The Connection Between Hypertension, Heart Disease, and Stroke

By Latifa deGraft-Johnson, MD
Medically reviewed checkmarkMedically reviewed
March 17, 2022

You’ve probably heard that high blood pressure is a risk factor for serious medical conditions such as heart attack and stroke.

But, unless you are a cardiologist, you may not fully understand exactly how these conditions are connected.

By learning why high blood pressure (hypertension) can lead to heart disease and stroke, you can also take action to lower your blood pressure and, in turn, decrease the risk of these other conditions.

In this article, I’ll define hypertension and explain the relationship between high blood pressure, cardiovascular disease, and stroke.

I’ll also provide suggestions for treating hypertension and advice on when to see a doctor about your blood pressure.

What Is Hypertension?

Your arteries and blood vessels carry blood to the organs and tissues throughout your body.

Blood pressure is the force with which your blood pushes against the walls of your arteries as it flows.

Blood pressure increases as the arteries narrow. 

Your blood pressure reading includes two numbers:

  • Systolic blood pressure: The top number on your BP reading, this measures the level of pressure in the arteries each time the heart beats.
  • Diastolic blood pressure: The lower number on your reading, this measures the level of pressure in the arteries when the heart rests between beats. 

Blood pressure is read in millimeters of mercury, or mm Hg. If your systolic pressure is 120 and your diastolic pressure is 75, you would say “120 over 75” or write 120/75 mm Hg.  

While it’s normal for blood pressure to fluctuate throughout the day, you may be diagnosed with hypertension if you have at least two high readings at two separate times, spaced at least 1 week apart.

Hypertension happens when the force of your blood against your artery walls is too high, increasing your risk for heart disease. 

High blood pressure is diagnosed if your systolic pressure is equal to or higher than 130 mm Hg or your diastolic blood pressure is equal to or higher than 80 mm Hg.

Keep in mind that if you have high BP, you may not have any symptoms.

That’s why it’s so important to see your primary care provider regularly. 

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If you have high blood pressure, you’re at a higher risk of health problems such as heart disease, heart failure, heart attack, and stroke

Over time, high blood pressure can damage the arteries or blood vessels, resulting in hypertensive heart disease.

If your heart can’t pump sufficient blood to meet the needs of your body, you have what’s called heart failure.

High blood pressure can also cause the arteries to harden with fatty deposits called plaque.

If this plaque builds up and blocks the arteries leading to your heart muscle (your coronary arteries), it interrupts blood flow to your heart.

This can lead to chest pain or irregular heart rhythms. Lack of blood flow to the heart can also cause damage or death to a part of your heart, which is called a heart attack.

Lastly, hypertension can increase the risk of stroke.

High blood pressure can cause your blood vessels to narrow, rupture, or form blood clots in the arteries leading to your brain. If this happens and the brain doesn’t get enough oxygen-rich blood, a stroke occurs.

During a stroke, since part of the brain isn’t getting enough oxygen, brain cells can become damaged or die.

How to Treat Hypertension

High blood pressure doesn’t always have one cause, so there’s not only one treatment.

Your healthcare provider can recommend the best ways to manage your blood pressure, including lifestyle changes, medication, or both. 

Lifestyle changes

Living a healthy lifestyle can help prevent hypertension, lower blood pressure in people who have it, and reduce the medical risks associated with high blood pressure.

Some of the most important lifestyle aspects are: 

  • Diet: Healthy eating promotes overall health and can lower blood pressure. Avoiding processed foods and fast food, and instead focusing on a balanced diet that includes fruits, vegetables, whole grains, low-fat dairy, and lean proteins, like chicken and fish, may help reduce or manage high blood pressure.
  • Weight: Being overweight isn’t always unhealthy, but if you have hypertension, your doctor might recommend losing weight to reduce how hard your heart has to work.
  • Exercise: Routine physical activity can help you lose weight and also help maintain healthy blood pressure levels. Aim for 150 minutes of moderate-intensity activity (such as brisk walking, biking, running, or playing sports), or 75 minutes of vigorous aerobic activity per week, as recommended by the American Heart Association.  Breaking up the time into 15-minute increments still counts and the benefits add up!  If your mobility is limited, lower intensity exercise can still help to decrease your risk of heart disease. Even 10 minutes of lower intensity exercise can lower your heart disease risk. Please check with your doctor before starting your exercise program.
  • Stress: Stress can cause blood pressure to rise. If you’re struggling to cope with chronic stress, it may help to see a psychotherapist or seek out loved ones for support. You can also try meditation, yoga, and deep breathing to relax.
  • Sodium intake: A high-salt diet leads to fluid retention, which can increase blood pressure. Try to consume less than 1,500 milligrams (mg) of salt per day. Fast food and packaged food are often high in sodium, so be mindful of how often you eat these and read nutrition labels when possible to find lower-sodium options.
  • Alcohol: Even moderate drinking can increase the risk of high blood pressure. If you’re an otherwise healthy adult, enjoy 1-2 alcoholic beverages a day at most.
  • Smoking: Tobacco can cause plaque to build up in the arteries, increasing blood pressure and the risk of other medical problems. Speak to your doctor about how to quit cigarette smoking.

Medication 

If lifestyle changes aren’t enough to control your hypertension, blood pressure medication may help.

The most common types of prescription drugs for hypertension are:

  • Diuretics: Too much sodium in the body can lead to water retention, increasing blood pressure. Diuretics (sometimes called water pills) help the kidneys excrete sodium and water. They’re usually the first line of treatment for high blood pressure. Common classes of diuretics are thiazide, loop, and potassium-sparing diuretics. 
  • ACE inhibitors: Angiotensin-converting enzyme inhibitors help blood vessels relax by blocking a chemical (angiotensin II) that causes them to constrict. Common ACE inhibitors include lisinopril (Prinivil, Zestril), benazepril (Lotensin), and captopril.
  • Angiotensin II receptor blockers: ARBs stop the action of angiotensin II, in turn, helping blood vessels remain open. The most common ARBs are candesartan (Atacand) and losartan (Cozaar).
  • Calcium channel blockers: These help the heart and artery cells relax and open by preventing calcium from entering the cells. Often prescribed along with ACE inhibitors, common calcium channel blockers are amlodipine (Norvasc) and diltiazem (Cardizem and Tiazac).

It’s possible that medications alone won’t properly control your high blood pressure.

In that case, your medical provider might prescribe additional medications to reduce your risk of heart disease.

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When to See a Doctor

Because high blood pressure is most manageable when it’s treated early on, it’s important to keep up with your primary care appointments.

Your medical provider should read your blood pressure at these visits and, if necessary, help you find ways to decrease it. 

If you think you might be experiencing a hypertensive crisis (which occurs when blood pressure reaches dangerously high levels), heart attack, or stroke, which can be caused by hypertensive crisis, call 911 or go to the emergency department right away.

Watch for the following symptoms: 

  • Severe chest pain 
  • Severe headache
  • Confusion
  • Blurred vision 
  • Nausea and/or vomiting 
  • Shortness of breath 
  • Anxiety
  • Seizures
  • Difficulty walking or loss of balance 
  • Slurred speech 

Sudden numbness in your face, arm, or leg, especially if it is on one side 

How K Health Can Help 

Did you know you can get affordable primary care with the K Health app? Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.

Frequently Asked Questions

Is hypertension considered a type of heart disease?
Hypertension in and of itself is not a type of heart disease; however, high blood pressure increases the risk of developing heart disease. If you’re concerned about your blood pressure, talk with your healthcare provider about the best ways to manage it.
How high does blood pressure have to be to lead to stroke?
Any level of hypertension can increase the risk of stroke. A hypertensive crisis, or a severe increase in blood pressure, can make a stroke much more likely due to blood vessel damage.
Will every high blood pressure patient eventually have a heart attack?
Not every high blood pressure patient will have a heart attack. Your risk of heart disease and heart attack decreases when your blood pressure returns to a healthier level. Both medication and lifestyle changes may help reduce high blood pressure and the risk of heart attack.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Latifa deGraft-Johnson, MD

Dr. Latifa deGraft-Johnson is a board-certified family medicine physician with 20 years of experience. She received her bachelor's degree from St. Louis University, her medical degree from Ross University, and completed her family medicine residency at the University of Florida. Her passion is in preventative medicine and empowering her patients with knowledge.