, and proven treatments that could change your next steps.
References:
* Grillo A, Grillo M, De Siena A, Cacciapuoti F. Autonomic Nervous System and Hypertension: Pathophysiology and Therapeutic Implications. J Clin Exp Cardiol. 2017 Oct;8(7):1000539. doi: 10.4172/2155-9880.1000539. Epub 2017 Oct 11. PMID: 29019777; PMCID: PMC5639149.
* 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: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018 May 15;71(19):e127-e248. doi: 10.1016/j.jacc.2017.11.006. Epub 2017 Nov 13. PMID: 29133354.
* Singh M, Singh V, Agrawal Y, Jain S. Sinus Tachycardia: Mechanisms and Management. J Clin Med Res. 2020 Jul;12(7):435-442. doi: 10.14740/jocmr4245. Epub 2020 Jul 15. PMID: 32644449; PMCID: PMC7359045.
* Cuspidi C, Tadic M, Kario K. White Coat Hypertension: Diagnosis, Clinical Implications, and Management. Curr Hypertens Rep. 2021 Jul 2;23(7):29. doi: 10.1007/s11906-021-01150-1. PMID: 34187063; PMCID: PMC8251846.
* Goessl NC, Kretzschmar LM, Dudenhöffer A, et al. Lifestyle Approaches to Prevent and Treat Hypertension. Curr Hypertens Rep. 2018 Apr 4;20(4):30. doi: 10.1007/s11906-018-0829-x. PMID: 29559670.
Q.
Normal Blood Pressure for Women 30-45: Signs & Next Steps
A.
Normal blood pressure for women 30 to 45 is under 120/80 mmHg; high blood pressure is usually silent, but urgent symptoms like chest pain, severe headache, shortness of breath, or confusion require immediate care. Check your blood pressure regularly and talk to a clinician if readings are consistently 130/80 or higher, especially with pregnancy, birth control use, stress, weight changes, or a family history of hypertension. There are several factors to consider, and complete guidance on ranges, monitoring frequency, lifestyle steps, and when medication may be needed is detailed below.
References:
* 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: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018 May 15;71(19):e127-e248. doi: 10.1016/j.jacc.2017.11.006. Epub 2017 Nov 13. PMID: 29133354.
* Parikh NI, Cugliari AM, Canto JG, et al. Sex Differences in Awareness, Treatment, and Control of Hypertension in the United States, 1999 to 2018. Hypertension. 2021 Mar;77(3):804-811. doi: 10.1161/HYPERTENSIONAHA.120.16335. Epub 2021 Jan 18. PMID: 33455437.
* Volpe M, Borghi C, Dell'Atti M, et al. Hypertension in women: unique features and clinical implications. Int J Cardiol. 2015 Mar 15;183:155-63. doi: 10.1016/j.ijcard.2015.01.077. Epub 2015 Jan 21. PMID: 25680456.
* American College of Obstetricians and Gynecologists. Preeclampsia and cardiovascular disease in women. Obstet Gynecol. 2013 Aug;122(2 Pt 1):433-40. doi: 10.1097/01.AOG.0000432240.23169.d4. PMID: 23880509.
* Piper MA, Evans CV, Burda BU, et al. Screening for high blood pressure in adults: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2014 Jan 7;160(1):31-43. doi: 10.7326/M13-1768. PMID: 24323133.
Q.
Metoprolol Side Effects in Women 65+: What You Need to Know
A.
Common metoprolol side effects in women 65+ include fatigue or low energy, dizziness when standing, cold hands and feet, and a slow heartbeat; seek medical care right away for fainting, very slow or irregular pulse, swelling or sudden weight gain, chest pain, or worsening shortness of breath. There are several factors to consider. See below to understand more about age-related sensitivity, drug interactions, fall risk, and the need for monitoring, including why doses often start lower, why you should not stop this medicine suddenly, and when to contact your clinician if side effects affect daily life or new symptoms appear.
References:
* Kasiakogias A, Mourtzinis G, Kassiakogias D. Sex differences in beta-blocker efficacy and adverse events. Cardiovasc Drugs Ther. 2017 Aug;31(4):449-459. doi: 10.1007/s10557-017-6743-x. Epub 2017 Jul 10. PMID: 28695325.
* Hussain A, Akbari A, Ahmed S, Ali T, Al-Rasheedi M, Rabbani G, Al-Hajji R, Abdulrahman Z, Sarfraz F, Siddiqi MN, Al-Haji H, Ahmad W, Al-Ansari A. Pharmacokinetic and pharmacodynamic considerations for prescribing beta-blockers in older adults. Eur Rev Med Pharmacol Sci. 2021 Oct;25(19):6062-6072. doi: 10.26355/eurrev_202110_26909. PMID: 34651346.
* AlGhatrif M, Al-Badri A, Tielsch JM, Pak P, Zieman SJ. Comparative effectiveness of beta-blockers in older adults: a systematic review and meta-analysis. J Am Geriatr Soc. 2017 Jan;65(1):161-168. doi: 10.1111/jgs.14441. Epub 2016 Oct 18. PMID: 27754593; PMCID: PMC5367807.
* Regitz-Zagrosek V, Oertelt-Prigione S, Prescott E, Rooney C, Seeland U, Stangl V, Cifkova R, De Buyzere M, Grotevendt A, Huisman M, Jensen T, Kautzky-Willer A, Morais J, Morbach C, Nibbrig A, Radau R, Scuteri A, Van Bussel B, van der Weerd L, Widdershoven J, Santamaria E. Age- and Sex-Related Differences in Response to Cardiovascular Drugs: A Focus on Hypertension. Cardiovasc Drugs Ther. 2015 Oct;29(5):481-9. doi: 10.1007/s10557-015-6617-y. PMID: 26362507; PMCID: PMC4582846.
* Gori G, Volpato S. Polypharmacy and Adverse Drug Events in Older Adults: A Narrative Review. Geriatrics (Basel). 2020 Jul 17;5(3):47. doi: 10.3390/geriatrics5030047. PMID: 32709088; PMCID: PMC7554900.
Q.
Metoprolol Over 65: Safe Blood Pressure Management Tips
A.
Metoprolol can be safe and effective for adults over 65 when started low, increased slowly, and closely monitored, with attention to dizziness on standing, slow pulse, shortness of breath, and fall risk, alongside lifestyle changes and home blood pressure checks. Do not stop it suddenly and review all medications for interactions; seek urgent care for chest pain, fainting, severe shortness of breath, new leg or ankle swelling, or stroke signs. There are several factors to consider; see below for dosing, monitoring, fall-prevention, interaction pitfalls, and when to call your doctor, as these details can shape your next steps.
References:
* Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Jr., Collins, K. J., Himmelfarb, C. J., ... & Wright, J. T. (2018). 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: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. *Journal of the American College of Cardiology*, *71*(19), e127-e248.
* Benetos, A., Waeber, B., de Leeuw, P. W., Doyle, A., & Pitt, B. (2019). The management of hypertension in elderly patients. *European Journal of Clinical Pharmacology*, *75*(5), 603-611.
* Messerli, F. H., & Ventura, H. O. (2015). Beta-Blockers for Hypertension in the Elderly. *Current Cardiology Reports*, *17*(10), 85.
* Aronow, W. S. (2017). Management of Hypertension in Older Persons. *Journal of Geriatric Cardiology*, *14*(10), 633-637.
* Gupta, A. K., & Aronow, W. S. (2020). Hypertension in the Elderly. *Cardiology in Review*, *28*(4), 161–165.
Q.
mpv in blood test: 5 things doctors wish you knew
A.
MPV reflects the average size of your platelets and, interpreted with your platelet count, can point to inflammation and cardiovascular risk, shifts from liver disease, or bone marrow and vitamin issues, though delays and analyzer differences can falsely raise or lower it. There are several factors to consider; see below to understand more, including when an unexpected MPV should be repeated promptly, how to pair it with other labs, and which symptoms or rising trends mean you should contact your clinician to guide your next steps.
References:
Tripodi A, & Mannucci PM. (2011). The coagulopathy of chronic liver disease: rebalancing hemostasis in cirrhosis. New England Journal of Medicine, 21468075.
de Franchis R, & Dell'Era A. (2007). Non-invasive diagnosis of cirrhosis and the natural history of portal hypertension… Best practice & research. Clinical gastroenterology, 17223493.
European Association for the Study of the Liver. (2014). EASL clinical practice guidelines for the management of patients with decompensated cirrhosis. Journal of Hepatology, 24986678.
Q.
Can cold medicine raise my blood pressure?
A.
Yes, some cold medicines can raise blood pressure, especially those containing pseudoephedrine or phenylephrine. See below to understand more.
References:
White WB, & Riotte K. (1985). Drugs for cough and cold symptoms in hypertensive patients. American family physician, 3976459.
https://pubmed.ncbi.nlm.nih.gov/3976459/
Morales-Carpi C, Torres-Chazarra C, Lurbe E, Torró I, & Morales-Olivas FJ. (2008). Cold medication containing oral phenylephrine as a cause .... European journal of pediatrics, 17899189.
https://pubmed.ncbi.nlm.nih.gov/17899189/
Coates ML, Rembold CM, & Farr BM. (1995). Does pseudoephedrine increase blood pressure in .... The Journal of family practice, 7807033.
Q.
Can cough medicine interact with blood pressure pills?
A.
Yes, some cough medicines can interact with blood pressure pills, potentially affecting blood pressure control. See below to understand more.
References:
Gabardi S, Carter D, Martin S, & Roberts K. (2011). Recommendations for the proper use of nonprescription .... Progress in transplantation (Aliso Viejo, Calif.), 21485938.
https://pubmed.ncbi.nlm.nih.gov/21485938/
Carpenter M, Berry H, & Pelletier AL. (2019). Clinically Relevant Drug-Drug Interactions in Primary Care. American family physician, 31038898.
https://pubmed.ncbi.nlm.nih.gov/31038898/
Honig PK, & Gillespie BK. (1995). Drug interactions between prescribed and over-the-counter .... Drug safety, 8785017.
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https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Desai AN. High Blood Pressure. JAMA. 2020 Sep 22;324(12):1254-1255. doi: 10.1001/jama.2020.11289. PMID: 32960243.
https://jamanetwork.com/journals/jama/fullarticle/2770851Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ; Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003 Dec;42(6):1206-52. doi: 10.1161/01.HYP.0000107251.49515.c2. Epub 2003 Dec 1. PMID: 14656957.
https://www.ahajournals.org/doi/10.1161/01.HYP.0000107251.49515.c2?cookieSet=1Xiong P, Liu Z, Xiong M, Xie F. Prevalence of high blood pressure under 2017 ACC/AHA guidelines: a systematic review and meta-analysis. J Hum Hypertens. 2021 Mar;35(3):193-206. doi: 10.1038/s41371-020-00454-8. Epub 2020 Dec 8. PMID: 33293630.
https://www.nature.com/articles/s41371-020-00454-8High blood pressure (hypertension)
https://www.nhs.uk/conditions/high-blood-pressure-hypertension/