Blood pressure is the force the heart uses to pump blood around the body. It is measured in millimetres of mercury (mmHg). A blood pressure reading consists of two measurements a systolic (while the heart is actively pumping) and a diastolic (while the heart is relaxing) value. The blood pressure is also dependent on the elastic recoil (stretchiness) of the blood vessels known as arteries which transport the blood to the organs in your body.
What is normal blood pressure?
Normal resting blood pressure is between 90/60mmHg and 120/80mmHg
What is considered high blood pressure?
Blood pressure is considered high when it is greater than 140/80mmHg. However as we get older the arteries can become less elastic (stretchy) and so higher values may be normal in older people.
In conditions that affect the health of our arteries such as diabetes the threshold the blood pressure should ideally be below 130/80mmHg to prevent problems down the line.
What causes high blood pressure?
In the majority of people high blood pressure also known as hypertension is caused by our lifestyle. Being overweight, eating a lot of salt, smoking, drinking too much alcohol and not exercising enough can all contribute to high blood pressure.
In a very few individuals or in those in which blood pressure is difficult to control there can be a structural or hormonal cause which can be treated.
Why is my blood pressure always high when I see the doctor?
Anxiety can increase your blood pressure. This is well known about and even has a name “white coat hypertension”. Therefore we usually rely on multiple different readings over a period of time or even a 24 hour blood pressure monitor to make a diagnosis.
What are the symptoms of high blood pressure?
Most people do not have any symptoms, but some people can experience headaches and visual disturbance.
If I feel well then why do I need treatment for high blood pressure?
Left untreated, high blood pressure has significant consequences for your health. Untreated high blood pressure increases the risk of having a stroke, heart failure, kidney failure and heart attacks.
Will I always need tablets?
No, the first step is change your lifestyle and often if this is done at an early stage then no further treatment is needed. However when high blood pressure has been there for a while the body re-sets itself and it can become difficult to change without tablets. Often combinations of tablets are needed to get the blood pressure under control.
At Wiltshire Cardiology we will first make sure that we make an accurate diagnosis. We may ask you to have multiple recordings of your blood pressure or arrange a 24 hour blood pressure monitor. We will take a comprehensive history and if this is a face-face consultation we will examine you. You will also have an ECG and we may also undertake an echocardiogram (ultrasound of the heart) and blood and urine tests. Based on this evaluation we will come up with an individualised plan to suit your particular needs.
Renal denervation: The regulation of blood pressure is controlled by the autonomic nervous system (ANS) which regulates bodily functions without you having to think about them. Therefore potential altering this system could help reduce blood pressure control. The area around the kidneys is rich in nerve fibres which carry signals from the sympathetic nervous system (the part of the ANS responsible for increasing the blood pressure). Renal denervation therapy uses a balloon to deliver high energy radiofrequency waves in the renal arteries to modify the signalling from these nerve fibres and reduce the blood pressure. This treatment is not yet established in the NHS but recent studies have been more promising.