Dangers of high blood pressure
Around the world, high blood pressure, known as hypertension, is the leading risk factor for premature death, stroke and heart disease. If left untreated it can lead to catastrophic health consequences. Yet, it usually causes no symptoms at all.
So how do you know if you are at risk, and what is the best way to manage it?
A quarter of all adults will have high blood pressure, and this figure rises massively with age – around three-quarters of women over 75 will suffer from this. Yet as it is generally asymptomatic, it is very difficult to know whether or not you might be at risk.
The only way to know for sure is to get a regular blood pressure check – this is super simple and involves a doctor, nurse or other health provider using an instrument known as a sphygmanometer. This inflates over your upper arm, measuring the pressure inside the arteries.
Your blood pressure reading will have two figures – an upper one known as the systolic level, and a lower one known as the diastolic.
The upper one is a measure of the pressure inside the arteries when your heart is pumping out, the lower one is a measure when your heart is at rest, between beats. Both are important.
Although it sounds like a cop-out, it is hard to say exactly what level qualifies as ‘‘high blood pressure’’ as it depends on how many other risk factors you might have.
An ideal reading is under 140/80, but you can safely walk around with blood pressure a little higher than this if you are fit, slim, don’t smoke, and don’t have any worrying personal or family health history. However, if you have a reading of 150/90, and are a diabetic and a smoker for example, that is far more significant.
It is important to note as well that we all have blood pressure readings that fluctuate throughout the day, depending on our stress levels, activity, and other factors.
So a one-off high reading (as long as it isn’t astronomically high) should never be interpreted in isolation – plenty of people have this for a brief period every day, during a gym session or particularly fraught meeting, for example, but it doesn’t mean it is an ongoing issue or a risk factor for them.
In fact, some people always get a high reading when visiting the doctor, a condition that used to be known as ‘‘white coat hypertension’’ – we are clearly scary individuals!
Sustained high readings over three or more separate occasions are considered diagnostic of high blood pressure and should be managed to reduce the overall risk of complications.
If you have a nice low blood pressure reading, and your health is otherwise good, there is no need to rush out and get this checked every few months. It isn’t something that usually changes rapidly, but tends to trend upwards with age.
I would suggest that, unless your doctor advises otherwise, you follow the Heart Foundation’s recommendations for when to have your first check (although many of us will have had a check much earlier than this, during pregnancy for example):
❚ People without known risk factors: Men from 45 years; Women from 55 years.
❚ Ma¯ ori, Pacific or South Asian people: Men from 30 years; Women from 40 years.
❚ People with other known risk factors or at high risk of developing diabetes: Men from 35 years; Women from 45 years
❚ People with Type II diabetes: As part of their annual diabetic review
❚ People with severe mental illness: From 25 years.
At this check-up, your doctor or nurse will advise you how often you should come back to get things re-checked.
If you do find out that you have high blood pressure, your doctor will talk to you about running some simple tests, including urine tests, blood tests, an eye check, and an ECG (tracing of your heart). These tests are done to ensure that
Sustained high readings over three or more separate occasions are considered diagnostic of high blood pressure and should be managed.
your blood pressure hasn’t already started to damage other organs or blood vessels in your body – we know if left untreated, hypertension can lead to blindness, aneurysms and kidney failure, as well as strokes and heart attacks.
In terms of treatment, this is aimed primarily at reducing the risk of complications.
Self-management by modifying lifestyle factors is a crucial part of this – this includes the ‘‘obvious’’ things such as stopping smoking, losing weight and increasing your physical exercise.
But it also includes, where possible, lowering your alcohol and salt intake, and minimising stress.
There are numerous medications that can assist in lowering blood pressure and, not uncommonly, it requires two or more used in combination to be truly effective.
For more information on blood pressure and how to manage it, speak to your primary care team, or visit healthnavigator.org.nz