Hypertension: The Silent Killer

Millions of people have it and many don’t even know it. It’s hypertension, or high blood pressure, also aptly named the “silent killer”. And it’s the most common risk factor for heart disease and stroke, two of the leading causes of death in the U.S.1


Blood pressure is the force of blood against the arterial walls as it circulates throughout the body. While it’s normal for blood pressure to rise and fall throughout the course of a day, it can cause health problems if it remains high for an extended time.

Start with the Heart

As the heart pumps against this increased pressure, it must work harder. Over time, this causes the heart muscle to thicken. This can exacerbate atherosclerosis — the increased cholesterol deposits along the inside of the blood vessels. High blood pressure can also cause the left ventricle of the heart to become enlarged, cutting down on the amount of blood pumped per minute. Left unchecked, hypertension can lead to ischemic heart disease due to the greater supply of oxygen needed by the enlarged heart muscle.

High blood pressure often has no warning signs or symptoms, so regularly monitoring blood pressure is advisable.

Causes of Hypertension

High blood pressure can be a result of many factors. Some research has shown that it can be genetically linked but is more often a combination of genetic predisposition and environmental factors. Some environmental factors include excess body weight, poor diet, lack of physical activity, mental stress, smoking cigarettes, high salt intake and consumption of alcohol and/or high levels of caffeine.


About 28% of American adults have a condition known as prehypertension.2 People with this condition are at greater risk to develop high blood pressure than are people with normal blood pressure levels. This is yet another reason why it is important to check blood pressure regularly.

Rating Blood Pressure

Blood pressure readings are commonly expressed as a ratio of two types of blood pressure, systolic and diastolic. Systolic blood pressure is a measure of blood pressure while the heart is beating. Diastolic pressure is a measure of blood pressure while the heart is relaxed, between beats.

Blood pressure readings are grouped into four general categories, from normal to Stage 2 hypertension. The table below summarizes these categories for adults.

Systolic Diastolic Category
Below 120 and Below 80 Normal
120-139 or 80-89 Prehypertension
140-159 or 90-99 Stage 1 hypertension
160 or more or 100 or more Stage 2 hypertension

Preventing & Treating Hypertension

Common treatments for hypertension include some combination of changes in diet, activity level, and in some cases, prescription medications depending on an individual’s blood pressure category.

Prehypertensive blood pressure levels are slightly higher than normal, and indicate that an individual is at greater risk to develop chronic high blood pressure. People with this condition are often advised by physicians to increase activity levels and to make modifications in their diets.

Stage 1 Hypertension refers to blood pressure with average readings above 140/90 but below the range for Stage 2. Doctors treating someone with Stage 1 hypertension may first instruct the patient to make dietary and activity modifications before prescribing any blood pressure treatment medication.

Treatment guidelines for Stage 2 hypertension typically involve the use of anti-hypertension medicines right away, as well as more frequent blood pressure checks and monitoring.

According to the Centers for Disease Control and Prevention (CDC), some lifestyle changes to reduce the risk of hypertension include:

  • Checking blood pressure regularly
  • Maintaining a normal body weight (body mass index (BMI) of 18.5-24.9; BMI is kilograms divided by height in meters squared).
  • Taking at least 1 brisk 10-minute walk, 3 times a day, 5 days a week.
  • Following a healthy eating plan full of fruits and vegetables and low in sodium.
  • Quitting smoking.
  • Drinking alcoholic beverages in moderation — no more than 2 drinks per day for men and no more than 1 drink per day for women.
  • Taking any prescribed high blood pressure medication as directed.


  1. Whitworth JA, World Health Organization, International Society of Hypertension Writing Group. 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension. J Hypertens 21:1983-92. 2003.
  2. www.cdc.gov/nchs/data/databriefs/db03.pdf


These resources are for the purpose of personal trainer growth and development through Continuing Education which advances the knowledge of fitness professionals. This article is written for NFPT Certified Personal Trainers to receive Continuing Education Credit (CEC). Please contact NFPT at 800.729.6378 or [email protected] with questions or for more information.
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