High Blood Pressure Treatment

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About

What is high blood pressure?

High blood pressure, or hypertension, means the pressure in the arteries is too high and the heart an arteries are working too hard to pump blood around the body. Blood pressure is measure by 2 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 measured as 140/90 mmHg (millimetres of mercury) or higher.

What causes high blood pressure?

The exact cause of high blood pressure is unknown, but certain things will increase your risk factor. 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 detected via an appointment with a doctor or nurse.  Adults over the age of 40 should have their blood pressure checked at least every 5 years to avoid dangerous complications.

How do you feel when you have high blood pressure?

You would usually not be able to tell if you have high blood pressure until it triggers something serious, such as a heart attack or stroke. 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 needs to be checked regularly to be diagnosed as high. Blood pressure of 140/90 mmHg or higher is considered too high.

Treatment

How is high blood pressure treated?

Medicines are used to treat high blood pressure where lifestyle changes are not enough to lower it alone. The type of medicine prescribed to you will depend on several factors, including your age, ethnicity and blood pressure level. Angiotensin II receptor blockers (ARBs) work by blocking the reception of the hormone angiotensin II, which plays a role in the narrowing of blood vessels and the retention of salt and water, helping blood vessels to relax. Angiotensin converting enzyme (ACE) inhibitors also work by blocking the mechanism of angiotensin II, as do Beta-blockers, which also slow the heart rate. Diuretics are sometimes prescribed in combination with the ACE inhibitor Enalapril, and work by relaxing the walls of blood vessels to allow blood to flow more easily. Finally, calcium channel blockers are prescribed to inhibit the role of calcium in causing blood vessels to constrict. 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 6 g of salt per day, and should include plenty of fruit, vegetables and wholegrains. There’s no need to avoid fatty or sugary foods completely, but try to keep a balanced diet by not eating them in excessive amounts. This is particularly important if you are overweight, as you will be at higher risk of developing high blood pressure. You can speak to a doctor or nurse about how to lose weight healthily and safely, and how you can maintain a healthy body mass index (BMI). Too much caffeine can increase your blood pressure, and you are advised to drink no more than 4 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 you heart healthy and strong, relieving pressure on your arteries, and making sure you get a good night’s sleep will keep your blood pressure low 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 6 g per day. Try cutting back on fatty foods and include plenty of fruit, vegetables and wholegrains 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?

It is up to a doctor to decide whether you need treatment for high blood pressure and whether it will be beneficial for you. In many cases, making the appropriate lifestyle changes is enough to lower blood pressure. The effectiveness of the treatment also depends on your personal medical record and whether it is accompanied by a healthy lifestyle changes, and you will need to go for regular check-ups to make sure treatment is working.

Which high blood pressure treatment is right for me?

Different treatments for high blood pressure are better suited to different people, and 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 who are over the age of 55 or of Afro-Caribbean origin, in which cases Calcium-channel blockers or Beta-blockers would 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. Dr Felix had put together this flow chart to help give you an idea of which treatment might be best for you.

How can diet affect your blood pressure?

One of the leading causes of high blood pressure is too much salt in the diet. Excessive salt can cause cholesterol to build up in your blood vessels, causing them to narrow and consequently leading to a rise in blood pressure. 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 the amount of saturated fats you eat and fill your diet with healthy fibre, including fruit, vegetables and wholegrains. 

Does exercise reduce your blood pressure?

Regular exercise is vital for lowering 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 in to your daily routine.

How can I lower my blood pressure quickly?

The first step to lowering your blood pressure is to make some lifestyle changes, which are 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 5 years to avoid developing further complications. Serious complications of high blood pressure include:

  • Heart disease, heart failure and 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 includes 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 whether this can lead to high blood pressure in the long run in unknown. 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 eating too much.

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. Stress alone is unlikely to be the cause of high blood pressure or of further health 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?

High blood pressure is diagnosed by calculating systolic over the diastolic blood pressure, which are both measured in millimeters 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 at 140/90 mmHg or higher.

What does my blood pressure reading mean?

If you have a blood pressure reading of 14o0/90 mmHg or higher, you will be diagnosed as having high blood pressure. Low pressure is measured at 90/60 mmHg or lower. 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, and is believed to occur due to the anxiety some patients experience in a clinical setting such as a hospital or a doctor’s office. Doctor’s rarely prescribe treatment after one reading, as this can lead to hypotension (low blood pressure), which can also be dangerous. For patients displaying ‘white coat syndrome’, a doctor may recommend an at-home blood-pressure monitor, or refer to a blood pressure clinic.

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