Illustration of plaque in arteries leading to hypertension

How are hypertension, heart disease, and stroke related?

Medically reviewed on February 24, 2023 by Jillian Foglesong Stabile, MD, FAAFP. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

According to the most up-to-date figures, the American College of Cardiology and the American Heart Association estimate that 46% of Americans live with hypertension [1]. At the same time, heart disease affects at least 7.2% of the population [2]. And every year, nearly 800,000 people in the U.S. have a stroke [3].

Already, you can see that these three conditions have something in common: They pose a health risk to many Americans.

But there’s more to the story than that. Hypertension, heart disease, and stroke are interconnected in several ways. In this guide, we’re exploring how these conditions are connected and how you can minimize the risk of all three.

Defining the terms

Before we discuss how hypertension, heart disease, and stroke are all related, it’s worth ensuring we’re on the same page. Let’s take a closer look at each of these conditions.

What is hypertension?

Hypertension may sound like a fancy term, but it’s nothing more than the clinical word for a common condition you’ve likely heard of: High blood pressure [4].

As your blood flows through your arteries, it applies pressure to the artery walls. This pressure fluctuates naturally throughout the day, rising during activities like exercise and falling when you’re at rest [4]. However, factors like genetics, age, and unhealthy lifestyle choices can cause a more permanent increase in blood pressure [5].

When your blood pressure is high for an extended period, the force and friction can damage the walls of your arteries [6]. Your heart may also have to work harder to pump blood [6]. Over time, tears may form in your artery tissues and plaque from LDL cholesterol can collect in them, making your arteries even narrower and increasing your blood pressure further [6].

So, how do you know if you have hypertension? You can measure your blood pressure at home, visit a healthcare provider, or use a public blood pressure cuff. No matter how you do it, you’re looking at two numbers:

  • Systolic blood pressure – The first number in your reading measures your blood pressure when your heart beats [4]. Ideally, this number should be under 120 [7].
  • Diastolic blood pressure – The second number measures your blood pressure between heartbeats [4]. This number should be below 80 [7].

If your measurements are higher than 130/80 mmHg on multiple occasions, you may have hypertension [4].

What is heart disease?

The term heart disease (also called cardiovascular disease) actually refers to a family of heart conditions [8]. Heart diseases are conditions that affect your blood vessels and your heart, and they’re the leading cause of death in the U.S. While you can be born with congenital heart disease, you can also develop them throughout your life [8].

The most common form of heart disease is coronary artery disease (CAD).9 This condition occurs when plaque builds up in your arteries, restricting blood flow to your heart [8].

Sounds a lot like hypertension, doesn’t it? You can start to see how high blood pressure and heart disease are connected.

When you have heart disease, you may experience a range of symptoms, including:

  • Angina – The lack of blood flow to your heart can cause these chest pains [8].
  • Arrhythmia – Problems with blood flow can also trigger chest palpitations. This fluttering, off-beat feeling in your chest may not be painful, but it can signal a more serious condition [8].
  • Heart attacks – If the lack of blood flow damages part of your heart muscle, you can experience a heart attack. Can you have a heart attack and not know it? It depends. However, symptoms of a heart attack range from chest and back pain to nausea and dizziness [9].
  • Heart failure – Contrary to popular belief, heart failure doesn’t mean that your heart stops beating [10]. Instead, heart failure occurs when your heart struggles to pump enough blood to support your organs [8].

While most of these symptoms are noticeable, they may take years to materialize, as heart disease can lie undetected [9]. That’s why regularly testing your heart health is essential.

What is a stroke?

Sometimes called brain attacks, strokes occur when the brain loses blood flow and, by extension, oxygen [11]. Your brain needs oxygen to perform its essential tasks. When that supply of oxygen is cut off—even for just a few minutes—a stroke can take place [12].

Strokes can happen for one of two reasons. These reasons help us differentiate the two types of strokes:

  • Ischemic stroke – If blood clots, plaque, or other particles clog the arteries leading to the brain, oxygen can’t reach the brain, and an ischemic stroke occurs [12]. The majority of brain attacks are ischemic strokes [12].
  • Hemorrhagic stroke – If an artery in the brain ruptures or leaks, the blood that comes out applies pressure to the brain cells and damages them [12].

Both types of stroke can lead to minor brain damage, long-term disability, and, in some cases, death [11]. As such, knowing how to recognize the signs of a stroke is vital. Typical stroke symptoms include the sudden onset of [11]:

  • Numbness in the face, legs, or arms
  • Blurred vision
  • Confusion
  • Dizziness or difficulty walking
  • Severe headaches

So, how are hypertension, heart disease, and stroke related? By now, you might have already recognized some of the similarities and connections between these three conditions.

Ultimately, it all comes down to one factor: blood.

Your blood is essentially your life force. Among other things, it carries oxygen and nutrients to your brain, heart, and other organs [13].

As such, when your blood doesn’t flow the way it should (as in the case of hypertension), it can contribute to other issues (like heart disease and stroke).

The underlying mechanism that connects all these conditions is your cardiovascular system (cardiovascular literally means “related to the heart and blood vessels”) [14]. Heart disease and stroke are two of the most prevalent cardiovascular conditions, but there are others, too.

To reinforce how hypertension, heart disease, and stroke are related, here are some more specific details about the connections between:

  • Hypertension and heart disease – Because hypertension can damage your arteries over time, your heart may receive less blood and oxygen [4]. Coronary artery disease, the most prominent form of heart disease, also goes hand-in-hand with high blood pressure, as the buildup of plaque in your arteries caused by CAD can increase your blood pressure.
  • Hypertension and stroke – Hypertension can eventually tear your artery walls, and plaque can accumulate in these damaged areas [4]. If enough plaque gathers to block the artery completely, your brain can’t receive oxygen and an ischemic stroke can occur [12].
  • Heart disease and stroke – As mentioned, one of the potential symptoms of heart disease is heart failure, which happens when your heart can’t pump enough blood to meet your organs’ needs. Well, one of your most important organs is your brain. In this way, heart disease can lead to a stroke; around 2–3% of people who suffer from heart failure also sustain a stroke [15].

4 ways to reduce your risk of hypertension, stroke, and heart disease

Just as these three conditions are related, so are the strategies for combating them. While a healthcare provider can give you specific instructions, these tips may help you lower your risk of developing cardiovascular disease:

  • Maintain a healthy weight – As per the CDC, even shedding 5–10% of your total body weight can improve your blood pressure levels and reduce your risk of chronic diseases like heart disease [16].
  • Keep your cholesterol levels in check – High blood cholesterol can worsen hypertension [4], and it’s one of the leading causes of heart disease [9]. One of the simplest ways to improve your cholesterol is to eat a varied, healthful diet low in saturated and trans fats [17]. Can cholesterol be too low or too high? To check your cholesterol levels from home, try a Cholesterol & Lipids Test from Everlywell.
  • Exercise – Regular exercise to lower cholesterol can improve your cardiovascular health by decreasing your blood pressure in the long run.18
  • Quit smoking (if applicable) – If you smoke, quitting can be one of the most effective ways to reduce your risk of heart disease and stroke. According to the CDC, quitting smoking can lower the risk of heart failure, reduce your chances of developing CAD, and slow the buildup of fat and cholesterol on your artery walls [19].

Test for potential indicators of hypertension, stroke, and heart disease with sample collection from home

Hypertension, heart disease, and stroke have one more similarity: They can be challenging to detect. Many people live with hypertension without knowing it, and signs of heart disease can take years to materialize. But if you don’t catch these conditions early enough, they can lead to strokes and other health concerns.

With that in mind, it’s wise to stay on top of your cardiovascular health through frequent testing. Unfortunately, visiting a healthcare provider for tests can be inconvenient and costly. For peace of mind between visits, consider taking an at-home Heart Health Test from Everlywell.

Everlywell allows you to monitor your well-being from the comfort of your home. Take the test at home, mail it back to our labs, and we’ll have detailed results and suggestions for you in days. While you won’t be able to measure your blood pressure with our Heart Health Test, your results can show you if you’re at risk for developing heart disease.

For more general wellness tests that can help you monitor your health from home, browse our full collection of products.

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  16. Losing weight. Centers for Disease Control and Prevention. URL. Published September 19, 2022. Accessed February 9, 2023.
  17. Treat and manage high cholesterol. Centers for Disease Control and Prevention. URL. Published October 24, 2022. Accessed February 9, 2023.
  18. Pinckard K, Baskin KK, Stanford KI. Effects of exercise to improve cardiovascular health. Frontiers in Cardiovascular Medicine. 2019;6. doi:10.3389/fcvm.2019.00069
  19. Benefits of quitting. Centers for Disease Control and Prevention. URL. Published September 23, 2020. Accessed February 9, 2023.
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