High blood pressure (hypertension) is very common. Although it doesn’t often come with symptoms, knowing you have high blood pressure could prevent life-threatening complications like heart attack and stroke. One in three adults in the UK has high blood pressure. The medical term for high blood pressure is ‘hypertension’, and it means your blood pressure is always too high. This means your heart is working harder when pumping blood around your body.
What is blood pressure?
Every time the heart beats it contracts, pumping blood into the arteries, which is carried through to every part of your body to give it the energy and oxygen it needs. As the blood moves along the artery, it pushes against the sides of the blood vessels. The force of this pushing is your blood pressure.
Blood pressure is measured using two numbers:
Systolic pressure: It’s the pressure against your arteries when your heart is pumping blood around your body. This is called the systolic pressure (top number) and should be around 120 or less.
Diastolic pressure: It shows how much pressure is in your arteries when your heart relaxes between beats. This is called the diastolic pressure (bottom number) and should be around 80 or less.
High blood pressure usually has no signs or symptoms, so the only way to know if you have high blood pressure is to have yours measured. However, a single high reading does not necessarily mean you have high blood pressure. Many things can affect your blood pressure throughout the day, so you will need to see that it stays high over time.
The table below shows what different readings can mean
|Blood pressure reading
|What this means
|What you need to do
|Less than 120 over 80
|Your blood pressure is normal and healthy
|Re-check in 5 years. Follow a healthy lifestyle to keep your blood pressure at this level
|Between 121 over 81 and 139 over 89
|Your blood pressure is a little higher than it should be. You may be at risk of developing high blood pressure in later life, and you should try to lower it
|Re-check in a year. Make healthy changes to your lifestyle
|140 over 90, or higher (over several weeks)
|You have high blood pressure
|Change your lifestyle – see your GP or practice nurse and take any medicines they may give you
Why is it important to know your blood pressure?
High blood pressure is a serious condition.
Your arteries are normally stretchy, so they can cope with your blood pressure going up and down. But with high blood pressure, your arteries lose their stretchiness, becoming stiff or narrow.
This narrowing makes it easier for fatty material (atheroma) to build up. This narrowing and damage to the arteries lining your heart or brain could trigger a life-threatening heart attack or stroke and according to the British Heart Foundation, around 50% of heart attacks and strokes are associated with high blood pressure.
Untreated high blood pressure can also cause kidney disease, and eye problems and is a risk factor for some forms of vascular dementia.
What causes high blood pressure?
The British Heart Foundation suggest that there isn’t a specific reason for the cause of high blood pressure, but most people develop it because of their diet, lifestyle or medical condition.
You might be more at risk if you:
- are over the age of 65
- have someone in your family with high blood pressure
- are someone who smoking
- drink too much alcohol
- eat too much salt and not enough fruit and vegetables
- don’t get enough exercise
- are overweight, especially around your mid-section.
Research shows us that people who are of black African or black Caribbean descent and people living in deprived areas are also at higher risk of having high blood pressure.
A small proportion of people may have high blood pressure that is linked to other medical conditions, such as kidney problems and diabetes. Therefore treating the medical problem can lower their blood pressure back to normal.
If you are worried that any medicine or remedy might affect your blood pressure, ask your doctor or pharmacist about it.
Where can I get my blood pressure measured or tested?
As many as 5 million adults in the UK have undiagnosed high blood pressure and don’t know they are at risk. The only way to know whether you have high blood pressure is to have it measured.
You can get your blood pressure checked at:
- GP surgeries
- some pharmacies
- some workplaces.
If you’re a healthy adult aged 40 to 74 and live in England or Wales, you’ll be invited to a free NHS Health Check every 5 years, which will include a blood pressure check.
You can also check your blood pressure at home. In England, a scheme called Blood Pressure @home is in place to support people with this, which you can ask your GP about.
The NHS has developed a useful tool to help you make a plan that you can discuss with your GP to lower your blood pressure. You can find that in the link below.
If your blood pressure is high or very high, your GP will usually offer you medicines on top of lifestyle changes.
Here are some helpful tips to help you lower your blood pressure.
If your blood pressure is too high, you can make healthy changes to your lifestyle to help bring it down. The following changes to your diet and activity can have a real effect on your blood pressure.
1. Cut down on salt
People who have a lot of salt in their diet are more likely to have high blood pressure. Adults should have no more than 6 grams of salt a day which is about a one-level teaspoon.
Most of the salt you eat is not what you add to your food, but is in prepared foods like bread, breakfast cereals and ready meals. Don’t add salt to food when cooking or at the table. When shopping for food, check the labels and choose low-salt options when you can.
Reducing the amount of salt you add to your food, as well as the number of ready meals and takeaways you eat will help.
Some people might opt for a salt substitute, made from potassium chloride. It can be useful for eating less sodium, but it won’t help you get used to a less salty taste. They are also not suitable for everyone, for example, those with kidney problems, heart failure and if you take certain blood pressure-lowering medication. Check with your doctor before using them.
2. Drink less alcohol
If you drink too much alcohol, this will raise your blood pressure over time. The current guidelines recommend no more than 14 units a week for BOTH men and women. 14 units is roughly 6 pints of 4% beer, 6 175ml glasses of 13% wine and 14 25ml glasses of 14% spirits.
3. Eat a healthy diet
A balanced diet that includes foods high in potassium, magnesium, calcium and fibre will help to lower blood pressure.
Fruits and vegetables are rich in potassium, magnesium and fibre. Aim to eat at least five portions a day. Eating more fruit and vegetables helps to lower your blood pressure. Adults should eat at least five portions of fruit and vegetables every day.
A portion is 80 grams or roughly the size of your fist. Try to eat a range of different fruits and vegetables. Dried, frozen and tinned are fine, but watch out for added salt, sugar or fats. Fruit juice and smoothies should be limited to a small glass a day
Potatoes, yams, cassava and plantains are all vegetables but they do not count towards your five a day as they are heavier in starch. However, you should still include them as part of a healthy diet.
Dairy foods are good sources of calcium. Opting for lower-fat versions such as semi-skimmed milk, low-fat yoghurts and low-fat cheese can help you to manage your weight. Aim to include at least two to three servings per day.
Wholegrain foods like wholegrain breakfast cereals and breads, brown pasta and rice and oats are high in fibre, potassium and magnesium. Aim for two to three servings per day.
Oily fish are rich in omega-3 fatty acids, which have been shown to have some effect on reducing blood pressure. Aim for at least one portion of oily fish a day. Examples of this are salmon, pilchards, sardines, mackerel, herring or trout per week.
Dietary supplements such as calcium, magnesium and potassium are not recommended for reducing blood pressure, as consuming more than you need can be harmful. Talk to your doctor if you are thinking about taking a supplement.
4. Keep to a healthy weight
Losing weight, if you need to, will help lower your blood pressure and reduce your risk of health problems.
Losing weight (even as little as 5-10% of your starting weight) will help. Slow and steady weight loss (about 1-2 lbs/0.5-1kg per week) is a healthy way to lose weight and gives you a better chance of keeping the weight off.
5. Get more active
Moving your body more and finding ways to do this daily will help to reduce your blood pressure by keeping your heart and blood vessels in good condition and also help with weight loss.
Try to build more physical activity into your daily routine by aiming for at least 150 minutes (2 ½ hours) of moderate-intensity activity across a week. This means any activity that makes you feel warmer, breathe harder and make your heart beat faster than usual. Speak with your doctor if you have heart problems or are new to exercise.
Think about how you can be more active in your daily life and set yourself small goals to achieve this.
6. Have less caffeine
Caffeine is found in things like coffee, tea and cola drinks and evidence suggests that having too much caffeine daily may increase your blood pressure.
7. Manage your stress levels
Getting enough sleep, learning relaxation techniques or asking for help, as well as eating a healthy diet, may all help.
Feeling stressed can raise blood pressure for a short time, which is normal. However, behaviours linked to stress like overeating, eating too much salt, drinking too much alcohol and not being active enough can lead to long-term high blood pressure.
Developed by Twané Walker – Registered Dietitian
Resources used while developing this article:
British Heart Foundation
British Dietetic Association
Blood Pressure UK