Introduction
High blood pressure – also called hypertension – rarely has obvious symptoms, so you may not realize you have it.
The only way of knowing there's a problem is to
.All adults should have their blood pressure checked. If you haven’t had yours measured, or you don’t know what your blood pressure reading is, ask your doctor to check it for you.
What is high blood pressure?
Blood pressure measures how strongly blood presses against the walls of your arteries (large blood vessels) as it's pumped around your body by your heart.
If this pressure is too high it puts a strain on your arteries and your heart, which makes certain conditions more likely, such as a
, a or .Blood pressure is measured in millimetres of mercury (mmHg) and it's recorded as two figures:
- systolic pressure: the pressure of the blood when your heart beats to pump blood out
- diastolic pressure: the pressure of the blood when your heart rests in between beats
For example, if your doctor says your blood pressure is "140 over 90", or 140/90mmHg, it means you have a systolic pressure of 140mmHg and a diastolic pressure of 90mmHg.
High blood pressure is when readings on separate occasions show your blood pressure to be 140/90mmHg or higher.
Generally, a normal blood pressure reading is between 90/60mmHg and 120/80Hg.
What are the symptoms?
High blood pressure usually has no obvious symptoms and many people have it without knowing.
Untreated high blood pressure can lead to serious diseases, including stroke and heart disease. The only way to know if you have high blood pressure (hypertension) is to
.All adults should get their blood pressure checked so speak to your healthcare professional to make an appointment/find out how regularly you should get checked.
In some rare cases, where a person has very high blood pressure, they can experience symptoms. See your doctor if you are experiencing:
- headaches
- blurred or double vision
- chest pain that comes and then goes.
Get emeregncy medical care if you experience any of these symptoms, as they may indicate a heart attack:
- sudden chest pain that doesn't go away – this can feel like pressure or a squeezing or burning sensation
- pain spreading to your left or right arm, your neck, jaw, stomach area or back
- chest pain and you also feel nauseous, sweaty, short of breath or light-headed.
Causes of high blood pressure
There's often no clear cause of high blood pressure but your chances increase as you get older. You're also at increased risk if you:
- are overweight
- have a close relative with high blood pressure
- are of African or Caribbean descent
- eat an unhealthy diet that is high in salt
- don't eat enough fruit and vegetables
- don't do enough exercise
- drink a lot of coffee (or other caffeine-based drinks)
- drink a lot of alcohol.
About 10% of high blood pressure cases are the result of an underlying condition or cause. These cases are referred to as secondary high blood pressure.
Common causes of secondary high blood pressure include:
- narrowing of the arteries (large blood vessels) supplying the kidneys
- hormonal conditions, such as (a condition where your body produces an excess of steroid hormones)
- conditions that affect the body’s tissue, such as
- oral contraceptive pill
- painkillers known as , such as
- recreational drugs, such as cocaine, amphetamines and crystal methamphetamine
- herbal remedies, such as herbal supplements.
You can take effective steps to lower your blood pressure with changes to your lifestyle and by taking medication.
How is it diagnosed?
You can have your blood pressure checked by your doctor or another healthcare professional, and you can also check it yourself with a home testing kit.
If you're at an increased risk of high blood pressure, you should have your blood pressure checked regularly, ideally at least once a year.
Blood pressure is often measured using a sphygmomanometer, a device which consists of a stethoscope, arm cuff, dial, pump and valve.
The cuff is placed around your arm and pumped up to restrict the blood flow. The pressure is then slowly released as your pulse is checked using the stethoscope.
Hearing how your pulse beats after the cuff is released allows a measurement to be taken on the mercury scale, giving an accurate reading of your blood pressure.
Many doctors surgeries now use digital sphygmomanometers, which measure your pulse using electrical sensors.
Before having your blood pressure taken, you should rest for at least 5 minutes and empty your bladder.
To get an accurate blood pressure reading, you should be sitting down and not talking when the reading is taken.
Blood pressure readings
Having one raised blood pressure reading does not necessarily mean you have high blood pressure. Blood pressure can fluctuate throughout the day. Feeling anxious or stressed when you visit your doctor can raise your blood pressure.
You'll probably be given a blood pressure kit to take home so you can monitor your blood pressure level throughout the day. This will confirm whether you have consistently high blood pressure.
You may also have blood and urine tests to check for conditions that are known to cause an increase in blood pressure, such as kidney disease.
Home testing kits
Portable testing kits that measure your blood pressure at home can be a useful way of getting a more accurate reading.
This is because some people become anxious in medical clinics, which can cause the blood pressure to rise. This is a condition called white coat hypertension.
Home or portable blood pressure monitoring kits may show that your blood pressure is in fact normal when you are relaxed.
You can buy a variety of testing kits so you can monitor your blood pressure at home or while you're out and about.
It is important to buy a blood pressure monitor that's reliable and gives accurate readings.
Find out
.Treatment for blood pressure
Below are some changes you could make to your lifestyle to reduce high blood pressure. Some of these will lower your blood pressure in a matter of weeks, others may take longer.
- cut your salt by avoiding foods high in salt such as processed meat, biscuits and ready meals
- eat a healthy, low-fat, balanced diet including plenty of fresh fruit and vegetables
- be active to prevent or control high blood pressure
- cut down on alcohol
- stopping smoking greatly reduces your chances of getting heart and lung diseases
- lose weight if you need to
- drink less coffee, tea or other caffeine-rich drinks such as cola. Drinking more than 4 cups of coffee a day may increase your blood pressure
- try relaxation therapies such as yoga, meditation and stress management
The more healthy habits you adopt, the greater effect there's likely to be on lowering your blood pressure.
In fact, some people find that by sticking to a healthy lifestyle, they don't need to take any medicines at all. Always see your doctor to find out the best way to lower your blood pressure.
Taking medication
Your doctor may prescribe blood-pressure-lowering medicines. You may need to take more than 1 type of medication because a combination of drugs is sometimes needed to treat high blood pressure.
In some cases, you may need to take blood pressure-lowering medication for the rest of your life. However, if your blood pressure levels stay under control for several years, you might be able to stop your treatment.
Most medications used to treat high blood pressure can produce side-effects but the large choice of blood pressure medicines means that these can often be resolved by changing treatments.
Let your doctor know if you have any of the following common side-effects while taking medication for high blood pressure:
- feeling drowsy
- pain around your kidney area (on the side of your lower back)
- a dry cough
- dizziness, faintness or light-headedness
- a skin rash.
Below are the most widely used medications for treating high blood pressure. Your doctor will consider which will work best for you when making a treatment plan.
ACE inhibitors
Angiotensin-converting enzyme (ACE) inhibitors reduce blood pressure by relaxing your blood vessels. The most common side-effect is a persistent dry cough. If side-effects become particularly troublesome, a medication that works in a similar way to ACE inhibitors, known as an angiotensin-2 receptor antagonist, may be recommended.
ACE inhibitors can cause unpredictable effects if taken with other medications, including some over-the-counter ones. Check with your doctor or pharmacist before taking anything in combination with this medication.
Calcium channel blockers
Calcium channel blockers keep calcium from entering the muscle cells of the heart and blood vessels. This widens your arteries (large blood vessels) and reduces your blood pressure.
Drinking grapefruit juice while taking some types of calcium blockers can increase your risk of side effects. You can discuss the possible risks with your doctor or pharmacist.
Diuretics
Sometimes known as water pills, diuretics work by flushing excess water and salt from the body through urine.
Beta-blockers
Beta-blockers work by making your heart beat more slowly and with less force, thereby reducing blood pressure.
Beta-blockers used to be a popular treatment for high blood pressure but now they only tend to be used when other treatments haven't worked. This is because beta-blockers are considered to be less effective than the other medications used to treat high blood pressure.
Find out more information about
.Beta-blockers can also interact with other medications, causing possible side effects. Check with your doctor or pharmacist before taking other medications in combination with beta-blockers.
Don't suddenly stop taking beta-blockers without first consulting your doctor. Stopping suddenly will lead to serious side effects, such as a rise in blood pressure or an
attack.Alpha-blockers
Alpha-blockers are not usually recommended as a first choice for lowering high blood pressure unless other treatments haven't worked. Alpha-blockers work by relaxing your blood vessels, making it much easier for blood to flow through them.
Common side effects of alpha-blockers include:
- fainting spells when you first start the treatment
- dizziness
- headache
- swollen ankles
- tiredness
Preventing high blood pressure
Having high blood pressure can be prevented by eating healthily, maintaining a healthy weight, taking regular exercise, drinking alcohol in moderation and not smoking.
Diet
Cut down on the amount of salt in your food and eat plenty of fruit and vegetables.
Salt raises your blood pressure. The more salt you eat, the higher your blood pressure. Aim to eat less than less than 6g (0.2oz) of salt a day, which is about a teaspoonful.
Eating a low-fat diet that includes lots of fibre (for example, wholegrain rice, bread and pasta) and plenty of fruit and vegetables has been proven to help lower blood pressure. Fruit and vegetables are full of vitamins, minerals and fibre that keep your body in good condition. Aim to eat a variety of fruit and vegetables every day.
Alcohol
Regularly drinking alcohol above recommended limits will raise your blood pressure over time. Drinking no more than 14 units across a week (6 pints of average-strength beer or 10 small glasses of lower-strength wine) will help reduce your risk of developing high blood pressure.
Alcohol is also high in calories, which will make you gain weight. This will also increase your blood pressure.
Caffeine
Drinking more than 4 cups of coffee a day may increase your blood pressure. If you're a big fan of coffee, tea or other caffeine-rich drinks (such as cola and some energy drinks), consider cutting down. It's fine to drink tea and coffee as part of a balanced diet but it's important that these drinks are not your only source of fluid.
Weight
Being overweight forces your heart to work harder to pump blood around your body, which can raise your blood pressure. If you do need to shed some weight, it's worth remembering that just losing a few pounds will make a big difference to your blood pressure and overall health.
Exercise
Being active and exercising regularly lowers blood pressure by keeping your heart and blood vessels in good condition. Regular exercise can also help you lose weight, which will also help lower your blood pressure.
Adults should do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity (i.e. cycling or fast walking) every week. For it to count, the activity should make you feel warm and slightly out of breath. Someone who's overweight may only have to walk up a slope to get this feeling. Physical activity can include anything from sport to walking and gardening.
Relaxation therapies
Relaxation therapy and exercise can reduce blood pressure. These therapies include:
- stress management, meditation or yoga
- cognitive behaviour therapy (CBT), which focuses on how thoughts and beliefs can affect the way you feel and how you cope with problems.
- biofeedback, where a small monitor constantly shows you your heartbeat or blood pressure, and is used to help you try to control your blood pressure.
Smoking
Smoking doesn't directly cause high blood pressure but it puts you at much higher risk of a
and a . Smoking – like high blood pressure – will cause your arteries to narrow. If you smoke and have high blood pressure, your arteries will narrow much more quickly and your risk of a heart or lung disease in the future is dramatically increased.