Blood pressure is the force of blood against the inner walls of your arteries. This can change throughout the day and throughout your life. When your blood pressure is well above the normal healthy range, it’s called high blood pressure or hypertension.

Sometimes you can have temporary spikes in blood pressure, caused by stress or other factors — including pregnancy. But when high blood pressure becomes an ongoing condition, it’s considered chronic.

There is no cure for chronic hypertension, but there are medications and lifestyle adjustments that can help keep your blood pressure under control.

No matter how hypertension begins, it’s important to work closely with a doctor and adopt a heart-healthy lifestyle to prevent chronic hypertension from causing severe and potentially life-threatening complications.

Blood pressure is expressed by two numbers: the systolic pressure or top number on your blood pressure reading, and the diastolic pressure or bottom number. The pressures are measured in millimeters (mm) of mercury (Hg).

Systolic pressure refers to the pressure of blood in your arteries when your heart contracts and pumps blood out to the body. Diastolic pressure is the force of blood against the artery walls when your heart is at rest.

High blood pressure is considered a systolic pressure of 130 mm Hg or higher or diastolic pressure of 80 mm Hg or higher. The Centers for Disease Control and Prevention (CDC) estimates that nearly half of all adults in the United States have high blood pressure.

Chronic hypertension is also called essential hypertension or primary hypertension. It accounts for about 90% of high blood pressure cases, according to the World Heart Federation. There’s usually no known cause of primary or chronic hypertension, though there’s a long list of risk factors, including:

  • advancing age
  • diabetes
  • excessive alcohol consumption
  • family history
  • high sodium consumption
  • obesity
  • sedentary lifestyle
  • tobacco use

Secondary hypertension, which accounts for far fewer cases than chronic hypertension, is high blood pressure caused by another medical condition, such as kidney disease or thyroid problems. It’s not considered chronic hypertension because treating the underlying condition can often result in a return to normal blood pressure.

It’s quite common for a pregnant individual to develop high blood pressure. The CDC reports that hypertension occurs in about 1 of every 12 to 17 pregnancies. But in pregnancy, chronic hypertension takes on a slightly different meaning and concern.

Chronic hypertension differs from other high blood pressure problems associated with pregnancy, including preeclampsia and gestational hypertension. Chronic hypertension means you had high blood pressure before you became pregnant (or before the pregnancy reached 20 weeks) and you continue to have high blood pressure throughout the pregnancy and afterward.

Preeclampsia is high blood pressure that first develops during pregnancy and means that there’s protein in your urine or there are other related health problems after 20 weeks. Gestational hypertension is also high blood pressure that first develops during pregnancy, but isn’t accompanied by protein in the urine or other heart or kidney issues.

Because chronic hypertension in pregnancy is such a common occurrence, it has been an active area of research for a long time.

For example, a 2017 study suggests that a person who had gestational hypertension or preeclampsia may be more inclined to develop chronic hypertension, though that risk can be substantially lowered by keeping a moderate weight and following heart-healthy lifestyle behaviors.

A 2022 study suggests that treating chronic hypertension in pregnant individuals to a blood pressure of under 140/90 mm Hg leads to better pregnancy outcomes, even among those who have mild chronic hypertension.

Discuss the lifestyle options for lowering your blood pressure when you’re diagnosed with primary or chronic hypertension.

Lowering your blood pressure may be done with a combination of medications and lifestyle changes designed to support healthy heart function. Among the behaviors that should help are:

Diet

Being overweight or obese is associated with high blood pressure while losing weight, and keeping a moderate weight is a key to controlling your blood pressure.

In addition, a diet high in sodium and unhealthy fats is associated with high blood pressure.

To that end, health experts recommend the Dietary Approaches to Stop Hypertension (DASH) diet or the Mediterranean-style eating plan to support better cardiovascular health. These diets emphasize fruits, vegetables, whole grains, and lean proteins, while the DASH diet in particular focuses on reducing sodium intake.

A 2020 study suggests that adhering to the DASH diet is an especially effective means of bringing your blood pressure under control.

Exercise

The American Heart Association recommends 150 minutes a week of moderate-intensity exercise for better heart health. Ideally, you want to exercise at least 30 to 40 minutes most days of the week.

A brisk walk or similar activity not only helps support weight management, but it gives your cardiovascular system a good workout, which supports vascular health and blood pressure control.

Other steps

Other lifestyle adjustments can make a big difference in lowering blood pressure. Consider the following changes for lower blood pressure and better overall health:

  • Get at least 7 to 8 hours of sleep per night and address any sleep disorders, such as obstructive sleep apnea.
  • Keep alcohol intake to a minimum.
  • Manage stress through relaxation efforts, such as meditation and deep breathing techniques.
  • Quit smoking.

In addition to living a heart-healthy lifestyle, the primary way to control chronic hypertension is with medications that lower blood pressure. Some of the more common antihypertensives include:

  • Diuretics: These medications reduce fluid levels in the body to relieve the burden in the arteries, but can also lower potassium levels, resulting in muscle-related side effects. People with diabetes may experience spikes in blood glucose levels after taking diuretics.
  • Angiotensin-converting enzymes (ACE) inhibitors: These ACE inhibitors help keep the arteries relaxed and open to improve blood flow and reduce blood pressure. They’re generally safe for most people, though anyone who’s pregnant or is considering becoming pregnant should talk with a doctor about an alternative medication.
  • Angiotensin II receptor blockers: Commonly known as ARBs, these help keep blood vessels relaxed and open, though they do so through a different mechanism. ARBs should also not be used during pregnancy.
  • Calcium channel blockers: These meds ease the force by which the heart contracts, thus reducing the pressure of blood flowing though the arteries.

A 2019 study of hypertension management also suggests that blood pressure-lowering medications — also known as anti-hypertensives — are safe and effective treatments for most people and that they can be especially helpful in lowering the risk of cardiovascular complications, such as heart attack and stroke.

Chronic hypertension is a common, but treatable, condition that can affect adults of all ages and sometimes children. Controlling high blood pressure takes discipline and the ability to adopt heart-healthy lifestyles, including a healthy diet and regular exercise. It usually requires daily medications, too.

If you follow your medication regimen and a routine of healthy eating and daily exercise, you may avoid some of the more severe complications of high blood pressure.