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JAMA Patient Page
june 25, 2008


JAMA. 2008;299(24):2914. doi:10.1001/jama.299.24.2914

Your heart pumping blood through your arteries puts pressure (tension) on the artery walls. Hypertension (high blood pressure) occurs when blood pressure stays elevated over time. The increased pressure puts a strain on your circulatory system, which can ultimately lead to serious problems, such as stroke, heart disease, kidney failure, and blindness. The June 25, 2008, issue of JAMA includes an article about controlling hypertension. This Patient Page is based on one published in the February 27, 2002, issue of JAMA.


Because hypertension usually does not cause symptoms until there is serious physical damage, it is often called the "silent killer." It is important to detect high blood pressure before it causes damage.

Blood pressure is measured by a quick and painless test using an inflatable cuff around the upper arm attached to a pressure gauge (sphygmomanometer). A stethoscope is used to listen to the sounds of blood pulsing through an artery. Blood pressure is recorded as 2 numbers measured in millimeters of mercury; for example, 120/80 mm Hg.

  • The first (or top) number is systolic pressure, the maximum pressure in the artery as the heart contracts.

  • The second (or bottom) number is diastolic pressure, the lowest pressure in the artery when the heart is between contractions.

Hypertension exists if the systolic pressure (first number) is 140 or higher, or if the diastolic pressure (second number) is 90 or higher. Normal blood pressure is less than 120 systolic and less than 80 diastolic. Blood pressures between 120/80 and 140/90 are called prehypertension.


See your doctor regularly and have your blood pressure checked. Hypertension cannot always be prevented, but following the steps below can help lower your blood pressure.

  • Stop smoking and do not use illegal drugs.

  • Lose excess body weight and follow a healthy, low-salt, low-fat diet.

  • Stay physically active and develop an exercise program under your doctor's supervision.

  • Limit alcohol intake to 1 drink per day for women and 2 drinks per day for men.

  • Once hypertension develops, it usually requires treatment with medication that must be taken every day to prevent damage from high blood pressure. Your doctor can prescribe the right medication for you.



To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at Many are available in English, Spanish, and French. A Patient Page on risk factors for heart disease was published in the August 20, 2003, issue.

Sources: American Academy of Family Physicians; American Medical Association Family Guide; Centers for Disease Control and Prevention; National Heart, Lung, and Blood Institute; US Food and Drug Administration

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.