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Residents Association MagazinearrowWinter 2002 - 8

HYPERTENSION

"Is it my Blood Pressure doc??"

As a GP this question may be quite a familiar one when faced with someone who has recently been diagnosed with heart disease. Contrary to popular belief high blood pressure or hypertension is NOT heart disease itself but is simply when a particular bodily measurement [the pressure in your arteries] is found to be above certain widely accepted limits. The measurement is taken with a blood pressure machine [the Sphygmomanometer] when the familiar cuff is placed around the patient's upper arm, inflated and then slowly released. High blood pressure if left untreated can lead to stroked or hear attacks but if left untreated for a long time can lead to kidney failure and eyesight problems. It is for this reason that we [the health professions] take its finding and treatment so seriously.

Most people with high blood pressure have no idea they have it as it rarely makes you feel ill. It is for this reason that blood pressure is so readily measured when you make a visit to a nurse or doctor. The actual measurement consists of two readings: a higher or systolic reading and a lower or diastolic reading. The pressure is created by the action of the pumping of the heart and the highest reading is caused by the contraction of the heart [a heartbeat] and the lowest the pressure between heartbeats. Blood pressure is measured in millimetres of mercury. Normal blood pressure in adults is generally taken to be below 160/90 but for those people who already have heart disease, have had a stroke or suffer with diabetes the target blood pressure is lower.

The cause of high blood pressure is largely unknown in that for nine out of ten people who have high blood pressure there is no single underlying cause found. This is known as 'essential hypertension'. There are certain things that can contribute to having a high blood pressure. They are being overweight, smoking, having excess salt in your diet, drinking too much alcohol and physical inactivity. If high blood pressure runs in your family you may also be at greater risk of developing it yourself.

When high blood pressure is picked up by a health professional it is usually repeated a number of times over a period of between three and six months before a decision is made as to whether to treat it with tablets. During this period of time you would also be asked to have a general examination and some basic tests such as blood and urine tests, an ECG [electrocardiogram] which is a test to record the electrical activity of the heart and possibly a chest X ray. It is these tests which can help to confirm whether you have any other problems which may be contributing to the high blood pressure.

If you should have your blood pressure measured and are told it is too high it is important not to become too worried about it as worry or stress itself can cause the blood pressure to become raised. In some cases when further blood pressure readings are taken they settle down and the blood pressure does not need treating but merely observing intermittently.

If you are found to have high blood pressure be reassured you are not alone and for the majority its finding will not have a detrimental effect on your lifestyle. Your doctor may recommend tablets but they would also advise on some very important lifestyle alterations, which can help lower your blood pressure.

The importance of lifestyle changes and the effects these may have on your blood pressure cannot be overestimated. The most important lifestyle changes that would help to lower your blood pressure are being more physically active, losing weight, cutting down on salt intake, drinking within sensible limits, stopping smoking and reducing stress.

Finally, if you are concerned you may have high blood pressure please don't hesitate to have it taken either in your surgery by your practice nurse or GP or in your local pharmacy where they may have the facility to do so. Remember, you'll never know until you do!!

Dr. Watkins

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Last Updated: 20th February 2004