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Is the Pressure on?
13/03/2006
IS THE PRESSURE ON?
Local pharmacist Roisin McKenna (Health Centre Pharmacy) gives us a general guide to blood pressure, risk factors for the condition and ways by which you can help yourself.
WHAT IS BLOOD PRESSURE?
Blood pressure is quite simply the force exerted by blood on your blood vessels.
WHAT DO THE NUMBERS MEAN?
When you have your blood pressure measured you will see it written as 2 sets of figures, one over the other, like a fraction e.g., 140/90mmHg.
The first number is the SYSTOLIC PRESSURE and is the pressure when your heart contracts while the second number is the DIASTOLIC PRESSURE and this is the pressure when your heart relaxes.
The mmHg refers to the way that that blood pressure is measured; height in millimetres of a column of mercury (Hg is the chemical symbol for mercury).
WHAT IS A HIGH BLOOD PRESSURE VALUE?
Every individual will of course vary but generally a normal blood pressure reading will be 129 (or less) / 85 (or less).
If your blood pressure is raised you will hear your doctor refer to it as hypertension.
MILD HYPERTENSION – 140/90mmHg or above but below 160/100mmHg
MODERATE TO SEVERE HYPERTENSION - 160/100mmHg or above.
HOW IS HYPERTENSION DIAGNOSED?
A one off raised reading does not mean you have hypertension. Your blood pressure will vary naturally throughout the day and may be high for a short term if you are anxious, stressed or have just been exercising. Indeed there is a condition, ‘white-coat hypertension’ where your blood pressure rises just because the doctor is taking your blood pressure!
You will be diagnosed as having hypertension if you have several high readings taken on different occasions and when you are relaxed.
WHAT ARE THE SYMPTOMS OF HYPERTENSION?
Hypertension is often known as the ‘silent killer’ as it very often does not produce any symptoms until it is very severe. Sometimes the first time people know they have it is when they have a stroke or heart attack.
That is why it is important to have your blood pressure regularly checked. All adults should have their BP checked at least once every 3-5 years but more often (at least once a year) in older people, people with previously high (or on high side of normal) readings and people with other medical conditions e.g. diabetes.
HOW COMMON IS HYPERTENSION?
In the UK about half of people over 65 and about 1 in 4 middle aged adults have high blood pressure; this works out at about 16million people. It is more common in males, up until the age of 64, after which it is more common in females. Most cases are mild but at least 1 in 20 adults have Bp of 160/100 or above.
WHY IS HYPERTENSION A PROBLEM?
Over the years, a consistently raised BP will damage your arteries and put a strain on your heart. This will increase incidence of angina, heart attack, and dementia and kidney damage. People with hypertension are three times more likely to develop heart disease and stroke and twice as likely to die from these as people with a normal BP
WHAT ARE THE RISK FACTORS FOR DEVELOPING HYPERTENSION AND RELATED CONDITONS?
· SMOKING
· LACK OF EXERCISE
· UNHEALTHY DIET
· EXCESS ALCOHOL
· OBESITY
· HIGH CHOLESTEROL LEVEL
· FAMILY HISTORY OF HEART DISEASE OR STROKE
· DIABETES
If you have 2 or more risk factors your overall risk is much greater than if you have just one.
HOW CAN I CHANGE MY LIFESTYLE TO LOWER MY BP?
1. CUT DOWN ON SALT- salt intake should be limited to no more than 5-6 grams per day. Avoid processed foods and foods which contain ‘hidden salt’ e.g. tinned soup, breakfast cereals and sauces. Do not salt while cooking, or at the table, and use herbs and spices to flavour your food instead.
2. EAT A HEALTHY DIET. Aim to eat at least 5 portions of fruit and vegetables per day (ideally 7-9) as these are a good source of potassium (which has opposite effect to salt) and also contain antioxidants which play an important role in preventing heart disease. Bananas, dried fruit, melon and potatoes are all particularly high in potassium.
You should cut down on saturated fat such as fatty meats, cheese and butter and instead eat lean meat or chicken. You should try and eat at least 2-3 portions of fish per week, at least one of which should be an oily fish e.g. herring, mackerel or fresh tuna (not tinned).
3. EXERCISE REGULARLY. Aim to exercise on 5 or more days per week for at least 30 minutes. You should be a little out of breath, but still able to talk, and be warm and slightly sweaty. Good examples are brisk walking, swimming and dancing but you should always check with your doctor before starting any form of exercise plan, especially if your blood pressure is very high or if you have other medical conditions.
4. REDUCE ALCHOL INTAKE. The exact way that alcohol affects BP is not known. Moderate intake actually seems to protect against heart disease and stroke but this beneficial effect is lost if alcohol is consumed in large amounts. It is recommended that men consume no more than 21 units per week (no more than 4 in any one day) and women no more than 14 units per week (3 in a day). A unit is about half a pint of normal strength beer, a small glass of wine or a small pub measure of spirits.
5. STOP SMOKING. Smoking is a risk factor for heart attack, heart failure and stroke so any smoker diagnosed with hypertension should do their best to give up immediately.
WILL I NEED TO TAKE TABLETS?
This will depend on how severe you hypertension is but it is important to pint out that, even if your doctor does give you tablets, you still need to make lifestyle changes.
The doctor will decide which medication to use, as there a wide variety of hypertension medications available. This decision will depend on factors such as your age, if you have any other medical conditions and are taking other medications and on the likelihood of possible side effects.
Most people will need to take more than one type of BP medication in order to bring their reading down to a target as near to 140/85mmHg as possible and in about a third of cases 3 or more different medications are needed. It is not always possible to achieve this ‘target’ level but any reduction in BP will be beneficial.
If you also have a high risk of heart disease or stroke your doctor may also prescribe you medication to lower your cholesterol and a daily dose of aspirin to lessen the risk of blood clots.
WILL I NEED TO TAKE MY TABLETS FOR LIFE?
In most cases the answer is YES. In some people, especially those who have made very significant lifestyle changes, and whose BP has been well controlled for 3 years or more their medication may be stopped. However, in the majority of case, medication will need to be restarted at some point. It is very important to remember that the effects of BP are very long term so it is extremely important to keep it well controlled.
HOW WILL I KNOW IF MY TREATMENT IS WORKING?
The only way is by regular blood pressure checks. This can be done through your doctor or nurse or some people monitor their own blood pressure at home.
HOW CAN I MONITOR MY OWN BLOOD PRESSURE?
Most people who monitor their own blood pressure do so by using an automatic machine. These can be purchased from your pharmacy and you should always consult your pharmacist before purchasing one. They can help you find a model that is suitable and convenient for you to use and that will give accurate reliable results. They will also advise you on the correct procedure for taking your own BP reading.
Home monitoring allows you to check your BP in a relaxed surrounding and may help you to feel more in control of your condition and help you understand more about BP, what affects it and how it changes. It can also give you some idea how well you are responding to either medication or lifestyle changes.
You should agree with your doctor or nurse how often you will take measurements and what to do if there seems to be any significant changes in your readings.
IF YOU WOULD LIKE ANY FURTHER INFORMATION ON HYPERTENSION OR WOULD LIKE TO BUT A BLOOD PRESSURE MONITOR FOR HOME USE THEN PLEASE RING ROISIN ON 02893356111 AND SHE WILL BE HAPPY TO ADVISE YOU.
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