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Hypertension (High blood Pressure)

Dr. M Chabok

Consultant Cardiologist (Intervention)

Hypertension (High blood Pressure)

“High blood pressure is a common condition, affecting around one in three adults in England. The risk of developing high blood pressure increases with age. Half of people over 75 years have the condition.”

Lifestyle targets

High blood pressure is usually defined as having a sustained blood pressure of 140/90mmHg or above. As hypertension often causes no symptoms, or immediate problems, it is known as the ‘silent killer’. However, it is a major primary risk factor in the development of coronary heart disease, stroke and kidney failure. The only way to find out whether you have high blood pressure is to have it checked regularly. If you have high blood pressure, your heart has to work harder to pump blood around your body. Over time, this can weaken it. The increased pressure can also damage the walls of your arteries, resulting in a blockage or causing the artery to split (haemorrhage). Both of these situations can cause a stroke. High blood pressure is a common condition, affecting around one in three adults in England. It is estimated that 18% of adult men and 13% of adult women have high blood pressure but are not getting treatment for it. The risk of developing high blood pressure increases with age. Half of people over 75 years have the condition.

There are two types of high blood
pressure:
Primary high blood pressure (90-95% of
cases), there is no identifiable cause for this type
of high blood pressure. A number of risk factors
increase your chances of developing the
condition including:
• age – the risk of developing high blood
pressure increases as you get older
• a family history of high blood pressure – the
condition seems to run in families
• being of Afro-Caribbean origin
• high-fat diet
• high amount of salt in your diet
• lack of exercise
• being overweight
• smoking
• excessive alcohol consumption
• stress
All available evidence shows that lifestyle plays
a significant role in regulating your blood
pressure.

Secondary high blood pressure (between 5
and 10%), where high blood pressure is caused
by an underlying cause, such as kidney disease,
or a particular type of medication that you are
taking.

High blood pressure can be treated or prevented
by making changes to your lifestyle, such as
eating a healthier diet, exercising more
regularly, and reducing the amount of alcohol
you drink.
Blood pressure is measured using two figures.
One figure represents the pressure of the heart
as it contracts to pumps blood around the body.
This is known as the systolic pressure. The
second figure represents the pressure of the
heart as it expands and fills with blood, while
waiting for the next contraction. This is known
as the diastolic pressure.
“All available evidence shows that lifestyle
plays a significant role in regulating your
blood pressure.”
It is important to recognise that blood pressure
will vary dependent upon many situational
factors. Physical activity, emotion, hydration,
smoking, caffeine and time of day are just some
of the factors that can significantly impact blood
pressure immediately.
For most people, a healthy blood pressure is a
systolic pressure of 90-120 millimeters of
mercury (mmHg) and a diastolic pressure of 60-
80mmHg. Or, as blood pressure is normally
expressed, a level between 90/60mmHg and
120/80mmHg.

Checking your blood pressure
Having one high blood pressure reading does
not necessarily mean that you have high blood
pressure. Your blood pressure can fluctuate
throughout the day. Therefore, your GP will
need to take several readings over a set period
of time, usually every month, to see whether
your blood pressure level is consistently high.
“Having one high blood pressure reading
does not necessarily mean that you have
high blood pressure.”
Before having your blood pressure taken, you
should rest for at least five 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.
The optimal BP target is 140 mm Hg systolic
and 85 mm Hg diastolic higher risk people
(established atherosclerotic disease, diabetes,
and chronic renal failure) a lower BP target of
130 mm Hg and 80 mm Hg.
The best way of preventing high blood pressure
and the associated risks of cardiovascular
disease, is to eat a healthy diet, maintain a
healthy weight, exercise regularly, drink alcohol
in moderation and avoid smoking.

Treating high blood pressure

Treatment for high blood pressure will depend
on your blood pressure levels and your
associated risk of developing a cardiovascular
disease, such as a heart attack or stroke.


Slightly High blood Pressure


If your blood pressure is slightly higher than the
ideal level (120/80mmHg), and your GP feels
that the risks of cardiovascular disease are low,
you should be able to lower your blood pressure
by making simple lifestyle changes, such as
improving your diet and taking regular exercise.

moderately High blood Pressure


If your blood pressure is moderately high
(140/90mmHg or higher), or your GP feels that
your risk of developing cardiovascular disease
in the next 10 years is more than one in five,
you will be prescribed medication and advised
about changing your lifestyle.

Very High blood Pressure


If your blood pressure is very high (180/110
mmHg or above) you will be referred to a
hypertension specialist (a doctor who specialises
in treating high blood pressure).
For more information visit:

www.nhs.uk/conditions/Blood-pressure-
(high)/Pages/Introduction.aspx
http://guidance.nice.org.uk/CG127