Under Pressure
What constitutes a healthy blood pressure?
Systolic blood pressure is pressure measured in the arteries at the peak of the cardiac cycle. This number should be less than 140. The diastolic number should be less than 90.
In the UK we say that a healthy blood pressure is non-hypertensive. A hypertensive blood pressure is diagnosed when pressure is measured at more than 140/90.
Why is high blood pressure an issue?
Because it is a major risk factor for cardiovascular disease, and is responsible for the loss of millions of lives every year through heart attacks and strokes.
Kidney disease is another common consequence. Kidney disease from high blood pressure can lead to the need for dialysis – in the UK, high blood pressure and diabetes are the leading causes of chronic kidney disease.
There are more than 15 million people in the UK with high blood pressure and at least 1 billion people worldwide have high blood pressure, with the figure projected to rise to 1.56 billion by 2025.
It’s critical we realise the importance of high blood pressure and when it is identified, we must bring it under control.
What causes high and low blood pressure?
High blood pressure can be caused by lifestyle factors such as excessive alcohol, lack of exercise, too much salt, and by genetic factors: having a family history.
Low blood pressure we understand less about. Many people, particularly women, tend to run lower blood pressure. Certain medicines can cause blood pressure to be very low, while some patients with various forms of endocrine or kidney problems can also have low blood pressure. But we see much less in the way of problems due to low blood pressure.
How can we reduce high blood pressure?
If it is not strikingly high, begin with making lifestyle changes. In the UK the average daily salt intake is about 8g to 9g. We think intake should be less than 3g to 4g. So one way to reduce high blood pressure is to cut back on salt.
Excessive alcohol is another contributor. We don’t ask patients to stop drinking alcohol, but we do ask them to moderate their alcohol intake. A healthy intake is less than 21 units per week for a man and 14 units for a woman.
Significant physical activity, such as jogging, cycling, rowing or swimming at least four or five times a week for 35 to 40 minutes, also helps.
If those measures don’t work, medication will have to be considered.
Why would the measures in the last point not work for some people?
Quite often people don’t put the effort in. Or when they do, the blood pressure lowering is insufficient, so medication is sometimes necessary. I see a lot of people who are fit and well, apart from having high blood pressure, but it turns out that they have a family history of it.
What are the symptoms of high blood pressure?
People argue that there are very few symptoms of high blood pressure but experience has taught us that patients can present with a lot of non-specific symptoms. A common one is headaches or tightness of the skull. Some patients also have disturbed vision.
A stroke or heart attack can sometimes be the first warning of high blood pressure, hence the term ‘the silent killer’. The first time we see some patients is when they come into hospital with kidney failure, because of untreated high blood pressure. And we get younger people who sometimes just don’t acknowledge the dangers of high blood pressure.
Are there any home tests you can buy?
There are a number of digital devices that are validated by the British Hypertension Society to be highly accurate. They are easy to use and cost from £20 from pharmacies.
How does high blood pressure affect your life?
The vast majority of people simply get on with things as normal, with no real complications apart from having to remember to take their medication and maintain a healthy lifestyle.
What side effects can you get from the medication?
Erectile dysfunction, ankle swelling, tiredness and coughing – but some patients have no problems. We do recognise that medicines can cause problems and patients can respond differently, so we try to prescribe the drugs that are best for them.
Dr Mel Lobo is Director of the Barts Hypertension Clinic, Barts Health NHS Trust in London.
Systolic blood pressure is pressure measured in the arteries at the peak of the cardiac cycle. This number should be less than 140. The diastolic number should be less than 90.
In the UK we say that a healthy blood pressure is non-hypertensive. A hypertensive blood pressure is diagnosed when pressure is measured at more than 140/90.
Why is high blood pressure an issue?
Because it is a major risk factor for cardiovascular disease, and is responsible for the loss of millions of lives every year through heart attacks and strokes.
Kidney disease is another common consequence. Kidney disease from high blood pressure can lead to the need for dialysis – in the UK, high blood pressure and diabetes are the leading causes of chronic kidney disease.
There are more than 15 million people in the UK with high blood pressure and at least 1 billion people worldwide have high blood pressure, with the figure projected to rise to 1.56 billion by 2025.
It’s critical we realise the importance of high blood pressure and when it is identified, we must bring it under control.
What causes high and low blood pressure?
High blood pressure can be caused by lifestyle factors such as excessive alcohol, lack of exercise, too much salt, and by genetic factors: having a family history.
Low blood pressure we understand less about. Many people, particularly women, tend to run lower blood pressure. Certain medicines can cause blood pressure to be very low, while some patients with various forms of endocrine or kidney problems can also have low blood pressure. But we see much less in the way of problems due to low blood pressure.
How can we reduce high blood pressure?
If it is not strikingly high, begin with making lifestyle changes. In the UK the average daily salt intake is about 8g to 9g. We think intake should be less than 3g to 4g. So one way to reduce high blood pressure is to cut back on salt.
Excessive alcohol is another contributor. We don’t ask patients to stop drinking alcohol, but we do ask them to moderate their alcohol intake. A healthy intake is less than 21 units per week for a man and 14 units for a woman.
Significant physical activity, such as jogging, cycling, rowing or swimming at least four or five times a week for 35 to 40 minutes, also helps.
If those measures don’t work, medication will have to be considered.
Why would the measures in the last point not work for some people?
Quite often people don’t put the effort in. Or when they do, the blood pressure lowering is insufficient, so medication is sometimes necessary. I see a lot of people who are fit and well, apart from having high blood pressure, but it turns out that they have a family history of it.
What are the symptoms of high blood pressure?
People argue that there are very few symptoms of high blood pressure but experience has taught us that patients can present with a lot of non-specific symptoms. A common one is headaches or tightness of the skull. Some patients also have disturbed vision.
A stroke or heart attack can sometimes be the first warning of high blood pressure, hence the term ‘the silent killer’. The first time we see some patients is when they come into hospital with kidney failure, because of untreated high blood pressure. And we get younger people who sometimes just don’t acknowledge the dangers of high blood pressure.
Are there any home tests you can buy?
There are a number of digital devices that are validated by the British Hypertension Society to be highly accurate. They are easy to use and cost from £20 from pharmacies.
How does high blood pressure affect your life?
The vast majority of people simply get on with things as normal, with no real complications apart from having to remember to take their medication and maintain a healthy lifestyle.
What side effects can you get from the medication?
Erectile dysfunction, ankle swelling, tiredness and coughing – but some patients have no problems. We do recognise that medicines can cause problems and patients can respond differently, so we try to prescribe the drugs that are best for them.
Dr Mel Lobo is Director of the Barts Hypertension Clinic, Barts Health NHS Trust in London.