Hypertension has few symptoms until it has started to cause damage. Hypertension (HT) affects one in four adults and once we reach 75, over two-thirds of us. It’s diagnosed when your blood pressure is consistently 140/90 mmHg or higher (the figures reflect arterial pressure during/ between heartbeats and ideally should be around 120/80 mmHg).
Sudden blood pressure rises can occur in conditions such as pre-eclampsia in pregnancy or as drug reactions and may cause headaches or visual disturbance. The damage however, is usually done by long-term pressure on the arteries, causing them to stiffen and narrow, especially in people with raised blood-cholesterol levels and/or diabetes.
Hypertension is a major cause of cardiovascular disease heart attacks, stroke, peripheral vascular disease, kidney failure, blindness and vascular dementia.
Around a tenth of Hypertension is secondary to other factors, such as pregnancy, kidney disease, hormone disorders, medicines (for example, the oral contraceptive Pill and some decongestants), alcohol or amphetamines, diabetes, but in many cases the cause isn’t known. It’s linked to age and gender, family history and ethnic origin (for example, people of Afro-Caribbean origin), but also risk factors you can change. Chinese researchers recently said HT may be more common in those with sleep disorders such as restless leg syndrome and obstructive sleep apnoea (blocked breathing).
Ways of checking blood pressure
Hypertension can be diagnosed using repeated surgery/clinic readings, or by ABPM (ambulatory blood-pressure monitor a wearable machine that checks it automatically), or a home monitor (HBPM) used at different times. Use a reputable upper-arm model — ask your pharmacist — and calibrate (accuracy-check) it annually. Sit quietly for a few minutes, then use a bare, supported arm with the cuff at heart-height and repeat raised readings after five minutes.
Have blood-pressure checks at least five-yearly after the age of 40, more frequently from 70, or if it’s been raised before, or if you have conditions/medication that can raise it, or are already on Hypertension treatment. It can be checked at your GP’s as part of a general health check and at some pharmacies and workplaces.
If you have Hypertension, you’ll need 3 checks to look for any damage and underlying causes. These 2 may include blood tests for cholesterol/sugar/hormone levels and kidney function, urine tests, a heart tracing (ECG), heart ultrasound scan (echocardiogram) or more complex tests. Complicated cases may need referring to a specialist.
You may be advised to try lifestyle changes first but may need to take one or more medicines indefinitely. NICE (National Institute for Health and Care Excellence) guidelines include several drug ‘families’, as different ‘family members’ often suit different ages, ethnic groups and/or other conditions better. They also have slightly different side-effects and can be added or swapped to find a combination that suits you best.
If you’re under 80, treatment targets are to achieve a BP under 140/90 mmHg in clinic and 135/85 mmHg for ABPM/HBPM (150/90 and 145/85 if you’re over 80 ); they’re lower still if you have diabetes and/or kidney disease. You’ll also need health checks at least annually.
6 Ways to Lower Blood-Pressure Risks
- Maintain a healthy weight so that your BMI (weight divided by height in metres multiplied by itself) stays between 18.5-24.9 kg/m.
- De-stress for example, with relaxation techniques mindfulness, yoga or Pilates.
- Eat more wholegrains, unsaturated fats, oily fish, nuts, seeds and fresh fruit and veg; less than 63 of sugar and salt daily.
- Drink alcohol only within recommended limits.
- Don’t smoke!
- Take at least 150 minutes of exercise a week even 10-minute chunks can add up.