High blood pressure, or hypertension, is common among Americans and a major risk factor for heart disease and stroke. Among veterans, hypertension is the most commonly reported medical problem. As many as 65 million Americans-nearly one-third of all adults-have hypertension. Thirty percent don't know they have it. For adults older than 50, the risk of developing hypertension is nearly 90 percent. Since blood pressure commonly increases with age, hypertension was once believed to be a normal part of aging. In fact, maintaining a normal blood pressure is desirable for all age groups.

What is hypertension?
Blood pressure is the force of blood against artery walls. Clinicians use two numbers to record a patient's blood pressure. The first number represents blood pressure when the heart beats (systolic pressure) and the second number is blood pressure in between heartbeats (diastolic pressure). Normal blood pressure is less than 120/80 mm Hg. Prehypertension is 120/80 mm Hg to 139/89 mm Hg, stage 1 hypertension is 140/90 mm Hg to 159/99 mm Hg, and stage 2 hypertension is 160/100 mm Hg and higher.

Diagnosis, prevention and treatment
All adults should have their blood pressure measured at each checkup. Using the proper technique to measure blood pressure is important for an accurate reading. A patient should be comfortably seated for at least five minutes with his or her arm raised to heart level before a reading. Three readings must be taken one week apart before hypertension can be diagnosed. Ask your VA healthcare provider whether monitoring your own blood pressure at home would be helpful. Medications are recommended when hypertension isn't satisfactorily responding to lifestyle changes like increasing physical activity, eating a healthy diet and reducing stress. Stage 2 hypertension requires a more aggressive approach. Studies have shown that, for most patients, diuretics work best as the first drug treatment. However, most patients require two medications to get their blood pressure under control.

The benefits of lower blood pressure are clear. Heart disease risk can be cut in half when your blood pressure is under control.