Blood pressure basics


Being told by your doctor that you have high blood pressure is never the news you want to hear, but that doesn't mean that the situation is irreversible. While unhealthy habits can force your blood pressure up, making positive changes to your lifestyle can significantly reduce it. Indeed, most people find that by sticking to a healthy lifestyle, they can avoid the more significant step of taking blood pressure lowering medication.

Generally, if your blood pressure level is below 140/90 then you won't require treatment unless any of the following apply;

- You have developed a complication of diabetes, especially kidney problems

- You have a personal history of cardiovascular events such as heart attack, stroke or TIA

- You have certain on-going kidney problems that may affect your blood pressure.

In which case, medication may be considered if your blood pressure is 130/80 or higher.

Medication will always be considered if your blood pressure is consistently 140/90 or higher (or 135/85 for home/ambulatory readings). You're particularly likely to need medication if your doctor considers you to be at high risk of developing cardiovascular disease or if you have a personal history of cardiovascular disease, diabetes or any kind of heart or kidney damage caused by high blood pressure.

In making their recommendation about blood pressure medication, your doctor will always assess your overall risk of developing cardiovascular disease so that a fully informed decision can be made in the context of your general health.

Making the right lifestyle changes

There are several changes you can make to your lifestyle to help reduce your blood pressure, with some of them being effective in a matter of weeks. The first step should be to ensure your salt intake is less than 6g a day, while you should also ensure you eat a healthy balanced diet that is low in fat and sugar and high in potassium. This should include plenty of fresh fruit and vegetables. Do check with your doctor whether increasing the potassium in your diet is safe if you're taking blood pressure medication already. Some blood pressure lowering tablets tend to increase your potassium levels, and it can be dangerous to eat too many potassium-containing foods (including lots of bananas or low sodium foods like LoSalt).

You should also increase your physical activity as this can have a significant impact on blood pressure control, and it will also help you to lose weight if you need to. Cutting down on cigarettes and alcohol can also help bring your blood pressure to a more normal level - as can reducing coffee, tea and cola intake in some people who are sensitive to caffeine. You should also take steps to manage your levels of stress.

Blood pressure medications

If you do need to use medication, there are a wide number of options available. Some people will use more than one drug as a combination will sometimes be more effective than a single medication. While most blood pressure drugs have some degree of side effect, the number of options available means that these can be dealt with simply by changing medications. However, if you experience any of the following you should let your GP know:

  • Drowsiness
  • Kidney pain (on the side of your lower back)
  • Dry cough
  • Dizziness, faintness or light-headedness
  • A skin rash.

In some cases, you may need to take blood pressure-lowering medication for the rest of your life. However, if your blood pressure levels stay under control for several years, especially in response to weight and lifestyle changes, you might be able to reduce or even stop your treatment.

The treatments used include:

  • Angiotensin-converting enzyme (ACE) inhibitors and Angiotensin Receptor Blockers (ARBs), which reduce blood pressure by relaxing your blood vessels
  • Calcium-channel blockers , which keep calcium from entering the muscle cells of the heart and blood vessels. This dilates your arteries (large blood vessels) and reduces your blood pressure
  • Diuretics, which are sometimes known as water pills, work by flushing excess water from the body through urine
  • Beta-blockers , which work by making your heart beat slower and with less force, thereby reducing blood pressure. Beta-blockers used to be a popular treatment for high blood pressure but now they only tend to be used when other treatments have not worked
  • Alpha-blockers, which work by relaxing your blood vessels, making it much easier for blood to flow through them. Alpha-blockers are not usually recommended as a first choice for lowering high blood pressure unless other treatments have not worked.