Hypertension: I’ve been diagnosed. What now?
Hypertension, or high blood pressure (BP), is a concept some patients struggle with. You’re told you have a health condition, and yet you feel well, it doesn’t cause you any symptoms, and you don’t feel any different once treatment is started.
You’re buying into the concept that looking after yourself (with lifestyle modifications and medication) will protect you from a serious illness such as kidney disease, strokes, or heart attacks in many years to come. Perhaps it’s best viewed as paying into your pension – you won’t ever feel like you’re reaping the rewards, but you’d kick yourself if you hadn’t invested.
What can you find here?
Can I do anything to control it?
Yes! Lots! If you’re leading a sedentary lifestyle, get active. Start gently, building up gradually to 30 minutes of exercise where you feel a bit out of breath, at least five times per week. Swap takeout and processed foods for fruits and vegetables – keep your eye on foods that are high in fat, sugar, or salt and avoid them.
Both exercise and following a healthy diet may also help you lose any extra weight you’re carrying – this can have a big impact on your hypertension. Alcohol can add unnecessary calories and is a risk factor for hypertension in itself, alongside smoking. Your doctor can help with quitting services to increase your chance of success.
If you’re working long hours, missing out on sleep, and feel perpetually stressed, you should look to address these, as they take a toll on your BP. Look for ways to take time out to relax and try to build up a healthier sleep routine to ensure you’re getting a quality night’s sleep.
What will my doctor do about it?
Normal BP is considered to be less than 120/80 mmHg. If your hypertension is borderline, you and your doctor may decide together to try lifestyle modifications alone. If this isn’t enough once reviewed, or your BP is fairly high, they may start medication in the form of tablets.
Your kidney function will be checked on a blood test before medication. Your doctor will check for other risk factors for heart disease, including cholesterol and diabetes, and you may need to provide a urine sample for an additional kidney check. An eye test will be arranged to check the back of your eyes, and you may be sent for an electrocardiogram (ECG) to check the electrical system of your heart.
If started on medication, your doctor will re-check your BP six to eight weeks later. Your kidney function will be checked again, too, in case the medication has affected this.
Your BP will then be checked every three months until it has reached a satisfactory level. Your doctor may tweak the medication in terms of doses, or swapping out a medication if you experience side effects. They may add another tablet in to reach your target BP.
How often am I reviewed?
Once you have achieved good hypertension control, you will be recalled on a yearly basis unless there’s reason to see you sooner, such as related conditions like kidney disease or diabetes.
If you want to keep an eye on your blood pressure, you can purchase a machine to have at home and take it every month or two.
For most adults with confirmed hypertension, including those with cardiovascular risk factors, you should aim for less than 130/80 mmHg. Your target may be lower if you have other conditions. Less aggressive goals may be more suitable for frail elderly or those with postural hypotension.
What’s caused it?
Most times, we don’t know, and this is called essential hypertension. Some factors put you at higher risk: age is the biggest of these, especially those over 65.
Other high-risk groups include those who are black, or those with a close family member diagnosed at an early age. Other factors include if you smoke, drink excess alcohol or lots of coffee or other caffeinated drinks, if you are overweight, eat a diet high in salt, fats, and sugars and low in fruit and vegetables, or if you lead a sedentary or high-stress lifestyle.
Up to 1 in 10 people with high blood pressure are diagnosed with secondary hypertension – it occurs as a cause of another condition or certain medications. These include problems with your kidneys, adrenal glands, thyroid, a connective tissue disorder, or obstructive sleep apnea. Medications that can provoke a high BP include long-term high-dose steroids, the combined contraceptive pill, nonsteroidal anti-inflammatories like ibuprofen or naproxen, and drugs of misuse, such as cocaine or excess alcohol.
Your doctor or hospital specialist will keep a close eye on your blood pressure if you have one of these conditions or are prescribed certain medications, and they will treat early if needed.
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