You're under 35 and feel fine, yet the doctor says your blood pressure is high and
you'd better come back to have it checked again. Being a red-blooded male, you
figure five years will be soon enough. After all, isn't high blood pressure an old man's
"Young men are less likely than older men to believe they have hypertension and less likely to
go back to the doctor," says Daniel Lackland, DrPH, spokesman for the American
Society of Hypertension. "Often these are patients whose blood pressure would
respond to weight management and other
lifestyle changes, but they're less likely to seek treatment."
Untreated hypertension damages the heart and other organs and can lead to
life-threatening conditions that include heart disease, stroke, and kidney
disease. It's called "the silent killer" because symptoms generally appear only
after the disease has caused damage to vital organs.
"With treatment, we can truly prolong life," Lackland tells WebMD.
If your blood pressure is 120/80, 120 represents systolic pressure,
or the pressure of blood against artery walls when the heart beats. Eighty
represents diastolic pressure, or the pressure between beats.
The Seventh Report of the Joint National Committee on Prevention, Detection,
Evaluation, and Treatment of High Blood Pressure (JNC 7) guidelines categorize
hypertension as follows:
Normal. Less than 120/80
Hypertension. 140/90 (130/80 for patients with diabetes or
chronic kidney disease)
Stage 2 hypertension. 160/100
Hypertension, or high blood pressure (HBP), exists when either the systolic
measurement is 140 or higher or the diastolic measurement is 90 or higher.
However, in the majority of people, controlling systolic hypertension is a more
important heart disease risk factor than diastolic blood pressure (except in
young people under the age of 50).
There are two types of hypertension: essential, which accounts for 90% to
95% of cases, and secondary. The cause of essential hypertension is unknown,
although lifestyle factors such as obesity, sedentary lifestyle, and excessive
alcohol or salt intake contribute to the condition. In secondary hypertension,
the cause may be kidney disease; hormonal imbalance; or drugs, including
cocaine or alcohol.
According to the JNC 7, half the adult population is prehypertensive or
hypertensive, and because blood pressure increases with age, most people will
become hypertensive if they live long enough.
Younger vs. Older Men With High Blood Pressure
Younger men with high blood pressure typically have high diastolic pressure
while older men have high systolic pressure. "In young men, the diastolic
pressure rises because the heart is pumping harder," says Lackland. "In older
men, the systolic pressure rises and stiffens arteries.
"Part of the problem with young men is increased body mass. Ten years ago we
wouldn't have seen hypertension in the teens and 20s, but now it's increasing
along with rising obesity rates. We're seeing the increase in particular in
African-American men, but it affects men of all races."