• Hypertension is more commonly known as high blood pressure.
  • Nearly 1 in 3 adults in the UK has high blood pressure and roughly 7 million people who may not be aware they have the condition.
  • Undiagnosed and untreated hypertension may lead to serious health problems, e.g. heart attack and stroke.

What is hypertension?

Our blood pressure is measured and expressed in millimetres of mercury (mmHg), systolic pressure above diastolic pressure. Systolic pressure is the pressure your heart uses to push blood out, whereas diastolic pressure is the resting pressure between heartbeats. Ideal blood pressure is generally between 90/60mmHg and 120/80mmHg, however, hypertension is diagnosed when one has a persistent blood pressure above 140/90mmHg.

The ‘Silent Killer’

High blood pressure is often asymptomatic, which means there could be no symptoms at all. This is why millions of people may have no clue they have it until they have a stroke or heart attack.

In some cases, non-specific symptoms may occur in those who have high blood pressure,

  • Chest pain
  • Blurred vision
  • General tiredness or fatigue
  • Dull headache
  • Feeling light headed and/or vomiting
  • Pale skin colour
  • Nosebleeds

With a significantly raised blood pressure, certain symptoms may start to appear, considered serious symptoms,

  • Severe headache
  • Difficulty breathing
  • Pounding in your chest, neck or ears
  • Ringing or buzzing sound in the ears
  • Chest pain and/or tightness
  • Irregular heartbeat
  • Blood in the urine

It is important for anyone experiencing these to seek medical attention as soon as possible.

Get in the ‘Know’

As symptoms are usually absent, the only way to know if you have hypertension would be through testing. There are plenty of places offering tests,

  • GP surgery
  • Some pharmacies
  • Public health campaigns e.g. NHS health checks, Love Your Heart campaign (February 2019)
  • At home (with a calibrated blood pressure monitor)

High blood pressure is not diagnosed based on one reading, as blood pressure could fluctuate due to various factors, such as stress or anxiety, white coat syndrome, or accelerated heart rate following exertion, to name but a few. Readings are either repeated at another instance, or taken at home when you are most relaxed, or wear an ambulatory blood pressure monitor (ABPM) over 24 hours. If the readings show that your blood pressure is consistently high, you will be advised on the most appropriate treatment.

Treatments for hypertension depends on the reading and the presence of accompanying risk factors, such as age, weight, or being of African and Caribbean origin. First step to reducing blood pressure is through making lifestyle changes,

  • Reduce salt intake to less than 6g (0.2oz) a day
  • Eat a low-fat and balanced diet
  • Exercise regularly
  • Stop smoking
  • Drinking within recommended limits
  • Reduce caffeine intake
  • Losing weight especially if you’re overweight in BMI
  • Have sufficient rest, at least 6 hours of sleep every night

If your blood pressure remains high after implementing lifestyle changes, or if your blood pressure is dangerously high and have certain risk factors, you may be offered medication to control your blood pressure. The choice of medication depends on your age and ethnicity.

  • Less than 55 years old: Angiotension-converting enzyme inhibitor (ACEi) or Angiotensin-II receptor blocker (ARB)
  • Over 55 years old, or patients of Afro-Caribbean origin of any age: Calcium channel blocker (CCB)

Other medications (beta blockers and diuretics) are usually reserved for when the initial treatments are not effective. It’s important to take your medication as prescribed, you may not feel any difference but it does not mean your medication is not working. If you notice any side effects or have any concerns, you should speak to your pharmacist or GP. Most instances, these can be resolved with a change of medication.

Why should I bother?

Untreated hypertension puts extra strain on your blood vessels and vital organs such as your brain, kidneys, and eyes. It could increase your risk of developing heart disease, vascular dementia, stroke, heart attack, heart failure, kidney disease, etc. The sooner you get yourself checked, the sooner you can take preventative steps.

References

  1. Zava. (2019). Symptoms Of Hypertension. [online] Available at: https://www.zavamed.com/uk/signs-and-symptoms-of-hypertension.html [Accessed 26 Jan. 2019].
  2. nhs.uk. (2016). High blood pressure (hypertension). [online] Available at: https://www.nhs.uk/conditions/high-blood-pressure-hypertension/ [Accessed 26 Jan. 2019].
  3. Steinbaum, S. (2018). High Blood Pressure Symptoms – Hypertension Symptoms. [online] WebMD. Available at: https://www.webmd.com/hypertension-high-blood-pressure/guide/hypertension-symptoms-high-blood-pressure [Accessed 26 Jan. 2019].
  4. Bhf.org.uk. (n.d.). 6 things you need to know about high blood pressure. [online] Available at: https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/6-things-you-need-to-know-about-high-blood-pressure [Accessed 26 Jan. 2019].
  5. Bloodpressureuk.org. (n.d.). Blood Pressure : What is high blood pressure?. [online] Available at: https://www.bloodpressureuk.org/BloodPressureandyou/Thebasics/Whatishigh [Accessed 26 Jan. 2019].
  6. nhs.uk. (2016). NHS Health Check. [online] Available at: https://www.nhs.uk/conditions/nhs-health-check/ [Accessed 26 Jan. 2019].
  7. Longmore, M., Wilkinson, I., Davidson, E., Foulkes, A. and Mafi, A. (2012). Oxford Handbook of Clinical Medicine. 8th ed. Oxford: Oxford University Press, pp.132-135.