High blood pressure (hypertension) happens when the force on the walls of blood vessels from the blood within them is more than normal. This means the heart has to work harder and the blood vessels are under more strain, making it a major risk factor for heart disease, stroke and other serious conditions.

  • About 33% of men and 25% of women aged 45-54 years have hypertension.
  • About 66% of men and 78% of women aged ≥75 years or older have hypertension.

What causes high blood pressure?

The cause of high blood pressure (hypertension) is not known in most cases

This is called essential hypertension. The pressure in the blood vessels (arteries) depends on how hard the heart pumps and on how much resistance there is in the arteries. It is thought that slight narrowing of the arteries increases the resistance to blood flow, which increases the blood pressure. The cause of the slight narrowing of the arteries is not clear. Various factors probably contribute.

In some cases, high blood pressure is caused by other conditions. It is then called secondary hypertension. For example, certain kidney or hormone problems can cause high blood pressure. In some cases, medication taken for other conditions can cause blood pressure to rise.

Risk factors for high blood pressure

High blood pressure is more common in people:

  • With diabetes. This is the case in both type 1 and type 2 diabetes. However, it is even more common in those with type 2 diabetes.
  • From African origin.
  • From the Indian subcontinent.
  • With a family history of high blood pressure.
  • Older age.
  • Gender (blood pressure (BP) tends to be higher in men than in women up to the age of 65 years, whereas the opposite tends to be true over the age of 65 years).
  • With certain lifestyle factors. That is, those who:
    • Are overweight.
    • Eat a lot of salt.
    • Don't take enough exercise.
    • Drink a lot of alcohol.
    • Have a lot of stress.

What is blood pressure?

Blood pressure is the pressure of blood in your blood vessels (arteries), measured in millimetres of mercury (mm Hg). Your blood pressure is recorded as two figures - for example, 150/95 mm Hg. You may hear this said as '150 over 95'.

  • The top (first) number is the systolic pressure. This is the pressure in the arteries when the heart contracts.
  • The bottom (second) number is the diastolic pressure. This is the pressure in the arteries when the heart rests between each heartbeat.

What is high blood pressure?

High blood pressure (hypertension) is a blood pressure that is 140/90 mm Hg or above each time it is taken at the GP surgery. High blood pressure can also be:

  • Just a high systolic pressure - for example, 170/70 mm Hg.
  • Just a high diastolic pressure - for example, 120/104 mm Hg.
  • Or both - for example, 170/110 mm Hg.

However, it is not quite as simple as this. Depending on various factors, the level at which blood pressure is considered high enough to be treated with medication can vary from person to person.

Blood pressure between 130/80 mm Hg and 140/90 mm Hg

For most people this level is fine. However, current UK guidelines suggest that this level is too high for certain groups of people. Treatment to lower your blood pressure if it is 130/80 mm Hg or higher may be considered if you:

  • Have developed a complication of diabetes, especially kidney problems.
  • Have had a serious cardiovascular event such as a heart attack, transient ischaemic attack (TIA) or stroke.
  • Have certain ongoing (chronic) kidney diseases.

Blood pressure of 140/90 mm Hg or above 

If your blood pressure is always in this range you will normally be offered treatment to bring the pressure down, particularly if you have:

  • A high risk of developing cardiovascular diseases (see below); or
  • An existing cardiovascular disease (see below); or
  • Diabetes; or
  • Damage to the heart or kidney (end-organ damage) due to high blood pressure.

Blood pressure of 160/100 mm Hg or above 

If your blood pressure is always in this range, you will almost certainly be advised to have treatment to bring it down.

Do I need any further tests?

If you are diagnosed as having high blood pressure (hypertension) then you are likely to be examined by your doctor and have some routine tests which include:

  • A urine test to check if you have protein or blood in your urine.
  • A blood test to check that your kidneys are working normally and to check your cholesterol level and sugar (glucose) level.
  • A heart tracing, called an electrocardiogram (ECG).

The purpose of the examination and tests is to:

  • Rule out (or diagnose) a secondary cause of high blood pressure, such as kidney disease.
  • Check to see if the high blood pressure has affected the heart.
  • Check for other risk factors such as a high cholesterol level or diabetes.

Can I get my blood pressure down without taking medication?

Sometimes there is quite a bit you can do with lifestyle changes, and in some people this may help them to avoid medication. In particular, the following help:

  • Losing weight if you are overweight.
  • Reducing the salt you have in your food.
  • Taking regular exercise.

Stopping smoking doesn't reduce your blood pressure as such, but smoking and high blood pressure put you at risk of the same conditions. So if you can quit smoking, you'll reduce your risk of strokes, heart attacks, etc.

Reference: Patient.co.uk patient leaflets on Hypertension  

 
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