High Blood Pressure – Hypertension
High blood pressure is known as the ‘silent killer’ because there are usually no warning signs and no obvious symptoms. As a result, many people are unaware they have it and many people who are diagnosed often find it difficult to accept.
What is high blood pressure?
When your heart beats it pumps blood around your body. This is vitally important because it supplies your body’s tissues and organs with the oxygen and nutrients it needs to function.
As the blood moves, it pushes against the inner walls of your arteries.1 The force or strength of this pushing is your blood pressure.
High blood pressure occurs when your blood applies too much force against the walls of your blood vessels.2a Elevated blood pressure is not necessarily cause for concern. For example, it increases when you exercise or when you are stressed.3a This is normal. However, if your blood pressure is persistently high, over a longer period of time it can lead to serious complications such as increasing your risk of:
- Heart disease
- Kidney failure
- Blood vessel damage
- Sudden cardiac death4
Hypertension is the medical term for High Blood Pressure
Who gets it?
High blood pressure occurs more frequently in older people but it affects most people in adulthood to some extent.3b While certain risk factors such as age and genetics cannot be modified, there are numerous factors such as lifestyle choices that can be controlled.
Regardless, hypertension does not go away on its own so it’s important to know what causes it, who is at risk and to get your blood pressure checked at least once a year.2b
According to the World Health Organisation, of the estimated 1.13 billion people who have high blood pressure, fewer than 1 in 5 have it under control
Causes and risk factors
Hypertension is often described as either primary or secondary.
Primary hypertension (unknown causes)
Also known as essential hypertension, primary hypertension is the most common type. It usually takes years to develop, and while it has no single identifiable cause, a combination of risk factors may play a role including:
- Genetics – gene mutations or abnormalities inherited from your parents
- Age – physical changes in the body as you get older
- Lifestyle – being overweight, lack of exercise, too much alcohol, smoking, and a high salt diet, sleep deprivation6a, 7a
Secondary hypertension (caused by other conditions and medications)
Secondary hypertension often occurs faster than primary hypertension. Causes may include:
- Tumours in the adrenal gland
- Thyroid problems – if the thyroid produces too much or too little thyroid hormone
- Obstructive sleep apnea – a condition where a person’s breathing regularly stops and starts while sleeping
- Congenital vascular malformation – hereditary problems with blood vessels
- Certain prescription medications such as oral contraceptives
- Alcoholism or drinking too much alcohol7b, 8
Signs and symptoms
Unlike a cold or flu, asthma, or a migraine, you cannot ‘feel’ high blood pressure. If you experience symptoms such as headaches, shortness of breath, dizziness, chest pain or nosebleeds, your blood pressure levels are likely at a dangerous or life-threatening stage.2c, 6b
You can have high blood pressure for years and not have any symptoms. Even when blood pressure elevates to dangerous levels, many people experience no signs or symptoms2c
How is high blood pressure diagnosed?
High blood pressure is easily detected. Diagnosis is simple and pain free. All you need is a blood pressure measurement taken by a healthcare professional (doctor, clinic sister or nurse) using an inflatable arm cuff and pressure measuring gauge or stethoscope.
Your blood pressure measurement recording shows two numbers, expressed as systolic blood pressure (SBP) over diastolic blood pressure (DB).
Diastolic blood pressure3d, 5c, 9b
- The bottom number measures the pressure inside your artery when your heart rests between beats and refills with blood. The cycle in which your blood pressure falls is called diastole.
Systolic blood pressure3c, 5b, 9a
- The top number measures the pressure inside your artery when your heart contracts, or beats and pumps blood through your body. Blood pressure is at its highest or in its peak cycle, which is called systole.
Understanding your blood pressure numbers:
Definitions and classification of office BP (mmHg)
If your blood pressure reading is high6c
If your blood pressure measurement is high, you may need to have more readings taken in the following days or weeks. A hypertension diagnosis is seldom given after just one measurement. There could be various reasons for your elevated blood levels such as stress about an upcoming business pitch. Also, keep in mind that your blood pressure naturally goes up and down throughout the day.
How to treat hypertension
Various factors, such as identified causes help to inform treatment options, which will likely start with lifestyle changes to lower your blood pressure particularly when it comes to primary hypertension. Lifestyle changes may be sufficient if your blood pressure levels are elevated but, if your blood pressure is really high, your doctor may prescribe medication straight away.6d
In the case of secondary hypertension, if your doctor identifies an underlying health condition, he or she will:
- Recommend treatment to address the underlying condition or 6e
If certain medications you are taking to treat a pre-existing condition are raising your blood pressure levels, he or she will:
- Change your medication6f
Educate yourself and others
Most doctors and clinic sisters take a blood pressure reading as part of a routine visit. If you don’t receive one at your next appointment, request it.
If your blood pressure sits in the healthy (normal) range, maintain or adopt a healthy lifestyle to prevent or delay the onset of high blood pressure. Eat a heart-healthy diet and limit your salt intake, exercise regularly, and limit your alcohol intake.2c
If you discover your blood pressure does not sit in the healthy range, a healthy lifestyle together with medication often helps to bring it under control to reduce your risk of life-threatening complications.2d
Please note: This is educational information only and should not be used for diagnosis. For more information on high blood pressure, consult your healthcare professional.
1. Blood Pressure UK. What is blood pressure. Available at: http://www.bloodpressureuk.org/BloodPressureandyou/Thebasics/Bloodpressure. Accessed 9 July 2019
2. Mayo Clinic. High blood pressure (hypertension). Available at: https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410. Accessed 9 July 2019.
3. Johns Hopkins Medicine. High Blood Pressure/Hypertension. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/high-blood-pressure-hypertension. Accessed 9 July 2019.
4. Medical News Today. Everything you need to know about hypertension. Available at: https://www.medicalnewstoday.com/articles/150109.php. Accessed 9 July 2019.
5. World Health Organization. Hypertension. Available at: https://www.who.int/news-room/fact-sheets/detail/hypertension. Accessed 9 July 2019.
6. Healthline. What is high blood pressure? Available at: https://www.healthline.com/health/high-blood-pressure-hypertension#overview. Accessed on 9 July 2019.
7. NHS. High blood pressure (hypertension). Available at: https://www.nhs.uk/conditions/high-blood-pressure-hypertension/causes/. Accessed 9 July 2019.
8. Health University of Utah. High Blood Pressure: Hypertension Clinic. Available at: https://healthcare.utah.edu/cardiovascular/treatments/hypertension-clinic.php. Accessed 9 July 2019.
9. The Heart and Stroke Foundation South Africa. Blood Pressure. Available at: http://www.heartfoundation.co.za/blood-pressure/
10. American Heart Association. Understanding Blood Pressure Readings. Available at: https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings. Accessed 9 July 2019.