What is high blood pressure?
High blood pressure (hypertension) is a potentially fatal long-term medical condition that affects around one third of UK adults. It affects both men and women and people of all ethnic backgrounds and socio-economic groups, with some variations in frequency. Men are slightly more likely to be affected than women and people of Afro-Carribean origin and from economically deprived areas are also more vulnerable to the condition.
Blood pressure is measured according to two criteria, systolic pressure and diastolic pressure. These are expressed as numbers e.g. 80/120.
Systolic pressure is the force that your heart requires to pump blood around your body. Diastolic pressure is the resistance to the blood flow in the blood vessels.
- Optimal healthy blood pressure is 80/120
- Prehypertension is a reading between 120/80 and 140/90
- Hypertension (high blood pressure) in patients under the age of 80 is a reading over 140/90
Suffering from high blood pressure raises your risk of strokes, heart attacks, heart disease, kidney disease and other serious medical conditions. High blood pressure can be reduced and managed by making changes to your lifestyle and sometimes by taking prescription medications like Ramipril.
Causes of high blood pressure
There are three main causes of high blood pressure or hypertension:
Genetic: If other people in your family have high blood pressure, you are more at risk of developing the condition.
Lifestyle: Leading a sedentary life, obesity, smoking, alcohol abuse, using cocaine, ecstasy, or methamphetamine, lack of sleep, and eating a poor diet can all cause high blood pressure.
Medical causes: The following medications may cause high blood pressure as a side effect.
- Angiogenesis inhibitors
- Antidepressants (including venlafaxine, bupropion, and desipramine)
- Ephedra and many other herbal products
- Oestrogens (including birth control pills)
- Migraine medicines
- Nasal decongestants
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Testosterone and other anabolic steroids and performance-enhancing drugs
Even a small reduction in your blood pressure can reduce the risks of further serious complications and a possible early death. Regardless of the causes of your high blood pressure, your doctor will probably recommend improvements to your diet and lifestyle in addition to any other treatment. These may include losing weight, giving up smoking, drinking less alcohol, taking more exercise, consuming less salt and caffeine, and ensuring that you get adequate sleep.
Symptoms of high blood pressure
One of the reasons why high blood pressure (hypertension) is so dangerous is that it often doesn’t cause any noticeable symptoms. Blood pressure is known as the ‘silent killer’ and an estimated 50% of UK sufferers do not know that they have hypertension. Unless you are checked regularly, you may not realise that you have the condition. The first indication could be a sudden medical emergency like a stroke, heart attack, or an aortic aneurysm.
When physical symptoms of high blood pressure do occur they may include:
- Bad headaches
- Unexplained tiredness or confusion
- Vision problems
- Chest pains
- Difficulty breathing
- Irregular heartbeat
- Blood in your urine
- Pounding sensations in your chest, neck, or ears
If you experience any of the above symptoms, you should get tested for high blood pressure as a priority. The test is painless and only takes a minute. If you haven’t experienced any of the above symptoms, you may still be at risk. If you are obese, smoke, drink alcohol to excess, lead a sedentary life, use illegal drugs, have a family history of hypertension, or are of Afro-Carribean origin, you should speak to your GP or nurse about an annual test.
Diagnosis of high blood pressure
High blood pressure can be diagnosed and monitored by a simple test. In the UK blood pressure tests can be performed by your GP, nurse, healthcare assistant, self-service machine, or in some chemists shops. There are also home testing kits available. The traditional method of testing blood pressure involved an inflated cuff around the upper arm, a stethoscope, and a pump and dial. This may still be used by some GPs. More modern methods include electronic devices with sensors and digital displays.
Anxiety and physical exertion can temporarily raise your normal blood pressure. It is best to sit quietly for at least five minutes before you are tested, breathing naturally and trying to relax. You may be tested again at the end of a consultation if your blood pressure seems higher than expected. Some people are naturally nervous or stressed during medical appointments and only relax when they are ending. If you appear to have high blood pressure you may be asked to do additional ambulatory testing at home. This involves wearing a 24 hour monitor to give a more accurate assessment of how high your blood pressure is on a day to day basis. The NHS recommends that healthy adults are tested at least every five years. At risk adults should be tested annually.
Treatments for high blood pressure
If you suffer from high blood pressure or prehypertension, your doctor will immediately question you about your lifestyle and may recommend several changes. These often include losing weight, eating less salt (particularly processed foods that contain high levels of salt) giving up smoking, cutting back on alcohol and caffeine, avoiding recreational drugs, and taking more exercise (possibly under medical supervision).
It may be that lifestyle changes alone will not be enough to reduce your blood pressure to a safe level, or may not do so quickly enough. If necessary your doctor will prescribe you with medication to manage your blood pressure. If you are under the age of 55 you may be offered an ACE inhibitor like Ramipril or an angiotensin-2 receptor blocker (ARB). If you’re over 55, or you’re of African or Afro-Carribean origin (regardless of age) you’ll probably be prescribed a calcium channel blocker. It may be necessary to take blood pressure medication for the rest of your life.
Doktor ABC’s online GPs may be able to prescribe the ACE inhibitor Ramipril to patients under the age of 55 who are suffering from high blood pressure. Begin your order by completing a short medical questionnaire to ensure that the medicine is appropriate for your needs. You will only be prescribed Ramipril if it is safe for you to use.
Prevention of high blood pressure
High blood pressure is often genetic and susceptible individuals may not be able to prevent it from occurring, although they may be able to reduce its severity by leading a healthy lifestyle and taking prescription medication.
Lifestyle induced high blood pressure can usually be avoided by leading a healthy life:
- Eat sensibly, exercise regularly, and do not allow yourself to become obese.
- Avoid foods that are high in salt. Read the labelling on processed foods that may have ‘hidden’ high salt levels.
- Don’t smoke, give up smoking if you already are a smoker.
- Don’t drink alcohol or caffeine to excess.
- Do not use cocaine, ecstasy, or methamphetamines.
- Get your blood pressure checked regularly and act on any warning signs.