Hypertension

Hypertension is the medical term for high blood pressure. Blood pressure is the force your blood exerts on the walls of your arteries as the heart pumps. It is written as two numbers, such as 130/80 mmHg: the higher number (systolic) is the pressure when the heart beats, and the lower number (diastolic) is the pressure when the heart rests between beats.

When blood pressure stays raised over weeks and months, the heart and blood vessels have to work harder, and the extra strain can slowly damage arteries and organs. Because this happens silently, many people do not know they have it until a routine check or until a complication develops.

High blood pressure rarely causes noticeable symptoms, which is why it is sometimes called a silent condition. Some people assume headaches, nosebleeds or dizziness are warning signs, but these are not reliable indicators and most people with high blood pressure feel completely normal.

Very high blood pressure can occasionally cause a severe headache, blurred vision, chest pain or shortness of breath. These symptoms can signal a medical emergency and need urgent assessment.

In most people no single cause can be identified; this is called primary or essential hypertension and tends to develop gradually with age. Factors that raise the risk include a family history of high blood pressure, being overweight, eating a lot of salt, drinking too much alcohol, smoking, lack of physical activity and ongoing stress.

Less commonly, high blood pressure is caused by another condition or medicine, known as secondary hypertension. Causes can include kidney disease, hormone disorders and some medications such as certain painkillers, decongestants or the contraceptive pill. Treating the underlying cause can often improve blood pressure.

Blood pressure is measured with a cuff placed around the upper arm. Because a single high reading can be due to anxiety or activity, a diagnosis is usually based on several readings taken on different occasions, and sometimes on monitoring at home or over 24 hours with a portable device.

If high blood pressure is confirmed, further tests may be arranged to look for any underlying cause and to check whether the heart, kidneys or eyes have been affected. These can include blood and urine tests, an electrocardiogram (ECG) and an assessment of overall cardiovascular risk.

Treatment aims to bring blood pressure down to a safe level and keep it there, reducing the long-term risk of heart attack, stroke and kidney damage. For many people the first step is lifestyle change: eating less salt, following a balanced diet rich in vegetables and fruit, being more active, reaching a healthy weight, limiting alcohol and stopping smoking.

When lifestyle measures are not enough, or when blood pressure is high, medicines are added. Several types are used, including ACE inhibitors, angiotensin receptor blockers, calcium channel blockers and diuretics, and some people need more than one. Blood pressure is then monitored regularly, and treatment is usually long term.

Many of the same habits that treat high blood pressure also help prevent it: keeping to a healthy weight, staying physically active, cutting down on salt and alcohol, eating plenty of vegetables and fruit, and not smoking. Having blood pressure checked regularly allows any rise to be caught and managed early.

With ongoing treatment and healthy habits, most people keep their blood pressure under control and significantly lower their risk of serious complications. Because it is a long-term condition, regular review and sticking with treatment are important even when you feel well.