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4 Things to Know About High Blood Pressure
June 02, 2025
They don’t call hypertension “the silent killer” for nothing. It often has no symptoms — until it triggers a serious health crisis.
That’s why it’s important to stay ahead of it. We asked an expert how.
1. But first, the basics.
Blood pressure measures, literally, the pressure of blood pushing against your artery walls.
“We check this by measuring two phases of your heart activity: when it’s beating and when it’s at rest,” says Anthony Sampino, DO, a family medicine expert at Hartford HealthCare Medical Group.
For convenience, these two results are almost always shown stacked — so we’re used to hearing about them as a top number “over” a bottom number.
What the numbers mean:
- Top number: Pressure while heart is beating. Known as systolic (Think “s” for squeeze.)
- Bottom number: Pressure while heart is at rest. Known as diastolic (Think “d” for down-time.)
> Related: These 6 Foods Can Lower Your Blood Pressure Naturally
2. Here’s when your blood pressure is too high.
“Normal” blood pressure is roughly 120/80 mmHg. When your top number creeps over 130 or your bottom number creeps over 80, you’re in hypertension range. The more these numbers climb, and the longer they stay there, the more concerned you should be.
“When your blood pressure is consistently too high, it’s hard on your body,” says Dr. Sampino. “Eventually, it can cause heart disease, stroke and kidney damage.”
Scary stuff. So long before this point, you’d assume your body would send up clear warning signals, right?
Wrong.
> Related: What Your Blood Pressure Says About Your Health
3. Even at dangerously high levels, most people don’t have symptoms.
While some people swear they notice physical signs of high blood pressure — like a tell-tale headache, for example — studies show these are unreliable guesses, at best.
“The truth is, most people don’t know they have high blood pressure until someone checks it,” says Dr. Sampino.
There is one exception: when blood pressure reaches life-threatening heights. At those levels, you’ll notice. Unfortunately, by then, it’s a crisis.
“In a hypertensive emergency — a top number of 180 or higher, and a bottom number of 120 or higher — you start to get organ damage,” says Dr. Sampino. “That can cause stroke-like symptoms, abdominal pain, the worst headache of your life, chest pain or trouble breathing. It depends which organ is being damaged.”
Do not wait until this point.
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4. Instead of waiting for signs of high blood pressure, commit to regular wellness checks.
If you don’t have high blood pressure, the standard guideline is to have your blood pressure checked once a year. This means that as long as you’re keeping up with annual physicals — and you are, aren’t you? — you’re all set.
However, if you have an established history of high blood pressure, your doctor may recommend more frequent screenings. They may also suggest you get a blood pressure machine for home. If that’s the case, choose a model that goes over the upper arm (they tend to be more accurate, according to Dr. Sampino). And bring it to your next doctor’s appointment.
“Just like any piece of equipment, you might get a lemon,” says Dr. Sampino. “Your doctor can check if it’s reading your blood pressure correctly.”
The main thing to keep in mind? Don’t assume your blood pressure is fine just because you feel healthy. Be proactive, and enlist your doctor’s help fixing any problems before they start.