How Are Hypertension, Heart Disease, and Strokes Related?
Medically reviewed and edited by Summary
- Hypertension usually causes no symptoms. Often, the only way to know if you have high blood pressure is to get a blood pressure reading. Without treatment, hypertension can lead to heart disease or stroke.
- High blood pressure damages the artery walls, making the arteries vulnerable to plaque buildup. This can result in a blockage or reduced blood flow.
- If the blockage occurs near the brain, it can result in a stroke. If it occurs near the heart, it can lead to a heart attack.
- You can lower high blood pressure by limiting your salt and alcohol intake, eating healthy foods, and exercising regularly. Your doctor may prescribe medications to help lower your blood pressure.
Left untreated, hypertension increases the risk of developing heart disease or stroke. The reason for this is that high blood pressure can lead to plaque buildup, which results in narrow arteries.
Narrow arteries can cause a blockage or reduced blood flow to the heart and the brain, resulting in a heart attack or a stroke, respectively.
Heart Attacks
In the United States, someone has a heart attack every 40 seconds. Every year, approximately 800,000 people in the U.S. have a heart attack and, of these, one in five is silent — in other words, the person is not aware of it.
Heart disease, which is also referred to as cardiovascular disease, includes a variety of health issues such as high blood pressure, heart attacks, hardening of the arteries, and strokes.
In the U.S., heart disease is one of the leading causes of death for people of almost all ethnic/racial groups.
According to the Centers for Disease Control and Prevention (CDC), approximately 697,000 people in the U.S. died from heart disease in 2020 — that’s one in every five deaths.
The most common type of heart disease is coronary artery disease (CAD) in which the coronary arteries (that carry blood and oxygen to the heart) narrow or become blocked. This is due to atherosclerosis — a buildup of fatty material and plaque in the coronary arteries.
The CDC reports that about 20 million adults over the age of 20 have CAD (about 7.2%) and in 2020, about two in 10 deaths from CAD occurred in adults less than 65 years old.
Strokes
Strokes are caused by blood clots and damaged or broken blood vessels in the brain. Strokes occur when there is loss of blood flow to a part of the brain, which damages brain tissue.
According to the CDC, in 2020, 1 in 6 deaths from cardiovascular disease was due to a stroke.
About 90% of all strokes are ischemic, in which blood flow to the brain is blocked.
A stroke is a leading cause of long-term disability, reducing mobility in more than 50% of survivors aged 65 and older.
The risk of having a stroke is nearly twice as high for people of African American descent compared to white Americans.
While the death rates have declined for all races/ethnicities, there has been an increase in death rates for Hispanic people since 2013.
Hypertension
Hypertension, also called high blood pressure, is the term used for someone whose blood pressure is higher than normal.
Blood pressure is measured in millimeters of mercury (mm Hg) and is represented as two figures:
Systolic blood pressure: the pressure when your heart pushes blood out.
Diastolic blood pressure: the pressure when your heart is at rest between beats.
The normal range for blood pressure is 120/80 mm Hg (or lower).
Hypertension puts you at a higher risk for heart disease and stroke, two of the leading causes of death in the U.S.
Key Point: The Prevalence of Hypertension
- Nearly half of adults in the U.S. (47%, or 116 million) have hypertension, with only one in four adults having this condition under control.
- An estimated 46% of adults with hypertension are unaware that they have the condition.
- Like heart attacks and strokes, hypertension is a leading cause of death worldwide.
Blood Pressure
Blood pressure is determined by the quantity of blood the heart pumps and how difficult it is for the blood to move through the arteries. The more blood the heart pumps and the narrower the arteries, the higher the blood pressure.
High blood pressure negatively impacts the arteries, because the force of blood on the artery walls is too high. As a result, the heart has to work much harder to pump blood around the body.
Key Point: What is the Measurement for High Blood Pressure?
- You are diagnosed with hypertension when you have a consistent blood pressure reading of 130/80 mm Hg or higher.
- If your blood pressure reading is more than 180/120 mm Hg, it is considered to be a medical emergency.
High Blood Pressure Symptoms
Most people with high blood pressure do not have obvious symptoms and many go for years with this condition without realizing it.
Some people with high blood pressure may experience:
Shortness of breath
Nosebleeds
Blood spots in the eyes
Flushing
Dizziness
A blood pressure reading is the best way to find out whether you have hypertension.
Heart Disease
High blood pressure causes your blood vessels to thicken and become stiff because of the stress of the blood forcefully pushing through them. This, in turn, puts stress on the heart and can lead to heart disease.
Putting too much stress on your heart can lead to different types of heart disease:
Coronary artery disease. The narrowed blood vessels accompanying high blood pressure result in plaque buildup on your artery walls.
This accumulation of plaque can cause coronary artery disease, which can result in a heart attack or heart failure.
Heart attack. When there is too much plaque in the arteries, a blood clot is likely to form. Blood clots block the flow of blood to the heart, preventing it from getting oxygen and nutrients. This causes damage to the heart muscle and results in a heart attack.
About 70% of Americans who have their first heart attack usually have high blood pressure.
Over time, the pressure exerted by high blood pressure enlarges the heart, making it less efficient. This can lead to heart failure, or the inability of the heart to provide enough blood to the body.
Types of Stroke
There are two main types of stroke: ischemic and hemorrhagic. Ischemic strokes are more common than hemorrhagic strokes, but hypertension is strongly related to each type.
Ischemic stroke. When blood clots form in arteries carrying blood to the brain, the result is an ischemic stroke. Without enough blood supply to brain cells, or neurons, they will stop working and heavily impair your body's most vital functions. Hypertension is the direct cause of approximately 50% of ischemic strokes.
Hemorrhagic stroke. High blood pressure can lead to blood vessels bursting. If a blood vessel bursts in the brain, it is called a hemorrhagic stroke.
The bleeding causes pressure — for example, if blood leaks into the cranium, the resulting pressure can severely damage brain tissue.
Research has found that hypertension increased the odds of hemorrhagic stroke by about 10 times.
A stroke can occur as a result of failing to treat hypertension, so it’s important to get your blood pressure checked regularly.
Treatment of Hypertension
You can decrease your chances of developing high blood pressure (thereby decreasing your risk for a heart attack or stroke), by following healthy lifestyle habits such as exercising regularly to strengthen your heart and take the strain off your arteries. Also key is eating foods that are low in sodium, saturated fat, and added sugars.
You may also need to take medication for hypertension to lower your blood pressure.
Other steps you can take to lower your blood pressure include:
Managing your weight, because being overweight increases your risk of high blood pressure
Reducing the amount of alcohol you drink
Quitting smoking. Smoking hardens arteries and increases blood pressure
Taking all prescription medications regularly
Getting enough sleep
Blood Pressure Tests
Blood pressure monitoring is an important component of monitoring your health. The frequency of blood pressure tests depends on your age and overall health.
From the age of 18 years old, it is recommended that you get a blood pressure reading every two years. If you're 40 years or older, or you're 18 to 39 with a high risk of high blood pressure, ask for a blood pressure check every year.
Your doctor or healthcare provider is likely to recommend more frequent readings if you have high blood pressure or other risk factors for heart disease.
Where Can I Learn More About Hypertension, Stroke, and Heart Disease?
If you’re concerned about some of the conditions covered here, you can talk to a board-certified doctor or nurse practitioner from your home using your smartphone, computer, or tablet. Head over to LifeMD to make a video appointment.
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