Hypertension living patient overview

Overview

High blood pressure (also called hypertension) is a common condition where the force of blood against your artery walls is too high for too long. Over time, this can damage your blood vessels and lead to serious health problems. It is often called a 'silent' condition because most people have no symptoms.

Yes, high blood pressure is extremely common. About 1 in 3 adults worldwide has it, and the risk increases with age.

Anyone can develop high blood pressure, but it is more common in people over 40, those with a family history, people who are overweight or inactive, and certain ethnic groups (such as people of African or Caribbean descent). It also becomes more common as you get older.

Symptoms

Common symptoms

• Most people with high blood pressure have no symptoms at all.
• Some people may occasionally have headaches, shortness of breath, or nosebleeds, but these are not specific to hypertension.

Symptoms in children

• Children with high blood pressure often have no symptoms. It is usually discovered during a routine checkup.

Symptoms in older adults

• Older adults usually have no symptoms, though very high blood pressure may cause headaches, dizziness, or nosebleeds.

Causes

Main causes

• Most cases of high blood pressure have no single cause (called primary or essential hypertension). It usually develops over many years as you age.
• Secondary hypertension is caused by an underlying condition, such as kidney disease, thyroid problems, sleep apnea, or certain medications (like some cold remedies, pain relievers, or birth control pills).

Risk factors

• Getting older
• Having a family history of high blood pressure
• Being overweight or obese
• Not getting enough physical activity
• Eating too much salt (sodium)
• Drinking too much alcohol
• Smoking or using tobacco
• Long-term stress
• Certain ethnic backgrounds (African, Caribbean, South Asian)

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above, call your local emergency number immediately.

Book a routine appointment if:

• If you are over 40, get your blood pressure checked at least every 5 years.
• If you have risk factors (like diabetes, kidney disease, or a family history of high blood pressure), get checked more often – your doctor can advise you.
• If you have been diagnosed with high blood pressure, see your doctor regularly to monitor your numbers and adjust treatment as needed.

Diagnosis

High blood pressure is diagnosed by measuring your blood pressure with a cuff (sphygmomanometer). A single high reading is not enough – your doctor will confirm it with several readings on different days. Sometimes a 24-hour monitoring device is used to get an average.

Tests that may be done

• Blood pressure measurement (manual or automated)
• Blood tests to check kidney function, blood sugar, and cholesterol
• Urine test to check for kidney problems
• Electrocardiogram (ECG) to check heart health
• Ambulatory blood pressure monitoring (wearing a portable device for 24 hours)

What to expect at your appointment

Your doctor will take your blood pressure in a calm room. They may measure it in both arms. You will be asked to sit quietly for a few minutes before the reading. You may need to return for repeat measurements. If diagnosed, your doctor will discuss treatment and make a plan tailored to you.

Treatment

Treatment for high blood pressure focuses on lowering your numbers to a safe level. This usually starts with healthy lifestyle changes. If those are not enough, your doctor may prescribe medication. The goal is to prevent damage to your heart, brain, kidneys, and blood vessels.

Self-care at home

• Eat less salt – aim for less than 6g per day (about a teaspoon). Avoid processed foods and added salt.
• Eat more fruits, vegetables, whole grains, and low-fat dairy. The DASH diet (Dietary Approaches to Stop Hypertension) is a good guide.
• Get at least 150 minutes of moderate activity each week (like brisk walking, swimming, or cycling).
• Maintain a healthy weight – even losing 5% of your body weight can help.
• Limit alcohol to no more than 14 units per week (spread out over several days).
• Quit smoking – it raises your blood pressure and damages arteries.
• Manage stress with relaxation techniques, hobbies, or talking to someone.

Medical treatments

If lifestyle changes are not enough, your doctor may prescribe one or more medicines to lower your blood pressure. There are several types, including water pills (diuretics), drugs that relax blood vessels, and medicines that reduce the heart's workload. Your doctor will choose the best option based on your age, overall health, and other conditions. You will need to take the medicine as directed, even if you feel fine.

When is surgery considered?

Surgery is not usually needed for high blood pressure itself. In very rare cases, if high blood pressure is caused by a secondary problem like a narrowed kidney artery (renal artery stenosis), a procedure to open the artery may be recommended.

Living with this condition

Living with high blood pressure means taking small steps every day to keep your numbers in check. Check your blood pressure at home if your doctor recommends it. Take any prescribed medications exactly as told. Keep a log of your readings to share with your healthcare team. Stay active, eat well, and manage stress.

Lifestyle tips

• Monitor your blood pressure regularly – ask your doctor how often.
• Stick to a heart-healthy diet (low salt, high fruits and vegetables).
• Stay physically active most days of the week.
• Avoid tobacco and limit alcohol.
• Get enough sleep (7–9 hours per night).
• Manage stress with activities like deep breathing, yoga, or walking.

Diet and exercise

A heart-healthy diet is key. Reduce salt, eat plenty of fruits, vegetables, whole grains, and lean proteins. The DASH diet is a proven approach. For exercise, aim for 30 minutes of moderate activity on most days – brisk walking is a great start. Always talk to your doctor before starting a new exercise routine.

Mental health and emotional wellbeing

Dealing with a long-term condition can be stressful, and stress itself can raise blood pressure. It is normal to feel worried or frustrated. Talk to your doctor or a counselor if you feel overwhelmed. Simple relaxation techniques like deep breathing, meditation, or spending time in nature can help.

Prevention

You can reduce your risk of developing high blood pressure by maintaining a healthy weight, eating a balanced diet low in salt, exercising regularly, limiting alcohol, and not smoking. Even if you have a family history, these steps can help delay or prevent it. Once you have high blood pressure, you can still prevent complications by managing it well.

Screening programmes

Regular blood pressure checks are the best way to catch high blood pressure early. Adults over 40 should have their blood pressure checked at least every 5 years. If you have risk factors, your doctor may recommend more frequent checks.

Complications

If left untreated

• Heart attack or heart disease
• Stroke
• Kidney damage or failure
• Vision loss (damage to blood vessels in the eyes)
• Peripheral artery disease (narrow blood vessels in the legs)
• Dementia (damage to blood vessels in the brain)

Long-term outlook

With proper treatment and lifestyle changes, most people with high blood pressure can keep their numbers in a healthy range and live a long, full life. It is a condition you can manage, not a sentence. The key is to stay informed, work with your healthcare team, and take care of yourself every day.

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