blood pressure overview for patients

Overview

Blood pressure is the force of your blood pushing against the walls of your blood vessels. It's measured with two numbers: systolic (pressure when your heart beats) and diastolic (pressure between beats). High blood pressure (also called hypertension) means your heart is working too hard to pump blood. Over time, this can damage your blood vessels and increase your risk for serious problems like heart attack and stroke.

Yes, high blood pressure is very common. About 1 in 4 men and 1 in 5 women in the UK have high blood pressure, and many people don't even know they have it.

High blood pressure can affect anyone, but it becomes more common as you get older. People with a family history of high blood pressure, those who are overweight, and those who eat a lot of salt or don't exercise enough are at higher risk.

Symptoms

Common symptoms

• Most people with high blood pressure have no symptoms at all. That's why it's important to have your blood pressure checked regularly, even if you feel fine.

Symptoms in children

• High blood pressure in children often has no symptoms. However, some children may have headaches, vision problems, or feel tired.

Symptoms in older adults

• Older adults with high blood pressure may not have symptoms either. But untreated high blood pressure can increase the risk of falls, confusion, or trouble thinking clearly.

Causes

Main causes

• The exact cause of primary (essential) high blood pressure is not known, but several factors can raise your risk.
• Secondary high blood pressure is caused by another health condition, such as kidney disease, hormone problems, or certain medicines.
• Lifestyle factors like eating too much salt, not eating enough fruit and vegetables, drinking too much alcohol, and not being active enough can all raise blood pressure.

Risk factors

• Being overweight or obese
• Not getting enough physical activity
• Smoking or vaping
• Drinking too much alcohol
• Eating a diet high in salt and low in potassium
• Having a family history of high blood pressure
• Being over the age of 65
• Having certain long-term health conditions, like diabetes or kidney disease
• Being of Black African or Black Caribbean descent (higher risk at a younger age)

When to see a doctor

See a doctor urgently if:

• If your home blood pressure readings are consistently above 180/120 mmHg
• If you have any emergency symptoms (see above)
• If you experience chest pain, shortness of breath, or sudden severe headache

Book a routine appointment if:

• If you are aged 40 or over, get your blood pressure checked at least once every 5 years — your GP surgery or local pharmacy can do this.
• If you have risk factors like diabetes, kidney disease, or a family history of high blood pressure, you may need checks more often.
• If you are unsure about your blood pressure, ask your healthcare provider for a check.

Diagnosis

Blood pressure is measured with a small instrument called a sphygmomanometer (a cuff that goes around your arm). Your healthcare provider will take two or more readings at different times to confirm a diagnosis. Sometimes a 24-hour monitor that checks your blood pressure throughout the day and night is used.

Tests that may be done

• Blood pressure measurement — usually using an automatic digital monitor or a manual cuff and stethoscope
• Urine test — to check for kidney problems
• Blood tests — to check kidney function and look for other causes
• Electrocardiogram (ECG) — to check heart health
• Echocardiogram (ultrasound of the heart) — if your doctor suspects heart damage

What to expect at your appointment

If you are diagnosed with high blood pressure, your doctor or nurse will talk with you about your lifestyle, any medicines you take, and your family health history. They will help you set a treatment plan that works for you. Most people need to make some changes to their diet and activity, and many also need medication to keep their blood pressure under control. Follow-up checks are usually every 3 to 12 months.

Treatment

Treatment for high blood pressure aims to bring your numbers down to a healthy level. This reduces your risk of heart attack, stroke, and other problems. Treatment usually starts with lifestyle changes, and many people also need one or more medications. Your healthcare team will work with you to find the best plan.

Self-care at home

• Eat a healthy, balanced diet — including plenty of fruits, vegetables, whole grains, and low-fat dairy. Cut down on salt (aim for less than 6g of salt per day).
• Be physically active — aim for at least 150 minutes of moderate activity each week (like brisk walking, cycling, swimming).
• Keep a healthy weight — losing even a small amount of weight (5 to 10% of your body weight) can lower blood pressure.
• Limit alcohol — no more than 14 units per week for both men and women, with several alcohol-free days.
• Stop smoking — it raises blood pressure and damages blood vessels.
• Reduce stress — try relaxation techniques, talking to friends, or hobbies that help you unwind.

Medical treatments

If lifestyle changes alone aren't enough, your doctor may prescribe medicines to lower your blood pressure. Several types of medicines are used, including ones that help your blood vessels relax, reduce the amount of fluid in your body, or slow your heart rate. Most people need to take medicine long-term. Your doctor will start with a low dose and may increase it gradually or add a different type if needed.

When is surgery considered?

Surgery is rarely used for high blood pressure itself. In very rare cases, if a specific cause like a narrowing of the arteries to the kidney is found, a procedure called angioplasty (stretching the artery open) may be considered. This is not a common treatment.

Living with this condition

Living with high blood pressure usually means making some changes to your daily routine, but it doesn't have to take over your life. Keep track of your blood pressure at home if your doctor recommends it. Take any medicines as prescribed, even if you feel well. Stay in touch with your healthcare team and attend your check-ups.

Lifestyle tips

• Monitor your blood pressure at home if advised — your doctor or pharmacist can help you choose and use a home monitor.
• Take your medicines exactly as prescribed — never stop or change them without talking to your doctor.
• Keep a simple record of your blood pressure readings to share with your healthcare team.
• Stay active and maintain a healthy weight.
• Limit salt and avoid processed foods high in sodium.
• Avoid or limit alcohol.
• Manage stress with relaxation exercises, yoga, or simply taking time for yourself.

Diet and exercise

A heart-healthy diet is key. The DASH (Dietary Approaches to Stop Hypertension) diet — which is rich in fruits, vegetables, whole grains, lean protein, and low-fat dairy — can help lower blood pressure. Aim to eat less than 6g of salt per day (about a teaspoon). Regular exercise, like 30 minutes of moderate activity most days, helps lower blood pressure and improve heart health.

Mental health and emotional wellbeing

Having high blood pressure can sometimes make you feel worried or stressed. It's normal to have concerns, but remember that it's a manageable condition. If you feel anxious or depressed, talk to your doctor. They can offer support and recommend counselling or other help if needed.

Prevention

Yes, in many cases you can prevent or delay high blood pressure by having a healthy lifestyle. This means eating a balanced diet low in salt, staying active, maintaining a healthy weight, limiting alcohol, not smoking, and managing stress. Even if you have a family history, these steps can make a big difference.

Vaccines

There are no vaccines for high blood pressure, but staying up to date with recommended vaccines (like the flu shot) can help keep you healthy overall, especially if you have heart problems.

Screening programmes

Regular blood pressure checks are the best way to catch it early. Adults aged 40 and over should have their blood pressure checked at least every 5 years. If you have risk factors, you may need checks more often. Many pharmacies offer free blood pressure checks.

Complications

If left untreated

• Heart attack — when blood flow to part of the heart is blocked
• Stroke — when blood flow to part of the brain is interrupted
• Heart failure — when the heart becomes too weak to pump effectively
• Kidney disease or kidney failure — damage to the small blood vessels in the kidneys
• Vision loss — damage to blood vessels in the eyes
• Aneurysm — a weakened, bulging blood vessel that can burst

Long-term outlook

The good news is that high blood pressure is very treatable. With proper management — including healthy lifestyle changes and, if needed, medication — most people can control their blood pressure and reduce the risk of complications. Many people with high blood pressure live long, active, and full lives. Work closely with your healthcare team and follow your treatment plan. There is plenty of hope!

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