Hypertension refers to high blood pressure (BP) in your arteries, the vessels that carry oxygen to your tissues and organs which enables them to function. If left untreated, hypertension puts you at a higher risk of having a stroke or heart attack.
Pressure provides the pumping mechanism from the heart to this artery pipework around the body. If the pressure is too high, this causes the narrowing of the arteries, which, over time, can damage vital organs such as the heart, brain, kidneys, and eyes. Think of it like limescale attacking your water pipes until they narrow and become bumpy with deposits, making it harder for the liquid to get through them. Eventually, the pipes may block entirely, which is what causes a heart attack.
BP is measured by a machine – a soft cuff is attached to your upper arm, which inflates and gives a fraction reading: one number at the top (your systolic BP) and one at the bottom (your diastolic BP).
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For most people, BP should be less than 120/80 mmHg to keep you at low risk of narrowing, or blocking, the arteries. A reading of 130-140/80-90 mmHg may warn you that you are at risk of hypertension, so change your weight, diet, or lifestyle where you can.
Other conditions increase your risk of blocking the arteries and causing organ damage – if you have diabetes mellitus or high cholesterol, or you’ve previously had a stroke or heart attack – you will need to keep your BP under even tighter control. Your doctor will keep a close eye on this and advise you on your target BP.
You won’t usually be able to feel high BP. Most people feel well. But we know that almost half of the adults in the US have hypertension, and many are undiagnosed. For most, high BP is found on a spot BP check for another reason – you might be starting a new medication, have other conditions, or have a routine check-up.
You may only have symptoms when BP hits a dangerous level, such as over 180 mmHg systolic. This may cause you to feel dizzy, and sweaty, have a whooshing sound in your ears, headache, and blurred vision. This is a reason to visit your doctor or emergency department with urgency.
We should all be looking after the health of our arteries from an early age; you don’t need to wait for a diagnosis of hypertension. Maintaining a healthy weight helps reduce fatty deposits in the arteries, and keeping fit and active helps them stay elastic and muscular. Smoking damages blood vessels, so seek help to give this up if you are a smoker, and excess alcohol also takes its toll on vessels. Avoid foods high in salt, fat, and sugars, or highly processed foods, and boost your intake of fruits and vegetables, and whole grains and swap in "good fats" such as olive oil rather than butter or ghee.
If you have been diagnosed with high BP, you should introduce these changes to your lifestyle. Your doctor may suggest starting a medication. They will review how well this is managing your BP at regular intervals.
Lots of ways! Everyone over 40 should schedule a check-up with a doctor, where BP is checked along with blood tests for diabetes, high cholesterol, and kidney function. You should have your BP checked at least every five years after age 40.
You can always ask your doctor or nurse if you’re there for any other reason, especially those over 65. Pharmacies often have BP machines to use. You may have a family member with a home BP machine, or you can purchase one yourself.
A one-off high BP reading isn’t enough for a diagnosis unless it’s extremely high. Several readings are needed before treatment is offered.
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