Hypertension, or high blood pressure, is a diagnosable medical impairment where blood pressure in the arteries is chronically elevated. Blood pressure is expressed as a ratio of two measurements: the systolic (maximum) and diastolic (minimum) pressures. For most adults, normal blood pressure range is 100-140 millimeters of mercury (mmHg) systolic, and 60-90 mmHg diastolic. Clinicians consider blood pressure persistently over 130/90 to be hypertension. High blood pressure is a widespread medical condition in our country, given the abundance of risk factors such as unhealthy diet and excess body weight. According to the CDC, about 75 million American adults, or approximately 1 in 3, have high blood pressure. Although common, many Americans are still able to work with a diagnosis of hypertension. However, Social Security Administration may consider a diagnosis to be disabling if it has more than a minimal impact on the ability to perform basic work activities (SSR 85-28).
There are usually no outward symptoms of high blood pressure, though some individuals will suffer fatigue and tension headaches. However, long-term hypertension is often dubbed the “silent killer,” as it is a major risk factor for other disabling impairments, such as coronary artery disease, stroke, or aneurysm. High blood pressure also forces your heart to work harder to pump blood throughout your body, and may cause left ventricular cardiomegaly or lead to congestive heart failure. Likewise, uncontrolled hypertension can cause the arteries around the kidneys to narrow, weaken, or harden, resulting in kidney damage or kidney failure. Where one or more organ systems is acutely impaired, there is malignant hypertension, also known as hypertensive emergency. Typically, this will occur when systolic pressure is at least over 180, or diastolic over 120. Severely elevated blood pressure with no evidence of organ damage is known as hypertensive urgency.
While there is no specific disability listing for hypertension, Social Security Administration will evaluate high blood pressure in reference to the specific body systems affected, because hypertension is a strong risk factor for disability.