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High Blood Pressure – the “Silent Killer”

Graphic image of a young man having his blood pressure taken by a female provider.

Of all the factors contributing to heart disease or stroke, high blood pressure is number one.

Mark Creager, MD, FAHA, FACC

Uncontrolled high blood pressure is often called the “silent killer.” Of all the factors contributing to heart disease or stroke, high blood pressure is number one.

More than 30 percent of adults live with high blood pressure, and many don’t know—those that do, may not be bringing their levels under control.

Blood pressure basics

Blood pressure readings combine two measurements: the maximum, or systolic, pressure your heart creates while beating, and the pressure in your blood vessels between beats, called diastolic pressure. A blood pressure reading is the systolic number “over” the diastolic, such as “120 over 70,” and is commonly written as “120/70.”

The American Heart Association recently updated their guidelines on blood pressure readings:

  • Normal: less than 120/less than 80
  • Elevated: 120-129/less than 80
  • Stage 1: high (hypertension): 130-139/80-89
  • Stage 2: 140 or higher/90 or higher

Anyone with Stage 1 or Stage 2 readings should speak to their doctor.

Causes of high blood pressure

There is no single cause of high blood pressure. Genetics, ethnicity and conditions, such as kidney or thyroid disease, can all be factors. And, the risk increases with age.

For many, lifestyle choices lead to high blood pressure. High amounts of sodium (e.g. salt) in your diet is a leading cause. The recommended intake is less than 2.3 grams of sodium per day, and ideally less than 1.5 grams for most adults.

High-sodium foods include canned soup, salad dressings, cured hams and other dried meats, cold cuts like pastrami, bread, pizza and vegetable juice, to name a few. Reading food labels helps you to monitor your daily sodium intake.

How to treat and manage your high blood pressure

Work with your doctor. Together, you can determine lifestyle changes, possible medications and create a plan to check and report your blood pressure from home.

Eat a heart-healthy diet that is low in sodium and fat, and includes whole grains, fruits and vegetables. Limit the amount of alcohol you drink to no more than one to two drinks a day.

Exercise and, if necessary, follow a weight-loss program. Ask your physician if fitness or nutritional counselors are available to help you.

Discuss your progress, challenges and any medication side effects with your physician—not just until your first good reading, but also for the weeks and possibly, months it may regularly take to control your blood pressure.

Mark Creager, MD,FAFA, FACC, is the director of the Dartmouth-Hitchcock Heart & Vascular Center, and the Anna G. Huber Professor of Medicine, and the Geisel School of Medicine at Dartmouth.