High blood pressure (or hypertension) often goes undetected because in the early stages there are few symptoms, however, if left untreated it can cause severe, long-term health problems. Certain factors may increase your risk of developing high blood pressure, these include being overweight, smoking, drinking alcohol, eating a lot of salt and not getting enough exercise. Making lifestyle changes can therefore effectively reduce your blood pressure. For those who do not respond well to these changes, prescription medication work in several ways to help control blood pressure.
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High blood pressure, also known as hypertension, affects at least 1 in 4 adults in England alone. It is a condition that relates to the body’s circulatory system, specifically the pressure exerted to pump blood around the body. If this pressure is too high then it is likely to cause extra stress on the heart and arteries (blood vessels), which can lead to more serious conditions such as stroke, kidney disease, heart attack and even heart failure.
The symptoms associated with hypertension can sometimes be hard to spot, which is why it is important for adults to have their blood pressure checked on a regular basis. It is recommended that adults have a check at least once every five years. A blood pressure check is a readily available test that can be performed by your GP, pharmacist or other healthcare professionals. It can also be carried out by yourself by using a home testing kit.
Blood pressure is measured in millimetres of mercury (mmHg) and is presented by two figures; systolic and diastolic pressure. For example, the ideal blood pressure in a healthy adult would be 120/80mmHg or 120 over 80. The systolic reading (120) relates to the pressure of the blood when your heart beats. The diastolic reading (80) shows the pressure of the blood as your heart rests between beats. The diastolic reading reveals how strongly the arteries are resisting the blood flow. If your resting blood pressure is 140/90 mmHg or over, then this will indicate hypertension or high blood pressure.
The risk of developing hypertension increases as we get older. Lifestyle choices can also strongly influence our risk of developing the condition. There isn’t always a clear cause but factors that increase the risk of developing hypertension include:
Hypertension, in most cases rarely presents with any obvious symptoms. In severe cases where the blood pressure is very high, the symptoms can become more apparent. These can include;
Symptoms such as these only occur in rare cases, if you are experiencing any of the above it is strongly advised you see a doctor as soon as possible. Experiencing any of the above symptoms would class as a medical emergency.
High blood pressure should always be diagnosed by a medical professional and not self-diagnosed based on home tests. Although a general idea of the blood pressure reading can be taken at home, deciding on the appropriate treatment (medicinal or lifestyle) should be carried out by a healthcare professional.
As stated above, hypertension rarely presents with any obvious symptoms. This highlights the importance of having your blood pressure checked regularly, especially if any of the risk factors for developing high blood pressure apply to you.
The diagnosis will be made using a blood pressure monitor. These devices are safe, quick and simple to use. A cuff is placed around the upper arm (in some cases the wrist) and is inflated, restricting the blood flow. The cuff will then slowly deflate, releasing pressure and allowing for a reading to be taken. This reading is based on how the pulse beats as the pressure from the cuff is relieved. To gain an accurate reading from a blood pressure test you should ensure that your bladder has been emptied and your body has been at rest for at least five minutes. As the test is being performed it is important to be sitting down with your legs uncrossed and your back supported. Also, it is important not to talk as the reading is being taken.
If during your first test the results come back as high it does not automatically mean that you suffer from hypertension. A person’s blood pressure will fluctuate throughout the day. Feeling stressed or nervous about visiting your GP can lead to raised blood pressure. This is known as ‘white coat syndrome’. If under these conditions a high reading has been taken then it is likely a home testing kit will be provided, allowing a second test to be performed in a more relaxed environment. Alternatively, a 24-hour heart rate monitor can be provided, allowing your blood pressure to be monitored throughout the day. These methods will help determine whether your blood pressure is consistently high and not merely the result of anxiety.
Other methods that can be used to help diagnose hypertension include blood and urine tests. These tests are designed to check for underlying conditions that are known to affect circulation and increase blood pressure, such as kidney disease.
High blood pressure can be reduced, or even prevented, by eating a healthy diet and maintaining a healthy weight. It is also important to take regular exercise and to only drink in moderation. Smoking is also a contributing factor in developing hypertension so cessation is recommended.
The first line of treatment in all cases of high blood pressure will always be to make simple lifestyle changes. Whether these changes are supplemented with blood pressure medication will depend on how high your blood pressure is:
There is a wide range of medication that is proven successful in treating hypertension. The choice of medicine, or combination of medicines, will be determined by your prescriber. Your GP’s first line of treatment is usually influenced by your age and ethnicity. If a sufferer is under 55 years of age then an ACE inhibitor or an Angiotensin Receptor Blocker (ARB) will generally be offered. If a patient is over 55 years old, a Calcium Channel Blocker will be the usual choice. If you are of African or Caribbean descent then regardless of age a Calcium Channel Blocker is the preferred option.
Hypertension medication can sometimes be a lifelong commitment. However, if a person’s blood pressure stays under control for several years then your doctor may suggest reducing or even stopping your treatment. As with all medication, it is important to follow the directions as stated. By consistently missing doses you could lower the effectiveness of the medication, lowering your protection against future illness.
The mechanism of action for the different types of blood pressure medication varies:
There are some Non-Prescription alternatives to help treat High Blood Pressure including;
High blood pressure (hypertension) is when you consistently, over a number of weeks, produce readings of 140/90 or higher.
Hypertension can also be classified if just one of the numbers (systolic or diastolic) is consistently higher than it should be over a number of weeks.
Having high blood pressure puts extra strain on the heart and blood vessels, which over time can increase your risk of suffering a heart attack or stroke.
An ACE Inhibitor works to reduce the amount of water in the blood whilst widening the arteries. Examples of ACE Inhibitors include; Captopril, Enalapril, Fosinopril, Perindopril and Ramipril.
These medicines are most effective in people under fifty-five years of age. ACE Inhibitors are less effective in black people and those over the age of fifty-five. They are also not suitable during pregnancy or breastfeeding.
The most common side-effects associated with ACE Inhibitors are; dizziness, headaches, fatigue and a persistent dry cough. Most ACE Inhibitor names end in 'pril'
ARB is an acronym for Angiotensin Receptor Blocker.
These medicines work to lower your blood pressure by blocking the actions of angiotensin II. This has the effect of relaxing the blood vessels, causing them to dilate (widen). This allows for blood to flow with greater ease through the body. ARB's also work to reduce the amount of water retained in the body, which results in a reduction in pressure.
The most common side-effects associated with ARB's are dizziness, headaches and cold and flu-like symptoms. In most cases, these side-effects are usually very mild. Examples of ARB's include; Candesartan, Irbesartan, Losartan and Valsartan. Most ARB names end in 'artan'
Diuretics are designed to reduce the amount of water in the blood and to widen the arteries.
Examples of Diuretics include; Bendroflumethiazide, Hydrochlorothiazide and Indapamide.
Diuretics are a good alternative for patients who cannot tolerate Calcium Channel Blockers. However, they are not suitable during pregnancy or for those whose suffer from Gout. Thiazide Diuretics can also raise the potassium and sugar levels in the blood so regular blood and urine tests are required. In some cases, Diuretics have been known to cause impotence. Most Diuretic medicine names end in 'ide'
Calcium Channel Blockers work to widen the arteries. They are found to be most effective in black people and those over the age of 55.
Examples of Calcium Channel Blockers include; Amlodipine, Felodipine, Lercanidipine, Nifedipine and Verapamil.
These medicines are not suitable for people with a history of heart or liver disease or for those with poor circulation. The most common side-effects associated with Calcium Channel Blockers are; dizziness, headaches, fatigue, swollen ankles and skin rashes (usually only temporary). Most Calcium Channel Blocker names end in 'pine'
The only way to know for certain whether your blood pressure is high is to have it measured. This is normally done at your doctor's surgery, after an initial assessment. Once complete, your GP can then decide what course of action is best for you. Usually, this will involve monitoring your blood pressure, to ensure your readings are consistently higher than normal. The frequency of this monitoring and whether medication is required will depend on upon your initial readings.
At The Independent Pharmacy, we only provide blood pressure tablets for patients who have already been prescribed medication from their doctor.
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