What is blood pressure?

Blood pressure is the pressure of blood in your arteries. The higher your blood pressure the greater your risk of developing narrowed arteries which can lead to heart problems and strokes. The good news is that if your blood pressure is high, it can be lowered by making changes to your lifestyle, for example changing your diet, exercising and losing weight, and when needed, with tablets. This will reduce your risk of developing heart and brain problems that might otherwise occur if your blood pressure is not treated. However, in many people, blood pressure is not checked or measured and in some people who have high blood pressure it may not treated adequately.

This pressure can be measured and is usually written down like this:

140/90mmHg

The top number, which is called the systolic pressure, shows the pressure in your arteries when your heart is forcing blood through them. The bottom number, called the diastolic pressure, shows the pressure in your arteries when your heart relaxes. The top number can be anywhere from 90 to 200 and the bottom number can be anywhere from 60 to 140. Blood pressure is measured in millimeters of mercury, which is written down as: mmHg

Everyone has a different blood pressure and it can change in the same person during the day and night. High blood pressure can also be called hypertension; both words mean the same thing

How is blood pressure measured?

Your blood pressure can be measured either by using a machine called a sphygmomanometer or by using an electronic machine.

 

A sphygmomanometer is the 'older' kind of equipment for measuring blood pressure (click on the image to the right for a larger version). The person taking your blood pressure will put a cuff around the top of your arm, pump up this cuff and then listen for sounds through a stethoscope placed on your arm. The sounds heard through the stethoscope will start and then finish at certain points and this will give the reading for your blood pressure.

There are also automatic electronic machines that can measure blood pressure. They also use a cuff around your arm and will give a readout of your blood pressure.

In order to be sure that you have high blood pressure, you will be asked to have readings taken more than once. Usually you will be asked to go and have you blood pressure checked several times. This is to make sure that you have consistently high blood pressure, rather than high blood pressure because you are nervous at the doctors or have rushed to get to your appointment

Why is blood pressure important?

If you have high blood pressure then you have a greater risk of having a stroke or a heart attack in the future. Having high blood pressure will cause strain on the vessels carrying blood around your body. This strain can cause vessels to become clogged up or to weaken and this in turn can lead to narrow blood vessels and clots, which can cause damage to the heart or brain. More rarely it can lead to the blood vessels bursting. Having high blood pressure can also cause heart failure. Heart failure is when your heart can not pump blood around the body as well as it should and this can cause you to become short of breath and can cause your ankles to swell. High blood pressure can also cause kidney failure.

So, there are many very good reasons for controlling your blood pressure both and now and in the future.

However, for most people there is no definite cause for their high blood pressure and doctors call this essential hypertension. The small blood vessels in the body narrow and this causes the pressure to build up, a bit like squeezing a garden hose.

Black and South Asian people are more likely to have high blood pressure than the rest of the population in the United Kingdom. If you are Black then you may be more sensitive to salt in your diet and more likely to have a stroke and if you are South Asian then you are more likely to have diabetes or a heart attack. The reasons why this happens are not fully understood.

Some other conditions are also linked to high blood pressure, such as diabetes, kidney disease and heart disease. If you have any of these conditions then it is even more important that your blood pressure is well controlled.

Your blood pressure is very much affected by your lifestyle and the important factors are:

How will my high blood pressure be treated?

How your high blood pressure is treated will depend on how high it is and on what other .Risk factors. You have for heart disease and stroke.

If your blood pressure is between 140/90-160/100mmHg then you will probably be asked to make some changes to your lifestyle. You will probably not need to take tablets providing that the changes you make work. In this way you can lower your own blood pressure without needing to take tablets. However, some people with a blood pressure in this range may be prescribed medication to take. This is usually if they are older or have other risk factors for heart disease and stroke, such as high cholesterol, smoking or already have complications such as a previous stroke or heart attack.

So if you have a blood pressure reading in this range you should:

If you are taking tablets for your blood pressure then you will need to keep taking them for the rest of your life. Many people find that once they get into a routine with their tablets, they become a part of their daily lives, like cleaning their teeth. It is important that you remember to take them and that you remember to renew your prescription before you run out.

Discuss your treatment with your doctor and if you feel that your tablets are making you feel unwell in any way make sure that you let your doctor or nurse know.

These changes to your lifestyle should be adopted by the whole family, as, increasing evidence suggests that this will lower blood pressure and prevent high blood pressure from occurring later in life. A healthy diet will also make you feel better.

These are the five main changes you can make:

Cut down on your salt
We each eat about 10grams of salt each day and this can easily be reduced by half to 5grams each day. That means cutting down from two teaspoons of salt every day to a teaspoon. You should not add salt to food or use it in cooking. However, most salt that you eat is hidden in processed foods and this may not be obvious, for example salt may be hidden in bread, many cereals and ready meals etc. so avoid these high salt foods where possible.

Eat more fruit and vegetables
We should all be eating at least 5 portions of fruit or vegetables each day and ideally more. If you can manage to do this and cut down the amount of salt that you eat then you should see your blood pressure fall by quite a large amount.

Take more exercise
Taking more exercise can help you to lower your blood pressure. It will also help you to lose weight and reduce the amount of fats (cholesterol) in your blood. If you are not doing very much exercise now then you do need to take care to begin with and build up gradually. Taking exercise doesn't have to mean jogging, it can mean walking the dog regularly and gradually increasing the amount of exercise you do over 3 to 6 months.

Find and reach your ideal weight
Everyone has an ideal weight. What your ideal weight is will depend on how tall you are and whether you are male or female. If you are overweight you should try and get down to a weight within the ideal range for you.

Many people find losing weight, and keeping it down, difficult. A healthy diet is an essential first step. Once you are eating a healthy diet cut down the amount of food you eat until you start to lose weight.

Drink alcohol in moderate amounts
Drinking alcohol in moderate amounts means that if you are a man you should be drinking 21 units, or less, each week and if you are a woman you should be drinking 14 units, or less, each week. A unit is a half-pint of ordinary strength beer or lager, a small glass of wine or a measure of spirit. If you are regularly drinking over these amounts then it is likely to affect your blood pressure and you should cut back. However, if you are sticking to moderate amounts then you do not need to cut down but you should avoid binge drinking.

As well as the five factors set out above there are two other key risk factors for stroke and heart disease, smoking and eating too much saturated fat. They don't in themselves cause high blood pressure but if you smoke and give up and if you can cut down the amount of saturated fat you eat, this will combine with the lowering of your blood pressure to cause a very large reduction in your risk of having a stroke or having a heart attack.

Giving up smoking
Smoking is the biggest risk factor for having a heart attack and if you smoke you must stop. If you smoke it will not directly affect your blood pressure, but it will cause your arteries to narrow, just as high blood pressure does. So, if you smoke and you have high blood pressure your arteries will narrow much more quickly. Nicotine is a powerful and addictive substance, and you will need to be strong willed. However, there are now lots of ways in which you can make giving up smoking easier for yourself. Nicotine replacement therapy, in the form of patches and gum, for example, and groups to help smokers quit are just a few. If you have difficulties talk to your doctor or nurse.

Cutting down on saturated fat
We all eat too much fat. The type of fat that causes the most problems is saturated fat, for example animal fats and some vegetable oils such as palm and coconut oil. Fat increases the amount of cholesterol in your blood. The higher the level of cholesterol in your blood the greater your risk of heart disease and stroke. If you have high blood pressure reducing you saturated fat intake is very beneficial.

These changes to your lifestyle will reduce your risk of heart disease or stroke, but they may not lower your blood pressure enough. It may be necessary for you to take tablets as well.

As with any medicines that we take, medicines for high blood pressure can occasionally cause side effects in some people. Most of these side effects are rare and will only happen in a small number of people. However, it is vitally important that if you feel that any medicine that you are taking is causing you to feel unwell that you go back to your doctor and talk about it. You can easily change your tablets to find one that keeps your blood pressure controlled and leaves you feeling well. However, in many people more than one tablet may be necessary to control their blood pressure.

There are now several different kinds of tablets that can be used for high blood pressure. They all work in a different way inside the body and some kinds of tablets may suit you better than others. The aim of any tablet, combined with the lifestyle changes you make, is to get your blood pressure to below 140/90mmHg.

Taking tablets for high blood pressure is something that most people will have to do for the rest of their lives and continuing to take them is vitally important. As soon as you stop your blood pressure will go back up, as will your risk of heart attack or stroke. If you are worried about any aspect of taking you tablets speak to your doctor or nurse.

The purpose of both the lifestyle changes that you make and the tablets that you take is to control your blood pressure with you feeling completely well, or feeling much better. Once your blood pressure is controlled you will be able to lead a completely normal life.