Blood Pressure

Overview

Blood pressure is the force of your blood pushing against the walls of your arteries as your heart pumps. When that pressure is too high, it can strain your heart and damage your blood vessels. High blood pressure is also called hypertension.

Yes. High blood pressure is one of the most common health conditions worldwide. It affects about 1 in 4 adults.

Anyone can get high blood pressure, but your chances increase as you get older. You are also more likely to have it if you are overweight, eat too much salt, drink a lot of alcohol, or do not exercise. Family history also plays a role.

Symptoms

Common symptoms

• Most of the time, high blood pressure has no symptoms.
• When blood pressure is very high, some people get headaches, blurred vision, dizziness, or nosebleeds.

Symptoms in children

• High blood pressure in children is rare, and symptoms are usually absent. A child may complain of headaches or tiredness, but most are found during routine check-ups.

Symptoms in older adults

• Older adults often have no symptoms. Some may feel dizziness or faintness, but that can also be due to a drop in blood pressure when standing. A routine test is the only way to know.

Causes

Main causes

• For most people, the cause is unknown. This is called primary or essential hypertension.
• Some health problems, such as kidney disease, thyroid conditions, or sleep apnoea, can cause it.
• Certain medicines, including some cold remedies and hormonal treatments, can raise blood pressure.
• Pregnancy can trigger high blood pressure.

Risk factors

• Getting older
• Family history of high blood pressure
• Being overweight or having obesity
• Eating a lot of salt
• Drinking too much alcohol
• Smoking
• Not being active
• Long-term stress

When to see a doctor

See a doctor urgently if:

• Call your local emergency number if you have chest pain, breathlessness, weakness on one side, or trouble speaking.
• If your home readings are 180/120 or higher, call your doctor's office for same-day advice.

Book a routine appointment if:

• If you are over 40 and have not had your blood pressure checked in the past year.
• If you have diabetes, kidney disease, or a family history of heart attack or stroke.
• If you are pregnant or planning to become pregnant.

Diagnosis

Your doctor or nurse will wrap a cuff around your upper arm. The cuff fills with air and then slowly comes down as they listen or use a sensor. The test gives two numbers: systolic pressure (top number) and diastolic pressure (bottom number). A diagnosis is usually made after multiple readings, not just one.

Tests that may be done

• Repeated blood pressure readings in the clinic
• Home blood pressure monitoring with a validated monitor
• An ABPM (ambulatory blood pressure monitor) that checks your pressure every 30 minutes during the day and night
• Urine and blood tests to look for causes or damage

What to expect at your appointment

Your doctor will ask about your lifestyle, medications, family background and any other illnesses. They may look at the back of your eyes, feel your pulse, and listen to your heart. The whole examination is simple. You will get clear advice on next steps, whether that means more measurements, lifestyle changes, or medicine.

Treatment

The main goal is to lower your blood pressure enough to protect your heart, brain and kidneys. For many people, lifestyle changes are the first step. If that is not enough, medicines are available. Treatment is tailored to you, and a routine check-up will help find the safest plan.

Self-care at home

• Cut down on salt – aim for less than a teaspoon (6 grams) per day.
• Eat more fruits, vegetables and whole grains.
• If you are overweight, losing a small amount of weight can make a real difference.
• Do aerobic exercise, such as brisk walking or cycling, for at least 30 minutes on most days.
• If you drink alcohol, keep it within recommended limits.
• If you smoke, seek support to quit.
• Take any medicine exactly as prescribed and discuss concerns with your pharmacist.

Medical treatments

Several groups of blood pressure-lowering medicines are available. The choice depends on your age, ethnicity, other conditions, and side effects. Many people need more than one. Your doctor will start with the lowest dose and adjust it. Do not use over-the-counter medicines without checking because some can raise blood pressure.

When is surgery considered?

Surgery is rarely needed. If an underlying condition such as a narrowed kidney artery or an adrenal gland tumour is the cause, surgery can sometimes help. Most people with high blood pressure will never need an operation.

Living with this condition

If your doctor suggests home monitoring, use a validated machine and check at the same time each day. Keep a simple record. Take your pills regularly. Bring your log to appointments so your doctor can see the pattern.

Lifestyle tips

• Have a consistent meal routine with plenty of vegetables and whole grains.
• Do regular physical activity that you enjoy, like gardening, dancing or swimming.
• Get enough sleep – poor sleep can raise blood pressure.
• Limit caffeine and avoid heavy drinking.
• Find everyday ways to relax, such as deep breathing or a walk.

Diet and exercise

A heart-healthy diet, like the DASH (Dietary Approaches to Stop Hypertension) meal plan, is often recommended. Base meals on vegetables, fruit, beans, lentils, and whole grains. Use little salt and choose unsalted nuts and seeds. Exercise can be brisk walking, cycling, or swimming – start gently if you have been inactive. Talk to your doctor before starting intense exercise if you have other health conditions.

Mental health and emotional wellbeing

Being told you have high blood pressure can make you feel anxious, especially because it often does not make you feel unwell. Worry about heart attacks or stroke can be real. It is normal to feel that way. Talk to your doctor or a counsellor, and remember that you are taking positive steps. Stress can raise blood pressure, so looking after your mental health is part of your treatment.

Prevention

You can prevent or delay high blood pressure. Eat a balanced diet, keep a healthy weight, stay physically active, drink alcohol in moderation, avoid smoking, and find healthy ways to manage stress. Small changes add up.

Vaccines

There is no vaccine for high blood pressure itself, but staying up to date with flu and pneumococcal vaccines is important for your overall heart health. Ask your pharmacist or doctor what is recommended for you.

Screening programmes

Adults over 40 should have their blood pressure checked at least once every five years. Your GP may suggest more frequent screening if you have risk factors. Some pharmacies and work-based health programmes offer checks, so keep an eye out for free opportunities.

Complications

If left untreated

• Heart attack and stroke
• Heart failure
• Kidney disease
• Vision problems due to retinal damage
• Brain conditions such as vascular dementia

Long-term outlook

The outlook is very good if you take action. Blood pressure is one of the most treatable long-term conditions. With lifestyle changes and, when needed, medicines, most people can keep their numbers in a safe range. That cuts the risk of heart attack and stroke dramatically. You can live a full, active life with high blood pressure.

Find support

International organisations

• World Health Organization ↗

Local organisations

• British Heart Foundation ↗ · United Kingdom
• NHS ↗ · United Kingdom

Helplines

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