High Blood Pressure Treatment

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Dr Samantha Miller

Reviewed by Dr Samantha Miller MB ChB
(2017, University of Glasgow)
GMC number: 7561464

Information last reviewed 06/08/2021

About

What is high blood pressure?

High blood pressure, or hypertension, is a medical condition characterised by a higher than normal pressure in the arteries. This means the heart and arteries are working too hard to pump blood around the body. Blood pressure is measured by two numbers: the systolic pressure or the force at which your heart pumps blood around the body, over the diastolic pressure, the resistance to the blood flow in the vessels. High blood pressure is generally defined as anything above 140/90 mmHg (millimetres of mercury). You can find out your blood pressure through your GP practice, or using a home blood pressure monitor.

What causes high blood pressure?

The exact cause of high blood pressure is unknown, but certain things will increase your risk factor. For example, you may be at higher risk of developing high blood pressure if you:

  • Are overweight or obese
  • Are over the age of 65
  • Are of African or Caribbean descent
  • Have a family history of high blood pressure
  • Eat too much salt and not enough fruit and vegetables
  • Don’t do enough exercise
  • Drink too much alcohol or caffeine
  • Smoke
  • Don’t sleep enough, or sleep badly

Is high blood pressure dangerous?

If uncontrolled, high blood pressure can be very dangerous. The extra strain can cause damage to blood vessels in the heart, brain, kidneys and other organs.

Symptoms

What are the symptoms of high blood pressure?

High blood pressure rarely has symptoms and is usually detected via routine measurement with a doctor or nurse. Adults should have their blood pressure checked at least once every five years to screen for hypertension.

How do you feel when you have high blood pressure?

You would usually not be able to tell if you have high blood pressure unless it triggers something serious, such as a heart attack or stroke. However, in rare cases, severe high blood pressure can cause nosebleeds, headaches and dizziness.

How is high blood pressure diagnosed?

Since symptoms are rare, blood pressure should be checked regularly, particularly in people with risk factors for hypertension, such as people who are overweight or over the age of 65. A blood pressure of 140/90 mmHg or higher is considered to be high.

Treatment

How is high blood pressure treated?

Mild high blood pressure is often initially managed with lifestyle changes. These may include improving diet, introducing or increasing exercise, reducing alcohol intake, reducing salt intake, stopping smoking and losing weight. For those whose blood pressure is not optimised with lifestyle changes alone, or for those at greater risk of complications of hypertension, medication may be recommended.

If medication is recommended, the optimal type will depend on several factors, including your age, ethnicity and blood pressure level. The most common types of medication used to treat high blood pressure are angiotensin-converting enzyme (ACE) inhibitors, angiotensin-II receptor blockers (ARB), calcium channel blockers, beta-blockers and diuretics. A doctor will be able to give you advice on which type of high blood pressure medication is right for you.

How to prevent high blood pressure?

The best way to prevent high blood pressure is to maintain a healthy lifestyle. Your diet should contain no more than 6g of salt per day and include plenty of fruit, vegetables and whole grains. You should also aim to maintain a healthy weight and body mass index (BMI). Too much caffeine can increase your blood pressure, and you are advised to drink no more than four cups of coffee per day. While smoking doesn’t directly increase your blood pressure, it does greatly increase your risk of experiencing a heart attack and stroke by causing your arteries to narrow. Finally, regular exercise will keep your heart healthy and strong, relieving pressure on your arteries, and making sure you get a good night’s sleep will keep your blood pressure optimal and improve your overall wellbeing.

Tips to reduce your blood pressure

There are some changes you can make to your lifestyle which will help you to reduce your blood pressure. A major cause of high blood pressure is a high salt intake, so try and limit the amount of salt in your diet to below the recommended maximum of 6g per day. Try cutting back on fatty foods and include plenty of fruit, vegetables and whole grains in your diet. If you haven’t already done so, quit smoking, and limit your alcohol intake to below the recommended maximum of 14 units per week. Regular exercise keeps your heart and blood vessels healthy and can also help to reduce your stress levels. Stress can exacerbate high blood pressure, so finding ways to reduce its impact on your life is important. Try and find the time to relax in your daily life, by taking walks and spending time with friends and family.

How effective are high blood pressure treatments?

In many cases, making the appropriate lifestyle changes is enough to lower blood pressure. The effectiveness of pharmacological treatments depends on your medical background, which medication you are recommended, and whether you’re able to adhere to a healthy lifestyle. If a particular medication is not effective, your doctor may advise a different medication instead of, or in addition to, your initial regime.

Which high blood pressure treatment is right for me?

Different treatments for high blood pressure are better suited to different people. Medications will be prescribed by a doctor based on your personal condition, medical history, and whether you’ve previously experienced side effects of a particular treatment. For example, ARBs and ACE inhibitors are often less effective in patients over the age of 55 or of Afro-Caribbean origin, in which cases calcium-channel blockers may be a better option. Patients at high risk of heart problems may need to try diuretics before any other option, while patients with exceptionally high blood pressure may recommend a combination of different treatments. Always speak with your prescriber if you’re not sure what’s right for you, and never take medication without consulting a doctor.

How can diet affect your blood pressure?

One of the leading causes of high blood pressure is too much salt in the diet. For this reason, you should try and limit your salt intake to below the recommended maximum of 6 g per day. You should also cut down the amount of saturated fats you eat, as these fats contribute to cholesterol deposition in the arteries. Cholesterol causes the arteries to narrow, resulting in a higher pressure within.

Does exercise reduce your blood pressure?

Regular exercise is vital for optimising blood pressure. Exercise helps make the heart stronger, allowing it to pump blood with less effort and decreasing the pressure on blood vessels. If you are new to exercise, start slowly and gradually build more physical activity into your daily routine.

How can I lower my blood pressure quickly?

The first step to lowering your blood pressure is often to make some lifestyle changes, intended to have positive long-term results. The rate at which you can expect results depends on your condition, but the body can respond surprisingly quickly to things like diet and exercise. With the right programme, your blood pressure can start to respond within just a few weeks.

Side Effects

What are the risks of high blood pressure?

High blood pressure increases the risk of developing potentially life-threatening conditions, including heart disease, heart attack, stroke, heart failure, peripheral arterial disease, aortic aneurysm, kidney disease, and vascular dementia.

What are the potential complications of high blood pressure?

Adults over the age of 40 are advised to have their blood pressure checked every five years to screen for hypertension. Serious complications of high blood pressure include:

  • Heart disease
  • Heart failure
  • Heart attack
  • Stroke
  • Peripheral arterial disease
  • Aortic aneurysm
  • Kidney disease
  • Vascular dementia

Q&A

What is the main cause of high blood pressure?

The main causes of high blood pressure are to do with lifestyle. These include being overweight, smoking, drinking too much alcohol, not exercising enough, and having a diet that contains too much salt and saturated fat, and not enough fruit, vegetables and fibre.

Does stress/anxiety cause high blood pressure?

Being stressed can cause your blood pressure to spike temporarily, but it is not known if this can lead to longer-term high blood pressure. If you already have high blood pressure, stress can aggravate your condition. What’s more, your reaction to stress can affect your blood pressure, whether it’s drinking alcohol, smoking, or overeating.

Is stress-related high blood pressure dangerous?

When related to stress, spikes in blood pressure can be dangerous when blood pressure is already consistently high. However, stress alone is unlikely to be the cause of high blood pressure or alone cause complications.

Does high blood pressure increase your risk of stroke?

High blood pressure can damage the blood vessels in many of your vital organs, including the brain. Damage or blocked blood vessels in the brain can obstruct blood flow, leading to a stroke.

What is systolic and diastolic blood pressure?

Blood pressure is calculated by obtaining the systolic and diastolic pressure readings in the arteries by use of a special blood pressure cuff. These values are measured in millimetres of mercury (mmHg). Systolic blood pressure refers to the force at which the heart pumps blood around the body, and diastolic blood pressure refers to the resistance to blood flow in the blood vessels. High blood pressure is diagnosed where the blood pressure is 140/90 mmHg or higher.

What does my blood pressure reading mean?

If you have a blood pressure reading of 140/90 mmHg or higher, this means you have high blood pressure or hypertension. Anything between 90/60 mmHg and 120/80 mmHg is considered ideal blood pressure.

I have ‘white coat syndrome’ how should I reliably check my blood pressure?

“White coat syndrome” describes the phenomenon when a patient’s blood pressure reads as higher than usual when in a medical setting, and is believed to occur due to anxiety. If you have this syndrome, your doctor may recommend an at-home blood pressure monitor or refer to a blood pressure clinic for a more accurate reflection of your blood pressure.

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