High Blood Pressure – Causes, Treatment and Measures

Persistently high blood pressure may damage the arteries and the heart. Untreated high blood pressure is the most common cause of a stroke. In the West, at least 1 in 5 people has high blood pressure, also known as hypertension.

High blood pressure is harmful because it puts a strain on the heart and arteries, resulting in damage to delicate tissues. If it’s left untreated, high blood pressure may eventually affect the eyes and kidneys. The higher your blood pressure the greater the risk that complications, such as heart attack, coronary artery disease and stroke, will shorten your life. Lowering your blood pressure even a little can cut your risk of having a heart attack by as much as 20 percent.

Your blood pressure varies naturally during the day with activity, rising when you exercise or feel stressed and falling when you rest and
sleep. It also varies among people, gradually increasing with age and weight.

High blood pressure per se rarely makes you feel ill. A small number of people get headaches but only if their blood pressure is very high. If your blood pressure is that high, you may have dizziness, blurry vision or nosebleeds. Hypertension is sometimes called the “silent killer” because people may have a fatal stroke or heart attack without warning.

However, if you know you have high blood pressure you’re not alone and you’re luckier than many because at least you’re aware that you have it. Over one-third of people with high
blood pressure aren’t being treated and their health is at risk.

What are The Causes of High Blood Pressure

Even though high blood pressure is more common among men there is no single cause All these factors can contribute:

• being overweight
• drinking large amounts of alcohol
• a stressful lifestyle
• excessive salt intake
• physical inactivity
• kidney disease.

In pregnant women, the development of high blood pressure can lead to the potential life-threatening conditions pre-eclampsia and eclampsia, in which the elevated blood pressure usually returns to normal after the birth.

What Might Be Done For High Blood Pressure

1. To detect high blood pressure it’s important to have your blood pressure measured routinely at least every two years after the age of 30.
2. If your blood pressure is more than 140/90mmHg, your doctor will ask you to return in a few weeks so that it can be checked again.
3. A diagnosis of hypertension isn’t usually made unless you have a raised blood pressure on three separate occasions.
4. Your doctor may arrange these other tests:
   heart tests including electrocardiography (ECG) or echocardiography
   eye tests to look for damaged blood vessels
   tests to identify the underlying cause.
   For example, urine and blood tests and ultrasound scanning may be arranged to look for kidney disease or a hormonal disorder.

Are there any Complications?

There is risk of damage to the arteries, heart and kidneys with severe hypertension that’s left untreated. Arteries that have been damaged are at greater risk of being affected by atherosclerosis, in which fatty deposits build up in blood vessel walls, causing them to narrow and restrict blood flow.

After many years, damage to the arteries in the kidneys may lead to chronic kidney failure. The arteries in the retina of the eye may also be damaged by hypertension.

Measuring blood pressure

An inflatable cuff is wrapped around your upper arm and inflated using a bulb. The cuff is slowly deflated while the doctor listens to the blood flow through an artery in your arm using a stethoscope.

Blood pressure is expressed as two figures given in millimetres of mercury (mmHg). The blood pressure of a healthy young person who’s been sitting down for five minutes shouldn’t be more than 120/80mmHg. In general, a person is considered to have high blood pressure when their blood pressure is persistently higher than 140/90mmHg after three readings on separate occasions, even at rest.

140/90 – what it means The pressure when the contraction of the heart forces blood around the body 90 – Diastolic pressure

140 – Systolic pressure The lowest pressure occurring between heartbeats

Will I Need Treatment Straight Away?

The need for treatment is contingent on the level of blood pressure PLUS other risk factors that may damage blood vessels, for example diabetes, continued smoking or being overweight. So, treatment can vary from person to person and isn’t always dependent on a certain level of blood pressure.

• Blood pressure that averages 160/100mmHg or higher over many readings is best treated with drugs (see table, below).
• Mild high blood pressure (between 140/90 and 159/99mmHg) may be checked regularly but not treated if the risk of damage to the arteries is low. This is often the case in young people, particularly in young women.
• On the other hand, mild blood pressure
  is best treated in older people and those who already have symptoms of blood pressure damage, such as those who suffer from angina.
• You’ll probably be checked by your GP for three or six months before starting treatment.
• For mild hypertension the first line of medical treatment is often water tablets (diuretics).

What is the Treatment for High Blood Pressure?

• High blood pressure can’t usually be cured but it can be controlled with treatment. If you have very mild hypertension, changing your lifestyle is often the most effective way of lowering your blood pressure.
• If self-help measures aren’t effective your doctor may prescribe antihypertensive drugs. These drugs work in different ways, and you may be prescribed just one type of drug or a combination of several. There are many drugs for treating blood pressure and they’ll lower your blood pressure gradually over several weeks or months.
• Women with high blood pressure can take HRT and who take the contraceptive pill should have blood pressure checks every six months.

Are There any Side Effects of These Drugs?

Most people will feel well but some will suffer side effects. Fortunately, these are few but one of the most distressing is impotence. If you experience impotence ask your doctor if your tablets could be responsible and whether you can change treatments.

Outlook of High Blood Pressure

In most cases, lifestyle changes and drug treatment can control blood pressure and reduce the risk of complications. You’ll probably have to stick to these measures for the rest of your life.

Self Help

What Changes You Should Make In Your Life Style

You can help yourself a great deal by changing your lifestyle. There’s a strong link between being overweight and having high blood pressure.

If your weight’s above normal for your height, you should aim to lose the extra pounds and bring your blood pressure down You don’t need to aim for an ideal weight. try to be within the healthy range for your height Losing 10kg (221bs) can reduce the bottom figure of your blood pressure by 20 points.

If you can’t lose weight yourself, your doctor may refer you to a dietician for advice on ways to change how and what you eat. You don’t have to give up eating all the food you enjoy Some people find a slimming group or club very helpful to give moral support.

The DO’S

Eat fish, white meat (for example, chicken without the skin), cottage cheese, low-fat yoghurt, semi-skimmed or skimmed milk.

Aim for seven items a day of fresh fruit and vegetables (eat seasonal vegetables and fruit when you can); when fresh vegetables are expensive eat frozen ones instead. When possible, grill food instead of frying it.

A diet containing plenty of fruit, vegetables and grains increases potassium intake, and this can help to lower your blood pressure too.

The DON’TS

Don’t eat butter, cheese and full-fat milk, fried foods and snacks, cakes, biscuits, chocolate and fatty meat.

Do Not Consume Too Much Alcohol

High alcohol intake increases your chance of developing high blood pressure.

• Limit your alcohol to no more than 21 units a week if you’re a man, 14 units if you’re a woman. One unit is equal to a glass of wine OR a half pint of ordinary-strength beer, cider or lager OR a single measure of spirits.
• Try to spread your units evenly over the week and avoid a big drinking session.
• A large amount of alcohol the night before can raise your blood pressure significantly the following day.
• Talk to your doctor if you’re drinking more alcohol than you should and finding it difficult to reduce the amount you drink.

Limit the Intake of Salt

A high salt intake raises your blood pressure about 10 points. Salt can also increase the amount of fluid that you retain in your body.

Fresh food contains very little salt. Most of the salt we eat is in processed foods, or in salt added to food while cooking or at the table.

So to reduce the amount of salt you eat:

• Look at food labels. If it says sodium chloride (NaCl), sodium benzoate or monosodium glutamate then you may be eating extra salt without realizing it.
• Cut down on processed foods. Salt is hidden in many processed foods, e.g. tinned or packet soups, breakfast cereals, bread, tinned or processed fish, crisps, nuts, hamburgers and prepacked meals.
• Look for low-salt bread.
• Cut down on corned beef, hard cheese, ham, bacon and sausages, which contain lots of salt.
• Use salt very sparingly in cooking, if at all.

If you feel that you can’t do without salt, you might try a salt substitute (after checking with your doctor). Rock salt and sea salt are not salt substitutes.

It’s preferable to avoid the taste of salt altogether. You’ll find fairly quickly that your sense of taste adjusts so that you no longer like the taste of salt, especially if you add herbs such as basil, thyme and rosemary to your cooking, which release the natural salts in food.

Exercise

Exercise can help reduce your blood pressure and keep your weight down. It is also a good stress reliever. Stress isn’t always a cause of high blood pressure. It will, however, aggravate raised blood pressure. If you haven’t done any exercise recently, check with your doctor first.

Types of Exercise You Should Do

Any vigorous activity such as walking, swimming, cycling, jogging, dancing or gardening is good for you. The important thing is to choose an activity that you enjoy -if you don’t like a particular form of exercise you’ll find it much harder to do it regularly.

Exercise doesn’t need to be too strenuous either. You should start slowly and build up the amount of exercise that you do. Start by walking briskly. You don’t have to jog unless you wish to. Walk the dog; use the stairs, not the lift, and keep active! Aim to do 20-30 minutes of exercise at least three times a week.

For some people, it isn’t advisable to lift very heavy weights or to do certain very strenuous activities such as playing squash. Check with your doctor first if you’re thinking of taking up a new sport that is very strenuous.

Stop Smocking

Giving up smoking won’t lower your blood pressure directly, but it lowers your risk factors
for high blood pressure by greatly reducing the chance of blood vessel damage that can lead to a heart attack or stroke.

It’s so important that you stop smoking that I suggest you make a plan and prepare yourself to stop. Have an action plan, prepare well, and you’ll succeed.

Your pharmacist, GP or practice nurse can advise on stopping smoking and on aids such as chewing gum and skin patches.