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HIGH BLOOD PRESSURE
Causes, Prevention, and Treatment
A Practical guide for the prevention and control of high blood pressure and its complication:
An Invaluable source of information to help you stay healthy and live longer…
INTRODUCTION: High Blood Pressure is also known as hypertension is one of the most common conditions affecting the population of adults in the most of the Western World and is becoming common in countries such as India.
BLOOD PRESSURE: The pressure of the arterial blood is regulated by the blood volume, total peripheral resistance, and the cardiac rate. These variables are regulated by a variety of negative feedback control mechanisms to maintain homeostasis. Arterial pressure rises and falls as the heart goes through systole and diastole.
“Acute Disease is an act of God, of chronic Disease the patient himself is the author”
Thomas Sydenham
1624-1689
Hypertension (High Blood Pressure): A threat to Human Health
There are three main organs that bear the brunt of the damage caused by untreated hypertension- the Heart, The Brain and the Kidneys.
Facts about Blood Pressure
Let us look at some several general facts about high blood pressure.
· A silent Killer: It is so unfortunate that mostly high blood pressure shows few obvious or visible symptoms, and therefore, Researchers and Doctors call it silent killer.
· A Lifestyle Disease: due to lack of Physical Exercise, smoking, obesity and high salt intake are some of the reasons for high blood pressure
What is high blood pressure?
You probably have high blood pressure (hypertension) if your blood pressure readings are consistently 140 over 90, or higher, over a number of weeks. You may also have high blood pressure if just one of the numbers is higher than it should be over a number of weeks.
If you have high blood pressure, this higher pressure puts extra strain on your heart and blood vessels. Over time, this extra strain increases your risk of a heart attack or stroke.
If you have high blood pressure, this higher pressure puts extra strain on your heart and blood vessels. Over time, this extra strain increases your risk of a heart attack or stroke.
High blood pressure can also cause heart and kidney disease, and is closely linked to some forms of dementia.
You can check your blood pressure on our Blood Pressure Chart.
High blood pressure usually has no signs or symptoms, so the only way to know if you have high blood pressure is to have yours measured. However, a single high reading does not necessarily mean you have high blood pressure. Many things can affect your blood pressure through the day, so your doctor will take a number of blood pressure readings to see that it stays high over time.
Occasionally people with very high blood pressure say they experience headaches, but it is best to visit your GP if you are concerned about symptoms.
Occasionally people with very high blood pressure say they experience headaches, but it is best to visit your GP if you are concerned about symptoms.
For most people, there may be no single cause for their high blood pressure. We do not know exactly what causes high blood pressure. We do know that your lifestyle can affect your risk of developing it. You are at a higher risk if:
- you eat too much salt;
- you don’t eat enough fruit and vegetables;
- you are not active enough;
- you are overweight; or
- you drink too much alcohol.
You can help to lower your blood pressure - and your risk of stroke and heart attack - by making lifestyle changes.
How to lower your blood pressure
An unhealthy lifestyle will raise your blood pressure over time. And the higher your blood pressure becomes, the higher your risk of having a stroke or heart attack in the future.But the good news is that if you have high blood pressure, healthy changes will help to bring it down. And you don't have to wait until you have high blood pressure to make healthy lifestyle changes. The more you can reduce your blood pressure, the lower your risk of a heart attack or stroke will be.
1. Blood Pressure Diet - Eat less salt
Too much salt raises your blood pressure, so it is important to eat as little as possible. In fact, some people with high blood pressure may be able to avoid blood pressure medicines by cutting down on salt.Most of the salt you eat is not what you add to your food, but is in prepared foods like bread, breakfast cereals and ready meals.
Don’t add salt to food when cooking or at the table. When shopping for food, check the labels and choose low-salt options when you can.
2. Blood Pressure Diet - Eat more fruit and vegetables
Eating more fruit and vegetables helps to lower your blood pressure. Adults should eat at least five portions of fruit and vegetables every day. A portion is 80 grams, or roughly the size of your fist.Try to eat a range of different fruits and vegetables. Dried, frozen and tinned are fine, but watch out for added salt, sugar or fats.
3. Blood Pressure Diet - Keep to a healthy weight
Losing weight, if you need to, will help lower your blood pressure and reduce your risk of health problems. The best way to lose weight is to choose more low-fat and low-calorie foods, and increase your physical activity.Set yourself realistic goals. Make small changes to your eating habits and activity levels that you can keep to for life.
4. Blood Pressure Diet - Drink less alcohol
If you drink too much alcohol, this will raise your blood pressure over time. The current recommended limits are 14 units of alcohol a week for men and women. A unit is roughly half a pint of beer or cider, a small glass of wine, or a single pub measure of spirits.If you keep to the recommended alcohol limits, this should help keep your blood pressure down.
5. Blood Pressure and Exercise - Get more active
Being moderately active for 30 minutes five times a week can keep your heart healthy, and can lower your blood pressure. If you can’t find 30 minutes in your day, increasing your activity by even a small amount can help.Think about how you can be more active in your daily life. Any activity that leaves you feeling warm and slightly out of breath is ideal.
There are some factors that increase your risk of developing high blood pressure, which you cannot control. These include:
- Age: as you get older, the effects of an unhealthy lifestyle can build up and your blood pressure can increase.
- Ethnic origin: people from African-Caribbean and South Asian communities are at greater risk than other people of high blood pressure.
- Family history: you are at greater risk if other members of your family have, or have had, high blood pressure.
Some people may have high blood pressure that is linked to another medical condition, such as kidney problems. For these people treating the medical problem may lower their blood pressure back to normal.
What is normal blood pressure?
Ideally, we should all have a blood pressure below 120 over 80 (120/80). This is the ideal blood pressure for people wishing to have good health. At this level, we have a much lower risk of heart disease or stroke.If your blood pressure is optimal, this is great news. By following our healthy living advice, you will be able to keep it this way.
If your blood pressure is above 120/80mmHg, you will need to lower it.
Most adults in the UK have blood pressure readings in the range from 120 over 80 (120/80) to 140 over 90 (140/90). If your blood pressure is within this range, you should be taking steps to bring it down or to stop it rising any further. Our five top tips will show you how.
The reason why people with blood pressure readings in this range should lower it, even though this is not classified as 'high' blood pressure, is that the higher your blood pressure, the higher your risk of health problems. For example, someone with a blood pressure level of 135 over 85 (135/85) is twice as likely to have a heart attack or stroke as someone with a reading of 115 over 75 (115/75).
What is low blood pressure?
Some people have a blood pressure level that is lower than normal. In general this may be good news - because the lower your blood pressure is, the lower your risk of stroke or heart disease. However, in a few cases, having low blood pressure can cause problems, so you might need to speak to your doctor or nurse.
A low blood pressure reading is having a level that is 90/60mmHg, or lower.
Only one of the numbers has to be lower than it should be to count as low blood pressure. In other words:
- if the top number is 90 or less (regardless of the botton number) this may be low blood pressure
- if the bottom number is 60 or less (regardless of the top number) this may be low blood pressure.
Some people have a blood pressure level that is naturally low. That is, there is no specific cause or reason why.
However, some health conditions or medicines can cause you to develop low blood pressure.
Usually, having low blood pressure is not a cause for concern. However, sometimes your blood pressure can drop to a point where you may feel faint or dizzy.
If you find that your blood pressure is suddenly much lower than usual, there may be a reason for this. Speak to your doctor or nurse.
Most people with low blood pressure will not need treatment.
If your doctor or nurse feels that you would benefit from treatment, they will often try to find a cause for your low blood pressure. If they can find the cause, they should be able to decide on the most appropriate treatment for you.
Types of blood pressure medicine
There is a wide range of high blood pressure medicines. You can take more than one type of medicine because they each lower your blood pressure in different ways.
There are four main types of medicine that doctors use to treat high blood pressure:
ACE inhibitors: these medicines help to control hormones that affect blood pressure. Most of these medicines have names that end in “pril”
Angiotensin receptor blockers (or ARBs): these also control hormones that affect blood pressure. Most of these medicines have names that end in “artan”
Calcium channel blockers: these medicines make the artery walls relax, making them wider, which lowers blood pressure. Most of these medicines have names that in “pine”
Thiazide diuretics: these medicines remove unwanted fluid from the body, which helps lower blood pressure. Most of these medicines have names that end in “ide”.
Other types of blood pressure medicines
Until recently another type of drug, called beta-blockers, were often given to people with high blood pressure. Beta-blockers are not usually given as a first choice because the other types of blood pressure medicines appear to be better at reducing your risk of heart disease and stroke. However, they may still be used if you have other health problems, because beta-blockers can be used to control those conditions. More on beta blockers...There are other types of drugs which are not very commonly used, but which can help to lower your blood pressure (see below). These blood pressure medications may be used in special cases – for example if you are pregnant, or if you cannot take the medicines described above. Your doctor will decide which medications are best for you.
Renin inhibitors
Non-standard blood pressure medicines
Combination blood pressure medicines
Taking more than one blood pressure medicine
Many people will need to take more than one medicine to fully control their blood pressure. This is because each type of medication works in a different way. None of them can control your blood pressure completely.As one medicine lowers your blood pressure, your body may try to use another way to raise it. You may then need to take other medicines to control these different ways your body is trying to use to raise your blood pressure.
This means that some people with high blood pressure may need to take two or three different medications, or sometimes even more.
Side-effects of blood pressure medications
A side-effect is any unwanted effect of medicines that you are taking. Some people can have side-effects from blood pressure medicines. Although these can be uncomfortable, they are usually not dangerous. They sometimes wear off over time, or your doctor or nurse can adjust your medicines to get rid of them.
Do all blood pressure medicines have side-effects?
Any medicine can have side-effects, and blood pressure medicines are no different. This does not mean that you will definitely have side-effects from your medicines. Most people who take blood pressure medicines will have no problems at all.There is usually no way to know if you will have side-effects from your medicine. If you do, you will usually notice them soon after starting a new medicine, or if the dose of your medicine is increased.
Different people can have different side-effects from the same medicine. For example, some people taking ACE inhibitors can have a dry cough. Other people taking the same medicine may have no cough, but may feel dizzy or have an upset stomach.
If you have problems with one medicine, this does not mean that all blood pressure medicines will give you side-effects. Other medicines may help your blood pressure with no difficulties at all.
How can I tell if what I am feeling is a side-effect?
Most medicines will come with an information leaflet which will have a list of known side-effects. These lists are often very long, but no one will ever have all of the difficulties mentioned. If you are worried about your medicines, it is best to speak to your doctor, nurse, or pharmacist.Sometimes what you think is a side-effect may be something else. For example, your blood pressure medicines could be reacting with other medicines you are taking. Make sure your doctor or nurse knows about all the medicines you are taking. This includes herbal medicines and over-the-counter treatments like cold remedies.
Other times, what you are feeling may not be related to your blood pressure medicines at all. What you may think is a side-effect could easily be a virus or infection.
How can I get rid of side-effects?
If you are having side-effects, you may be tempted to stop taking your medicines. Do not do this without speaking with your doctor or nurse. Stopping your medicines will raise your blood pressure again, putting you at risk of serious health problems.Many side-effects wear off after time, as your body adjusts to the medicine you are taking. If they are minor, then you may be able to put up with them to keep your blood pressure under control. But if they make it difficult for you to carry on with your daily life, then your doctor or nurse can help.
You may be able to take a lower dose of your medicine, on its own or together with another medicine. Taking two or more medicines at lower doses may be as effective at lowering your blood pressure as one medicine at a high dose, and would be less likely to cause you side-effects.
Alternatively, your doctor or nurse may change your medicines entirely. There is a wide range of blood pressure medicines available, and just because one medicine gives you side-effects does not mean that they all will.
If you are having great difficulty controlling your blood pressure without side-effects, your GP may suggest an appointment with a blood pressure specialist. A specialist can often help you get the right balance between good control of your blood pressure, and possible problems with your medicines.
Reporting side-effects
Any medicine can have side-effects, but some of these will not be noticed until many people have used the medicine over a long time. The Yellow Card scheme allows you to report suspected side-effects from any medicine that you are taking. This is especially useful if you are taking a newer medicine. The scheme is run by the Medicines and Healthcare products Regulatory Agency (MHRA).References
2. Textbook of Medical Physiology by Dr. John E. Hall
3. Fox Human Physiology Straut Ira Fox
4. High Blood Pressure
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