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Dr Chris Steele explains the dangers of hypertension


Mon 11 Apr, 2011 10:00 am BST


Everyone knows high blood pressure is bad for you, but most of us are pretty ignorant of its symptoms and consequences. So what is it, and why should you be aware of it?


High blood pressure or hypertension is a condition in which the body’s blood pressure is above the normal range. Having high blood pressure is one of the main risk factors for both heart disease and stroke, the two leading causes of death in the UK.


Your blood pressure is the amount of force on the walls of your arteries which occurs when blood flows through them. If this is too high, your heart has to work harder to send blood around the body.


How do I know if I have high blood pressure?


Most people with high blood pressure don’t have symptoms. The only way to know if you have high blood pressure is to get it checked by your GP.


The medical gadget used to measure blood pressure is called a sphygmomanometer (pronounced sfig-mo-man-meet-er) or BP machine!


When your doctor checks your blood pressure, they will give you two figures e.g. 135/80.


The first or top figure (135) is called the systolic pressure. This is the pressure in your arteries when your heart contracts.


The second or bottom figure (80) is called the diastolic pressure. This is the pressure in your arteries when your heart relaxes between beats.


Medical experts now agree that systolic readings in or above the range 140-159, and diastolic readings in the range 90-99 need to be treated. For example, a BP reading of 170/100 would need to be treated with medication, whereas a reading of 135/80 is fine.


Health problems linked to high blood pressure


High blood pressure increases your risk of life threatening conditions such as:


  • *Stroke
  • *Heart attack
  • *Heart disease
  • *Kidney disease

 

Who should have their blood pressure checked?


High blood pressure is common. Around 40 per cent of adults and 50 per cent of people over the age of 65 have high blood pressure.


About 90 per cent of people with high blood pressure have no obvious cause for it – officially known as Essential Hypertension. Although the actual cause is unknown, there are known risk factors for high blood pressure, including:


  • *Age
  • *A family history of high blood pressure, heart disease or stroke
  • *Obesity
  • *Smoking
  • *Excessive alcohol consumption
  • *Lack of exercise
  • *Diet high in fat
  • *Diet high in salt
  • *Stress
  • *African-Caribbean or South Asian descent

 

Women who have had toxaemia in pregnancy may also be at an increased risk.


In the remaining 10 per cent of people, high blood pressure may be related to other medical conditions such as diabetes, kidney disease or disorders of the adrenal glands, which sit on top of the kidneys.


Many experts think that everyone over the age of 35 should have their BP checked every three to five years.


What are the symptoms?


It’s not called a silent killer for nothing. High blood pressure is usually without any symptoms until it has reached a very high level. When it does cause symptoms, the most common are:


  • *Headaches – especially as pain at the back of the head, or as a tight band around the head
  • *Dizziness
  • *Nausea
  • *Nosebleeds
  • *Shortness of breath
  • *Blurred or double vision
  • *Palpitations – irregular heart beat
  • *Drowsiness

 

Anyone who experiencing some of these should contact their GP immediately.


Lifestyle changes which can help lower blood pressure


If your blood pressure is slightly high your doctor will probably suggest some lifestyle changes to try to lower your blood pressure. These will include:


  • *Stopping smoking
  • *Reducing your alcohol consumption
  • *Reducing the amount of salt and saturated fat in your diet and increasing fruit and vegetables
  • *Regular exercise
  • *Weight reduction if you are overweight

 

Reducing stress levels will also help, as may taking up some form of relaxation such as yoga, meditation or even self hypnosis. Alternative therapies such as aromatherapy may help, as can courses in stress management.


Medication


When lifestyle changes don’t help with controlling high blood pressure, treatment with drugs is necessary.


Drug treatment is not usually started until it is found that the blood pressure is consistently high over three or more measurements.


This is because many people experience’ White Coat Hypertension’, which is an increase in blood pressure, resulting from the anxiety caused by someone, such as your doctor, measuring your blood pressure!


Many people don’t feel relaxed when visiting hospitals or the GP’s surgery, and as result develop a raised blood pressure which eventually settles down as the patient becomes relaxed.


Initially a simple ‘water’ tablet or diuretic, which gets rid of excess water from the body, after being taken each morning, may be enough to bring the BP down into the normal range. When taking this type of medication, you either pass water more frequently or pass more water each time you urinate.


If a diuretic isn’t enough, extra drugs may be used, such as beta blockers, calcium channel blockers, or ACE (Angiotensin Converting Enzyme) inhibitors, Angiotensin II inhibitors, Alpha blockers and other types of hypotensives.


Side effects


Some of these drugs can cause an unfortunate side effects. In men, impotence, or to give it it’s full medical term, erectile dysfunction, can occur.


Sadly, some men with impotence don’t tell their GP that they have this problem. If they did, their GP might identify their medication as the cause and change the therapy immediately!


Other side effects of some of these medications can include dry mouth, feeling tired, cold extremities, drowsiness, nasal congestion, diarrhoea, skin rashes, anaemia and even loss of taste. These adverse effects are not common and do not occur with all hypotensives, but users should be aware of them and report them to their doctor.


Patients taking any of the ACE inhibitors could experience a dry irritating cough, which is not controlled by cough medicines, and may have to change their medication. Because ACE inhibitors can affect kidney function, patients have blood tests to specifically assess kidney health before they start treatment, within a few weeks of starting these drugs, and ideally every 3 to 12 months thereafter.


Patients taking beta blockers may experience sleep disturbances, dreams, asthma, alopecia (hair loss), dry eyes and skin rashes. Certain conditions such as gout, diabetes and raised cholesterol can be made worse by certain blood pressure drugs.


Most patients taking hypotensives experience no problems from their medication, so don’t be alarmed by this list of potential side effects. Raised blood pressure can kill, so treatments should never be stopped.


Thankfully, there are a large number of drugs for high blood pressure, so if one doesn’t suit you, your GP can easily suggest an alternative.


Source: http://uk.health.lifestyle.yahoo.net/Spotlight-on-blood-pressure.htm


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