Hypertension means high blood pressure. This generally means:
- systolic blood pressure is consistently over 140 (systolic is the “top” number of your blood pressure measurement, which represents the pressure generated when the heart beats)
- diastolic blood pressure is consistently over 90 (diastolic is the “bottom” number of your blood pressure measurement, which represents the pressure in the vessels when the heart is at rest)
- Either or both of these numbers may be too high.
Pre-hypertension is when your systolic blood pressure is between 120 and 139 or your diastolic blood pressure is between 80 and 89 on multiple readings. If you have pre-hypertension, you are likely to develop high blood pressure at some point. Therefore, your doctor will recommend lifestyle changes to bring your blood pressure down to normal range.
Treating high blood pressure
Your choice of treatment will depend on your blood pressure level and your risk of developing a cardiovascular disease, such as a heart attack, stroke or kidney failure.
If your blood pressure is consistently above 140/90mmHg (or 135/85mmHg at home) but your risk of cardiovascular disease is low – you should be able to lower your blood pressure by making some changes to your lifestyle (see below). You may be offered yearly blood pressure assessments.
If your blood pressure is consistently above 140/90mmHg (or 135/85mmHg at home) but below 160/100mmHg – you will be offered medication to lower your blood pressure if you have existing or high risk of cardiovascular disease.
If your blood pressure is consistently above 160/100mmHg – you will be offered medication to lower your blood pressure.
Below are some changes you could make to your lifestyle to reduce high blood pressure. Some of these will lower your blood pressure in a matter of weeks, others may take longer.
- Cut your salt intake to less than 6g (0.2oz) a day. Find out how you can reduce the amount of salt in your diet.
- Eat a healthy, low-fat, balanced diet, including plenty of fresh fruit and vegetables. Get tips on eating more healthily.
- Be active: being physically active is one of the most important things you can do to prevent or control high blood pressure. Get tips on being more active.
- Cut down on alcohol. Get tips on cutting down, download a drinks diary and keep track of your drinking.
- Stop smoking. Smoking greatly increases your chances of getting heart and lung diseases. Get help quitting.
- Lose weight. Find out what your ideal weight is using the BMI healthy weight calculator.
- Drink less coffee, tea or other caffeine-rich drinks such as cola. Drinking more than four cups of coffee a day may increase your blood pressure.
- The more healthy habits you adopt, the greater effect there is likely to be on lowering your blood pressure.
- In fact, some people find that, by sticking to a healthy lifestyle, they do not need to take any medicines at all. Find out more about preventing high blood pressure.
There is a wide range of blood-pressure-lowering medicines to choose from and a combination is usually needed to treat high blood pressure.
The first medication you are offered will depend on your age.
If you are under 55 years old – you will usually be offered an ACE inhibitor or an angiotensin receptor blocker (ARB).
If you are aged 55 or older – you will usually be offered a calcium channel blocker.
In some cases, you may need to take blood pressure-lowering medication for the rest of your life. However, if your blood pressure levels stay under control for several years, your doctor might be able to reduce or stop your treatment.
Most medications used to treat high blood pressure can produce side effects but the large choice of blood pressure medicines means that these can often be resolved by changing treatments.
Let your GP know if you have any of the following common side effects while taking medication for high blood pressure:
- feeling drowsy
- pain around your kidney area (on the side of your lower back)
- a dry cough
- dizziness, faintness or light-headedness
- a skin rash
- swelling of your feet
Angiotensin-converting enzyme (ACE) inhibitors reduce blood pressure by relaxing your blood vessels. The most common side effect is a persistent dry cough. If side effects become particularly troublesome, a medication that works in a similar way to ACE inhibitors, known as an angiotensin-2 receptor antagonist (ARB), may be recommended.
ACE inhibitors can cause unpredictable effects if taken with other medications, including some over-the-counter ones. Check with your GP or pharmacist before taking anything in combination with this medication.
Calcium channel blockers
Calcium channel blockers keep calcium from entering the muscle cells of the heart and blood vessels. This widens your arteries (large blood vessels) and reduces your blood pressure.
Drinking grapefruit juice while taking some types of calcium blockers can increase your risk of side effects. You can discuss the possible risks with your GP or pharmacist.
Sometimes known as water pills, diuretics work by flushing excess water and salt from the body through urine.
Diuretics may sometimes be used as an alternative to calcium channel blockers.
- Beta-blockers work by making your heart beat more slowly and with less force, thereby reducing blood pressure.
- Beta-blockers used to be a popular treatment for high blood pressure but now they only tend to be used when other treatments have not worked. This is because beta-blockers are considered to be less effective than the other medications used to treat high blood pressure.