High blood pressure - diagnosis & treatment
High blood pressure, also called hypertension, causes a significant risk to a person's health, including a higher risk of stroke and heart attack. However, high blood pressure rarely causes any obvious symptoms.
Around 30% of people have hypertension, but many of them don’t know it.
High blood pressure is usually identified during a general check-up or doctor's appointment.
How do I know if I have high blood pressure?
Adults should have their blood pressure checked at least every five years.
Your doctor or practice nurse will check your blood pressure with a blood pressure cuff. It's important to pay attention to both the higher (systolic) and the lower (diastolic) numbers in your blood pressure readings. While high diastolic readings were once thought to be the most harmful to the body, it's now known that high systolic readings - greater than 140 - are dangerous, especially in adults over age 50. Systolic blood pressure is a much more important heart disease risk factor than diastolic pressure.
Lifestyle changes to treat high blood pressure
Making lifestyle adjustments is key to maintaining normal blood pressure. Most doctors will suggest lifestyle changes before recommending medication. Lifestyle changes are also the recommended treatment for people whose readings are higher than the recommended 120/80 mmHg but do not amount to hypertension. These changes include:
- Lose weight. Losing excess weight can help decrease your blood pressure. If you're overweight, work with your doctor to design a safe weight loss plan to get closer to your ideal weight.
- Eat healthily. Studies show that a diet low in salt and fat and high in fruits and vegetables can significantly lower blood pressure.
- Exercise. Regular aerobic activity such as brisk walking on most days of the week can lower blood pressure.
- Limit alcohol. The latest UK guidelines say men and women shouldn't drink more than 14 units a week spread over 3 days or more, with some alcohol-free days. A standard glass of wine is 2.1 units and a pint of beer is around 2 units.
- Reduce stress. Emotional factors do play a role in blood pressure. Studies show that relaxation techniques such as meditation, yoga or even therapy to change reactions to stress may reduce blood pressure.
- Stop smoking. Although smoking doesn’t directly cause high blood pressure it does increase the risk of stroke and heart attack.
Women should discuss with their doctor the increased risk of high blood pressure from taking oral contraceptives - especially if they're over 35 and overweight.
See a doctor for an accurate diagnosis and treatment plan for high blood pressure. While hypertension cannot be cured, it can be effectively treated.
Medications to treat high blood pressure
Sometimes high blood pressure requires medication, either because of its severity or because it doesn't respond adequately to lifestyle changes and self-help measures. Blood pressure medication usually needs to be taken for life. A number of drugs can be used alone or in combination to treat high blood pressure:
- Diuretics ('water pills') rid the body of salt and excess fluids.
- Calcium-channel blockers reduce blood pressure by dilating blood vessels.
- Angiotensin-converting enzyme (ACE) inhibitors block factors that cause blood vessels to constrict, which makes vessels dilate and thus reduces blood pressure. These drugs can decrease the risk of kidney disease, heart disease, and stroke, and are especially useful in people with heart disease or diabetes.
- Angiotensin II receptor blockers (ARBs) work in a similar way to ACE inhibitors.
- Alpha1-adrenergic blockers and centrally acting agents lower blood pressure by relaxing and dilating arteries.
- Beta-blockers make the heart beat more slowly and with less force. These are particularly effective in people with heart disease.