High blood pressure, or hypertension, is often called the "silent killer" because it typically causes no symptoms while quietly damaging the heart, blood vessels, kidneys, and brain over time. It affects approximately 47% of US adults — nearly 116 million people — and is a major modifiable risk factor for heart attack, stroke, heart failure, kidney disease, and vision loss. Blood pressure is recorded as two numbers: systolic pressure (the pressure when the heart beats) over diastolic pressure (the pressure between beats). Normal blood pressure is less than 120/80 mmHg. Hypertension is defined as a sustained reading of 130/80 mmHg or higher. Stage 1 hypertension ranges from 130–139/80–89 mmHg, while Stage 2 is 140/90 mmHg or higher. Hypertensive crisis — readings above 180/120 mmHg — requires immediate medical attention. The vast majority of cases (approximately 90–95%) are classified as primary (essential) hypertension, with no identifiable single cause. Risk factors include age, family history, being overweight or obese, physical inactivity, a high-sodium diet, low potassium intake, excessive alcohol consumption, tobacco use, stress, and certain chronic conditions. Secondary hypertension — caused by an identifiable condition such as kidney disease, primary aldosteronism, or obstructive sleep apnea — accounts for 5–10% of cases and may be correctable. Because hypertension is largely asymptomatic, regular blood pressure monitoring is essential for detection. When symptoms do occur in severe or rapidly worsening hypertension, they may include headaches, nosebleeds, shortness of breath, dizziness, and blurred vision. Persistent elevated blood pressure causes arteriosclerosis (stiffening of arteries), left ventricular hypertrophy, and damage to target organs. Treatment begins with lifestyle modifications: the DASH diet (Dietary Approaches to Stop Hypertension), weight reduction, regular aerobic exercise, limiting sodium and alcohol intake, smoking cessation, and stress management. When lifestyle changes are insufficient, antihypertensive medications — including thiazide diuretics, ACE inhibitors, ARBs, calcium channel blockers, and beta-blockers — are prescribed. Our cardiology and primary care teams at Silvaris work with patients to achieve and maintain optimal blood pressure control through personalized management plans.
