Editing Blood pressure (section)

===High blood pressure===
{{Main|Hypertension}}
[[File:Main complications of persistent high blood pressure.svg|thumb|right|300px|Overview of main complications of persistent high blood pressure.<ref name=aha23/>]]

[[Arterial hypertension]] can be an indicator of other problems and may have long-term adverse effects. Sometimes it can be an acute problem, such as in a [[hypertensive emergency]] when blood pressure is more than 180/120 mmHg.<ref name="aha23">{{cite web |title=The facts about high blood pressure |url=https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure |publisher=American Heart Association |access-date=14 May 2023 |date=2023 |archive-date=14 May 2023 |archive-url=https://web.archive.org/web/20230514190952/https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure |url-status=live }}</ref>

Levels of arterial pressure put mechanical stress on the arterial walls. Higher pressures increase heart workload and progression of unhealthy tissue growth ([[atheroma]]) that develops within the walls of arteries. The higher the pressure, the more stress that is present and the more atheroma tend to progress and the [[Myocardium|heart muscle]] tends to thicken, enlarge and become weaker over time.

Persistent [[hypertension]] is one of the risk factors for [[stroke]]s, [[myocardial infarction|heart attacks]], [[heart failure]], and [[arterial aneurysm]]s, and is the leading cause of [[chronic kidney failure]].<ref name=aha23/> Even moderate elevation of arterial pressure leads to shortened [[life expectancy]].<ref name=aha23/> At severely high pressures, mean arterial pressures 50% or more above average, a person can expect to live no more than a few years unless appropriately treated.<ref>{{cite book | vauthors = Guyton AC |title=Textbook of Medical Physiology |date=2006 |publisher=Elsevier Saunders |location=Philadelphia |isbn=978-0-7216-0240-0 |edition=11th | page = 220 }}</ref> For people with high blood pressure, higher [[heart rate variability]] (HRV) is a risk factor for [[atrial fibrillation]].<ref name="pmid35260686">{{cite journal | vauthors = Kim SH, Lim KR, Chun KJ | title=Higher heart rate variability as a predictor of atrial fibrillation in patients with hypertensione | journal= [[Scientific Reports]] | volume=12 | issue=1 | pages=3702 | year=2022 | doi= 10.1038/s41598-022-07783-3 | pmc=8904557 | pmid=35260686 | bibcode=2022NatSR..12.3702K }}</ref>

Both high [[Systole (medicine)|systolic]] pressure and high [[pulse pressure]] (the numerical difference between systolic and diastolic pressures) are risk factors.<ref name=aha23/> Elevated pulse pressure has been found to be a stronger independent predictor of cardiovascular events, especially in older populations, than has systolic, diastolic, or mean arterial pressure.<ref name="Cleveland Clinic 2021"/><ref name="Mitchell Izzo Lacourcière Ouellet 2002 pp. 2955–2961"/><ref name="Benetos Safar Rudnichi Smulyan 1997 pp. 1410–1415"/><ref name="Franklin Khan Wong Larson 1999 pp. 354–360">{{cite journal | last1=Franklin | first1=Stanley S. | last2=Khan | first2=Shehzad A. | last3=Wong | first3=Nathan D. | last4=Larson | first4=Martin G. | last5=Levy | first5=Daniel | title=Is Pulse Pressure Useful in Predicting Risk for Coronary Heart Disease? | journal=Circulation | publisher=Ovid Technologies (Wolters Kluwer Health) | volume=100 | issue=4 | date=27 Jul 1999 | issn=0009-7322 | doi=10.1161/01.cir.100.4.354 | pages=354–360| pmid=10421594 | doi-access=free }}</ref> In some cases, it appears that a decrease in excessive diastolic pressure can actually increase risk, probably due to the increased difference between systolic and diastolic pressures (ie. widened pulse pressure). If systolic blood pressure is elevated (>140&nbsp;mmHg) with a normal diastolic blood pressure (<90&nbsp;mmHg), it is called [[isolated systolic hypertension]] and may present a health concern.<ref name=aha23/><ref name="urlIsolated systolic hypertension: A health concern? – MayoClinic.com">{{cite web |url=https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-answers/hypertension/faq-20058527 |title=Isolated systolic hypertension: A health concern? |website=MayoClinic.com |access-date=2018-01-25 |archive-date=2013-12-28 |archive-url=https://web.archive.org/web/20131228153711/http://www.mayoclinic.com/health/hypertension/AN01113 |url-status=live }}</ref> According to the 2017<ref>{{cite book | vauthors = Tan JL, Thakur K | chapter = Systolic Hypertension |date=2022 | chapter-url = http://www.ncbi.nlm.nih.gov/books/NBK482472/ | title = StatPearls |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=29494079 |access-date=2022-10-03 }}</ref> American Heart Association blood pressure guidelines state that a systolic blood pressure of 130–139 mmHg with a diastolic pressure of 80–89 mmHg is "stage one hypertension".<ref name=aha23/>

For those with [[heart valve]] regurgitation, a change in its severity may be associated with a change in diastolic pressure.  In a study of people with heart valve regurgitation that compared measurements two weeks apart for each person, there was an increased severity of [[aortic insufficiency|aortic]] and [[mitral regurgitation]] when diastolic blood pressure increased, whereas when diastolic blood pressure decreased, there was a decreased severity.<ref name='Gottdiener2002'>{{cite journal | vauthors = Gottdiener JS, Panza JA, St John Sutton M, Bannon P, Kushner H, Weissman NJ | title = Testing the test: the reliability of echocardiography in the sequential assessment of valvular regurgitation | journal = American Heart Journal | volume = 144 | issue = 1 | pages = 115–121 | date = July 2002 | pmid = 12094197 | doi = 10.1067/mhj.2002.123139 }}</ref>