Why is hypertension (aka high blood pressure) dangerous?

Heart Health

by Michael Sills, MD

Jun 4, 2022

You’ve heard of hypertension and you get your blood pressure checked regularly at your doctor’s visits, but what is high blood pressure, and why is it worrisome? Here’s what you need to know, especially if you have a history of high blood pressure.

“Your heart is a muscle—but it’s not like the other muscles in your body,” said Michael Sills, MD, a cardiologist on the medical staff at Baylor Scott & White Heart and Vascular Hospital – Dallas. “You can make your heart stronger, but not in the same way you would lift weights at the gym to improve your biceps. That’s resistance exercise, and you don’t want your heart to have to work against higher resistance. But that’s what high blood pressure does—it makes your heart work harder and you wear it out early.”

What is hypertension?

From the standpoint of your heart, when your blood pressure is normal, your heart is functioning in its preferred environment. But when your blood pressure increases, your heart has to generate more force and work much harder. High blood pressure, or hypertension, is a blood pressure greater than 130/80 mmHg.

“Consider your arteries to be like a garden hose,” Dr. Sills said. “If you put your thumb over the end of the hose, the velocity of the water coming out increases. It’s the same for the blood in your arteries—blood pressure is the force at which you’re pushing the blood through.”

The dangers of hypertension aren’t just due to the impact on organs and the stretching of your arteries, potentially damaging them, he said.

“High blood pressure also causes chemical changes that we’re not always sure about,” Dr. Sills said. “It’s one thing to have an aneurism rupture from high blood pressure, but it also tends to be associated with coronary artery disease and plaque in all the arteries. There’s a whole lot of biochemical changes that occur when your blood pressure is too high.”

Why you need regular blood pressure screenings

Another problem is that there are generally no warning signs for high blood pressure, while there are noticeable side effects from taking the medicines prescribed for it.

“You can have high blood pressure and not feel bad, which is why it was called ‘the silent killer’ back in the ‘70s,” said Dr. Sills. “In fact, your body can actually get used to having high blood pressure so that it feels ‘normal’ to you. That makes hypertension even more dangerous. When you have high blood pressure you need these medications—sometimes several medications, because there are many different factors that affect high blood pressure. As your doctors, it’s our job to adjust those medications and find the right balance for you.”

Because there often are no symptoms, that means people can have undetected high blood pressure, even in their 20s and 30s. In fact, for many people, their high blood pressure goes undetected for years and it’s not until they go to the doctor for something else in their 40s or 50s that their high blood pressure is detected.

The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends screening adults for high blood pressure every two years if their blood pressure is normally less than 120/80; however, the Committee recommends that adults with high blood pressure should have their blood pressure checked every year or more often.

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About the Author

Michael Sills, MD, is a cardiologist on the medical staff at Baylor Scott & White Heart and Vascular Hospital – Dallas. His clinical interests include diagnostic and preventive cardiology as well as cardiac imaging. He is an avid runner, chef and proud grandfather.

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