High blood pressure (hypertension) happens when the force on the walls of blood vessels from the blood within them is more than normal. This means the heart has to work harder and the blood vessels are under more strain, making it a major risk factor for heart disease, stroke and other serious conditions.
Blood pressure is literally the pressure in your blood vessels, specifically your arteries - the blood vessels that carry blood away from your heart to your organs, providing them with oxygen. High blood pressure (hypertension) is not a disease or illness. But it does put you more at risk of conditions such as strokes and heart attacks.
How do you know if you have high blood pressure?
Unless your blood pressure is super-high, you won't know unless it is measured. If blood pressure is very high, it can give you symptoms such as headaches. But usually you only know it's 'up' because it has been checked. So who should be checked? Healthy adults should have a blood pressure check at least every five years from the age of 40. It will be checked regularly at a younger age in conditions such as diabetes mellitus, pregnancy or kidney diseases. It will be checked more frequently (every 6-12 months) as you get older, if you have had high or borderline readings in the past, or if you have diabetes.
You can read more about symptoms of high blood pressure.
How is it blood pressure measured?
A blood pressure machine (sphygmomanometer) is used. A cuff is placed around your upper arm and is then tightened by pumping air into the cuff. It is then gradually let down (deflated) while the pressure readings are taken. This is usually done two or three times over a few minutes. You'll find your blood pressure tends to bob up and down so it's usually checked a few times before any treatment is considered. If you get consistently high readings, you may be asked to have this done with a special machine which measures blood pressure regularly over a 24-hour period.
Learn more about having your blood pressure checked in the diagnosis section.
What do the blood pressure numbers mean?
There are two numbers to blood pressure, a top number and a bottom number. Both are important. Ideally, for most people, you want your top number to be 140 or less, and you want your bottom number to be no more than 90. Your doctor may want your blood pressure lower if you have other medical conditions.
Read more about what the numbers represent, and what levels need treatment in the diagnosis section.
Why is my blood pressure high?
Most of the time, nobody knows. It is very common, and some people are just prone to it. In some cases there is a specific cause or risk factor. You can read about the cause of high blood pressure.
Why does high blood pressure matter?
With your blood vessels and heart under strain due to increased pressure, you are more at risk of all sorts of serious health problems, such as heart attacks, strokes, kidney damage and eye damage. If your blood pressure is reduced, by lifestyle changes and/or medicines, you can reduce your risks of all these conditions. Fairly obviously, this improves your chances of living with good health into a ripe old age. Read more about the health risks associated with high blood pressure in the symptoms section.
Can I get my blood pressure down without taking medication?
Sometimes there is quite a bit you can do with lifestyle changes, and in some people this may help them to avoid medication. In particular, the following help:
- Losing weight if you are overweight.
- Reducing the salt you have in your food.
- Taking regular exercise.
Stopping smoking doesn't reduce your blood pressure as such, but smoking and high blood pressure put you at risk of the same conditions. So if you can quit smoking, you'll reduce your risk of strokes, heart attacks, etc.
Read more about lifestyle treatments for high blood pressure.
What if I need medication to lower my blood pressure?
There are hosts of different medicines for high blood pressure. They work in various different ways. Your doctor will advise on the best one for you. If it doesn't work, or you get side-effects, there are plenty of other options. The idea is to get you on one or more pills which suit you, and which control your blood pressure. Once you and your doctor have cracked it, you'll need to keep taking your medication long-term to make sure you stay protected. Your blood pressure will be checked regularly and medication adjusted if need be.
Read more about medication for high blood pressure.
Further reading and references
Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults; Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, 2017
Hypertension: management of hypertension in adults in primary care; NICE Clinical Guideline (August 2011)
Guidelines for the management of arterial hypertension; ESH/ESC Clinical Practice Guidelines, European Society of Cardiology (2013)
He FJ, Li J, Macgregor GA; Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials. BMJ. 2013 Apr 3346:f1325. doi: 10.1136/bmj.f1325.
Description of the DASH (Dietary Approaches to Stop Hypertension) Eating Plan; National Institutes of Health
Ettehad D, Emdin CA, Kiran A, et al; Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet. 2016 Mar 5387(10022):957-67. doi: 10.1016/S0140-6736(15)01225-8. Epub 2015 Dec 24.
Alcohol Guidelines Review – Report from the Guidelines development group to the UK Chief Medical Officers; Department of Health, January 2016
2016 European Guidelines on cardiovascular disease prevention in clinical practice; European Society of Cardiology (2016)
So my sister is battling with hypertension. She has had 120+ ops in 18 months. The biggest lately is a craniectomy and it hasnt worked. Im not looking for sympathy... I want to know there is an end...jean070586
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