What Is Hypertension? What Adults 40–59 Should Know

High blood pressure can develop without obvious warning signs.

You may feel completely healthy while elevated blood pressure places added stress on your arteries, heart, kidneys, and brain. For this reason, regular blood pressure checks become especially valuable during middle age.

According to the Centers for Disease Control and Prevention (CDC), 52.5% of U.S. adults ages 40–59 had hypertension from August 2021 through August 2023. Among men in that age group, prevalence reached 55.9%, while 49.0% of women had hypertension.

So, what exactly is hypertension, what does it do to your blood vessels, and what can you do about it?

Quick Answer: What Is Hypertension?

Hypertension is a medical condition in which blood pressure remains at unhealthy levels over time.

Blood pressure measures the force of blood pushing against the walls of your arteries.

It is expressed as two numbers:

• Systolic pressure: the pressure when your heart contracts and pumps blood.
• Diastolic pressure: the pressure when your heart relaxes between beats.

Under the 2025 American Heart Association/American College of Cardiology guideline, blood pressure is classified as follows:

Blood Pressure Category	Systolic	Diastolic
Normal	Less than 120	and less than 80
Elevated	120–129	and less than 80
Stage 1 Hypertension	130–139	or 80–89
Stage 2 Hypertension	140 or higher	or 90 or higher

Blood pressure is measured in millimeters of mercury, or mm Hg.

One elevated reading does not automatically mean you have hypertension. Your healthcare professional will consider repeated measurements, your medical history, medications, and your overall cardiovascular risk.

Home blood pressure monitoring may also be recommended to confirm a diagnosis or track treatment.

Hypertension in Adults Ages 40–59

52.5%: U.S. adults ages 40–59 with hypertension

55.9%: Men ages 40–59 with hypertension

49.0%: Women ages 40–59 with hypertension

(Source: CDC/NCHS, August 2021–August 2023)

Prevalence of Hypertension in adults age 18 and older, by sex and age (United States 2021 – 2023)

(SOURCE: National Center of Health Statistics)

Why Does Hypertension Become More Relevant During Middle Age?

Blood pressure tends to rise as people get older.

The National Heart, Lung, and Blood Institute (NHLBI) explains that blood vessels may become thicker and stiffer with age. These changes affect how arteries respond to blood flow and may raise the likelihood of developing hypertension.

Other risk factors may also accumulate during middle age, including:

• Weight gain
• Physical inactivity
• High sodium intake
• Excessive alcohol consumption
• Poor-quality sleep
• Chronic stress
• Diabetes
• High cholesterol
• Smoking

These factors do not affect everyone in the same way. Together, however, they can increase cardiovascular and vascular risk.

Middle age provides an opportunity to identify elevated blood pressure and address risk factors before complications develop.

Why Is Hypertension Called a “Silent” Condition?

High blood pressure may cause no noticeable symptoms.

A person can have elevated readings without headaches, dizziness, chest pain, or other obvious warning signs.

The NHLBI recommends regular blood pressure checks because hypertension may be present for years before serious complications become apparent.

People tend to seek medical attention when something hurts. Hypertension may not give you that warning.

The blood pressure cuff may tell you something your body does not.

What Happens to Your Arteries When Blood Pressure Stays High?

Healthy arteries are designed to expand and contract as blood moves through your body.

Persistent high blood pressure increases the force against artery walls. Over time, this stress can alter the structure and function of the vessels.

High blood pressure may also damage the inner lining of arteries, creating conditions that allow cholesterol, fats, and other substances to accumulate within the artery wall.

Vascular disease rarely develops from one factor alone.

Hypertension, high LDL cholesterol, diabetes, smoking, obesity, and physical inactivity may all contribute to cardiovascular and vascular disease.

Managing blood pressure is therefore one part of a broader strategy for protecting your arteries.

How Are Hypertension and Atherosclerosis Connected?

Atherosclerosis is the buildup of plaque within the walls of arteries.

Plaque is made up of cholesterol, fats, calcium, and other substances found in the blood.

Over time, high blood pressure may damage artery walls and contribute to the development and progression of atherosclerosis, particularly when other cardiovascular risk factors are present.

As plaque accumulates, arteries can become narrower and less flexible. This may reduce blood flow.

When atherosclerosis affects arteries supplying the legs, it can contribute to peripheral artery disease (PAD).

When it affects arteries supplying the heart or brain, it can increase the risk of heart attack or stroke.

Blood pressure control is an essential part of protecting vascular health.

How Does Hypertension Affect Your Heart?

Your heart must generate enough force to move blood throughout your circulatory system.

When blood pressure remains high, the heart has to work against greater resistance.

Over time, that increased workload may lead to structural and functional changes in the heart.

The 2025 AHA/ACC guideline identifies hypertension as a major modifiable risk factor for conditions including:

• Coronary artery disease
• Heart failure
• Atrial fibrillation
• Stroke
• Chronic kidney disease
• Cognitive decline and dementia

Blood pressure affects far more than one number on a monitor.

How Does Hypertension Affect Your Kidneys?

Your kidneys continuously filter waste and excess fluid from your blood.

To perform this job, they rely on a network of small blood vessels.

High blood pressure can damage these vessels over time and interfere with normal kidney function.

The relationship can also work in the opposite direction: kidney disease may make blood pressure more difficult to control.

This can create a harmful cycle in which hypertension damages the kidneys while declining kidney function contributes to worsening blood pressure.

Controlling hypertension also helps protect kidney health.

What Raises Your Risk of Hypertension?

Some risk factors cannot be changed.

These include:

• Age
• Family history
• Genetic factors

Other risk factors can be modified.

The NHLBI and current cardiovascular guidelines identify several factors associated with an increased risk of hypertension, including:

• Excess sodium intake
• Physical inactivity
• Overweight or obesity
• Excessive alcohol consumption
• Poor-quality or insufficient sleep
• Chronic stress
• Unhealthy eating patterns
• Smoking and tobacco exposure

Certain medications and medical conditions may also raise blood pressure.

Can Stress Increase Blood Pressure?

Yes. Stress can affect blood pressure.

When you experience stress, your body activates systems designed to respond to a perceived threat.

Your heart rate may increase, blood vessels can change their tone, and blood pressure may temporarily rise.

Chronic stress may also influence behaviors that affect cardiovascular health, including sleep, eating patterns, alcohol use, and physical activity.

Stress, however, does not explain every case of hypertension.

Blood pressure reflects many influences, including genetics, age, weight, diet, activity, sleep, medications, and other medical conditions.

Learn more about the relationship between chronic stress and blood flow.

How Can You Lower or Manage High Blood Pressure?

Treatment depends on your blood pressure readings, medical history, and overall cardiovascular risk.

Lifestyle changes are a central part of preventing and treating hypertension.

Follow a Heart-Healthy Eating Pattern

A diet rich in vegetables, fruits, whole grains, legumes, nuts, lean proteins, and healthy fats supports cardiovascular health.

The DASH diet — Dietary Approaches to Stop Hypertension — was specifically developed to help lower blood pressure.

Reduce Sodium

Excess sodium may contribute to elevated blood pressure.

Reducing highly processed foods and checking food labels can help lower daily sodium intake.

Stay Physically Active

Regular physical activity can help lower blood pressure while improving cardiovascular fitness, blood sugar control, weight management, and vascular health.

Maintain a Healthy Weight

For people who are overweight or obese, even modest weight loss may improve blood pressure and reduce cardiovascular risk.

Prioritize Sleep

Poor sleep and untreated sleep disorders can contribute to hypertension.

Consistent, adequate sleep supports cardiovascular health and blood pressure regulation.

Manage Chronic Stress

Regular exercise, adequate sleep, social connection, relaxation techniques, and other stress-management strategies may help reduce the cardiovascular effects of ongoing stress.

Limit Alcohol

Excessive alcohol consumption can raise blood pressure and make hypertension more difficult to control.

Take Medication When Prescribed

Some people need medication in addition to lifestyle changes.

Blood pressure medications work in different ways. The right treatment depends on your readings, medical history, kidney function, cardiovascular risk, and other health conditions.

Do not stop or change blood pressure medication without speaking with your healthcare professional.

Should You Check Your Blood Pressure at Home?

For many people, home blood pressure monitoring can provide useful information.

Your healthcare professional may recommend home measurements to:

• Confirm whether blood pressure is consistently elevated
• Track changes over time
• Evaluate how well treatment is working
• Compare office readings with measurements taken at home

For accurate results, use a validated upper-arm blood pressure monitor and follow your healthcare professional’s instructions regarding when and how frequently to measure.

Keep a record of your readings and bring them to your medical appointments.

When Is High Blood Pressure an Emergency?

A very high blood pressure reading requires attention.

If your blood pressure is higher than 180/120 mm Hg, wait at least one minute and measure it again.

If it remains that high, contact your healthcare professional promptly for guidance.

If your blood pressure is above 180/120 mm Hg and you are experiencing symptoms such as chest pain, shortness of breath, weakness, numbness, difficulty speaking, vision changes, or severe back pain, call 911.

Do not wait for the blood pressure to come down on its own when serious symptoms are present.

The Bottom Line

Hypertension is common, frequently has no obvious warning signs, and deserves greater attention as cardiovascular risk increases during middle age.

The CDC reports that more than half of U.S. adults ages 40–59 have hypertension, including 55.9% of men and 49.0% of women in that age group.

The good news is that blood pressure can be measured, monitored, and treated.

You do not need to wait until symptoms appear.

Know your numbers, understand your cardiovascular risk, and work with your healthcare professional to protect your heart, arteries, kidneys, and overall vascular health.

Blood pressure is only one part of vascular health.

If you also experience symptoms such as leg pain while walking, slow-healing wounds, changes in the color or temperature of your feet, or other signs of poor circulation, your healthcare professional can determine whether a vascular evaluation may be appropriate.

Frequently Asked Questions

Academic and Medical Sources

Centers for Disease Control and Prevention

CDC — Hypertension in Adults: United States, August 2021–August 2023

American Heart Association / American College of Cardiology

American Heart Association — 2025 High Blood Pressure Guideline

American Heart Association — When To Call 911 About High Blood Pressure

National Heart, Lung, and Blood Institute

NHLBI — High Blood Pressure: Causes and Risk Factors

NHLBI — High Blood Pressure: Symptoms