Why hypertension (high blood pressure) is also called The Silent Killer

Courtesy of Healthwise, In

High blood pressure, also known as hypertension, occurs at a higher rate in many people of color and of lower socioeconomic status. Serious health problems can result from uncontrolled hypertension.

Potential damage

Your arteries carry blood from your heart to other parts of your body to deliver oxygen. The pressure inside the arteries is the force of blood pushing against the walls of arteries. This pressure normally rises and falls throughout the day, but if it stays high for a long time, it can damage the walls of the arteries and harden them.

This hardening of the arteries can decrease the blood flow to your heart, which limits oxygen to the heart. Chest pain, heart attack, or heart failure may occur. 

Brain injury is also possible due to blocked or ruptured brain arteries due to hypertension, and this may lead to a stroke. Lastly, the kidneys filter blood, but the artery hardening can lead to long-lasting kidney failure.

One in three adults have hypertension, and only about half of these people have their blood pressure under control. This is important, as continued elevated blood pressure can cause heart disease with possible heart attack, stroke and kidney failure.

Incidentally, heart disease and stroke are two of the leading causes of death in in the United States. Elevated pressure may be without signs or symptoms, which is extremely dangerous and why it is also labeled “the silent killer.”


The best way to diagnose hypertension is having your doctor or provider measure your blood pressure. The numbers found are usually measured in millimeters of mercury (mmHg). Normal pressure for emptying the heart (systolic pressure) is 120 or less, and filling the heart pressure (diastolic pressure) is less than 80. 

Blood pressure is usually written as a fraction with the systolic pressure listed over the diastolic pressure. For instance, 120/80 mmHg is a classic blood pressure listed or stated in movies.

Prehypertension (blood pressure slightly higher than normal): systolic 120-129, diastolic 80-89

Stage 1 hypertension: systolic 140-159, diastolic 90-99

Stage 2 hypertension: systolic greater than 160, diastolic greater than 100

Conditions and behaviors associated with hypertension

  • A diet high in fats and salt
  • Preexisting conditions like kidney disease, diabetes (more than half of people with diabetes also have high blood pressure), prehypertension
  • Lack of exercise
  • Being overweight or obese
  • Stress
  • Tobacco
  • Race (particularly non-Hispanic African Americans)
  • Older age (the elderly in particular) 
  • Some medications such as birth control 
  • History of hypertension in parents or other close family


Treatment strategies include changing one’s lifestyle. This includes a diet with less salt and more regular exercise, as well as quitting smoking.

One should also cut out caffeine, a stimulant that can increase your blood pressure. Caffeine is in coffee, tea, and some energy drinks.

Stress can increase blood pressure, so to reduce stress one can try exercise, meditation, and sometimes prescribed medication. If medications are started, they must be continued and not stopped abruptly; otherwise, even higher blood pressure can be triggered.

Treatment barriers

Many people have barriers to treating hypertension, such as:

  • No access to foods with low sodium or saturated fats
  • Failure to exercise for at least three hours per week
  • Failure to take prescribed medications 

Have your health provider check your blood pressure regularly and, if it is beyond normal ranges, be sure to follow treatment recommendations to protect yourself from adverse health consequences.

Sean J. Ennevor, M.D. graduated with a B.A.S. in biology and economics from Stanford University, and as a Dean’s Scholar from UCLA School of Medicine where he received his MD. He completed his medical residency and fellowship in anesthesiology at Yale University, where he was chief resident and on staff. He practiced medicine in the Twin Cities for over 14 years, and presently serves as an advisor and investor for medical technology companies throughout the country.