High blood pressure or hypertension is one of the most common and important cardiovascular risk factors. It is sometimes labeled a “silent killer” because hypertension normally does not cause any alarming symptoms, but over time can lead to a significant damage. In England, 30% people suffer from high blood pressure and many of them are unaware of any problem. The patients with hypertension are at high risk of heart attack or stroke if left untreated. Everybody should therefore get their blood pressure checked at least every five years or during any GP consultation.
Some people have high blood pressure readings only in hospital or GP surgery due to stress and anxiety and their blood pressure taken at home is perfectly within limits; this is called 'white-coat hypertension' (even if not many doctors wear white coats nowadays!) The gold standard diagnostic test is therefore 24-hour blood pressure monitoring or home blood pressure monitoring which eliminates the stress due to medical environment.
If blood pressure is high, the heart has to pump harder to overcome the resistance which leads over time to thickening of the heart muscle (LVH, left ventricular hypertrophy) that can be diagnosed with ECG or echocardiogram. Arteries in the body often develop atherosclerosis which contributes to elevated risk of heart attack, stroke, kidney disease and many other conditions.
Blood pressure measurements are given as two figures: systolic blood pressure and diastolic blood pressure. Systolic blood pressure indicates the pressure taken at the point when the heart contracts to pump the blood into the arteries and diastolic blood pressure indicates the pressure when the heart relaxes. Blood pressure is measured in millimeters of mercury (mmHg). When you hear from your doctor that your blood pressure is e.g. 130/80 mmHg, it means your systolic blood pressure is 130 mmHg and the diastolic blood pressure is 80 mmHg. High blood pressure refers to the reading 140/90 mmHg or above.
The risk of high blood pressure increases with the advancing age, obesity, smoking, stress, African or Caribbean descent, family history of hypertension, diet high in salt and poor in fruits and vegetables, alcohol excess, lack of physical activity and diabetes mellitus. If you have one or more of the above conditions, try to modify your lifestyle to prevent the development of high blood pressure. You should also get your blood pressure checked more often than the standard 5 year interval.
There are many things you can do to prevent the onset of high blood pressure:
If you have been diagnosed with hypertension, your GP or consultant will advise you to modify your lifestyle and to take medicines if appropriate. The most common classes of antihypertensives are ACE inhibitors (lisinopril, perindopril, ramipril), calcium channel blockers (amlodipine, felodipine, diltiazem) and diuretics (indapamide, bendroflumethiazide).