Hypertension refers to high blood pressure (BP) in your arteries, the vessels that carry oxygen to your tissues and organs to allow them to function. If left untreated, hypertension puts you at 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 narrowing of the arteries which, over time, can lead to damage to 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 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).
For most people, BP should be less than 140/90 mmHg to keep you at low risk of narrowing, or furring up, the arteries. If you’re fit and well, BP should ideally be between 90/60 and 120/80. A reading of 120-140/80-90 mmHg may be a warning shot that you are at risk of hypertension, so make changes to your weight, diet, or lifestyle where you can. Other conditions increase your risk of furring up the arteries and 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 1 in 3 adults in the UK have hypertension, and many are undiagnosed. For most, high BP is found on a spot BP check – you might be starting a new medication, have other conditions, or you may be having a routine NHS or private check-up. The only time you may have symptoms is on the rare occasion BP hits a dangerous level, such as over 180 mmHg systolic. This may cause you to feel dizzy, sweaty, have a whooshing sound in your ears, headache, and blurred vision. This is a reason to attend 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 is very damaging to 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 fruit and vegetables, whole grains and swap in "good fats" such as rapeseed 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 treating your BP at regular intervals.
Lots of ways! Everyone over 40 can request an NHS Health Check, 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 the age of 40. You can always ask your doctor or nurse if you’re there for any other reason, especially those over 65, and some doctor surgeries have a BP machine to check yourself in the waiting room. Pharmacies often have BP machines and scales to use. You may have a family member who has 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.