What is normal blood pressure?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
What is normal blood pressure?
We all have a blood pressure to maintain the circulation of blood which is essential to provide vital oxygen and nutrients to the major organs, such as the heart, kidneys, liver and brain. The blood is pumped round the body by the beating of the heart which pushes five litres (8 pints) of blood around the body through the blood vessels. Without the pressure from the heart no blood would flow through the arteries.
The heart contracts and then relaxes in an alternating rhythm, at a rate which usually varies between 60 and 100 times per minute. Each cycle of contraction & relaxation is often called “a heart beat” (and usually can be felt at the wrist as the “pulse”). As the heart contracts the pressure in the blood vessels rises to a peak level, and then as the heart relaxes (so it can refill with blood) the pressure in the blood vessels steadily falls to a trough level. The peak blood pressure level is called the systolic pressure, and the trough blood pressure level is called the diastolic pressure. The unit of pressure used is millimetres of mercury (mmHg). Our blood pressure varies day to day, hour to hour and minute to minute. It also varies from person to person. The levels of normal systolic and diastolic blood pressure vary with age.
Last reviewed February 2010.
What is high blood pressure?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
What is high blood pressure?
High blood pressure is a condition in which the blood circulating around the body is under increased pressure. Blood pressure can go up when we are frightened, exercising, or even just altering our position. The blood pressure may remain high because of a change in the blood vessels through which the blood travels. This condition is often called 'hypertension', and people with it are described as 'hypertensive.' If a person's blood pressure is found to be high on one occasion, this does not necessarily mean that they are hypertensive because the blood pressure normally varies (see 'What is normal blood pressure?'). For this reason the diagnosis of high blood pressure is not usually made on the basis of a single high reading of the blood pressure but from a series of readings over weeks or months.
Most young people have a blood pressure below 120[systolic]/ 80[diastolic]. As people get older the blood pressure levels tend to increase. There is much discussion at what level the blood pressure should be considered too high. In general it is accepted that adults should have a blood pressure under 140/85. Many people who have high blood pressure may be quite unaware of it since it does not make them feel unwell in any way.
When high levels are found on several occasions a decision has to be made at some point to try and bring it down. This will prevent some of the more serious outcomes that occur more commonly in people who have untreated high blood pressure for many years, compared with people with normal blood pressure or people who have blood pressure that has been well controlled.
Contrary to popular myth, high blood pressure is not a disease of the nervous or highly-strung, or simply the result of a stressful lifestyle. The current understanding is that a blood pressure problem develops when certain chemical substances alter the blood vessels. This makes the vessels less elastic and so increases the pressure of the blood within the vessel. The change may take many years and usually high blood pressure appears gradually.
Most people get stressed and anxious when seeing their doctor and this tends to put their blood pressure up. This is another reason for the doctor to measure your blood pressure several times before deciding to treat.
Last reviewed February 2010.
I don't feel ill, why does it matter that I have high blood pressure?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
I don't feel ill, why does it matter that I have high blood pressure?
Most people who have high blood pressure are unaware that they have it. They only discover it when they have their blood pressure measured for some other reason, like an insurance exam, or at a routine check. High blood pressure does not usually cause any immediate problem unless it is extremely high (a condition called malignant hypertension). Persistently high blood pressure is a serious matter because it eventually can damage the lining of blood vessels and strain the heart, which in turn can lead to a heart attack, stroke or kidney damage. Occasionally people with nose bleeds, or bad headaches are found to have high blood pressure, and other people sometimes 'feel' when their blood pressure is high, though there is little research to support this.
Last reviewed February 2010.
How is Blood Pressure measured?
The information in this section was compiled by Dr Richard Lehman, Healthtalkonline’s Medical Advisor.
How is Blood Pressure measured?
The device for measuring blood pressure is called a sphygmomanometer. Traditionally this consisted of a cuff put around the arm connected to a glass tube containing mercury. As the pressure in the cuff is increased, it squeezes the artery in the arm (brachial artery). When the pressure in the cuff reaches the diastolic pressure , the artery makes a tapping noise which continues until the cuff is inflated up to systolic pressure, when all flow is cut off. At the same time the air in the cuff pushes the column of heavy mercury (Hg) up to certain number of millimetres, so blood pressure is recorded as mm Hg, systolic over diastolic.
This is still the most reliable way of measuring blood pressure, but because of restrictions on the use of mercury, other kinds of pressure measuring machines have been developed. Many of these detect the sound made by the artery via a microphone rather than through the traditional health professional's stethoscope. This makes them easier to use, especially in home settings, but unfortunately they are less accurate, and can give misleading results in some circumstances, e.g. if the heart rate is irregular, or if there is a problem with the electronic detectors.
Last reviewed February 2010.
Last updated February 2010.
Should I measure my blood pressure at home?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
Should I measure my blood pressure at home?
Blood pressure varies in everybody, and in some people it always rises when seeing health professionals - the so-called "white coat" effect. So before starting or altering blood pressure lowering treatment, it is often useful to get measurements done at home. The doctor or nurse may be able to lend out a machine for this purpose, and increasing numbers of people on blood pressure treatment are buying their own. These home readings can be very useful to health professionals during consultations, and also allow you to judge the effects of the treatments you are given on a day to day basis.
However, it is important to buy a reliable machine and to seek advice if readings seem too high or too low. A continuously updated guide to blood pressure machines is available on the
British Hypertension Society website.
Last reviewed February 2010.
Last updated February 2010.
Why didn't my doctor pick it up earlier?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
Why didn't my doctor pick it up earlier?
Since most people with high blood pressure do not have any immediate problems it may not be discovered until they visit a doctor for some unrelated problem. As high blood pressure is so common it is a good idea to have your doctor or nurse checks your blood pressure at regular intervals, at least every three to five years. If a close relative (parent, brother, sister) has high blood pressure you should mention this to your doctor.
All GP practices in the UK try to ensure that every adult has her or his blood pressure measured at least every five years. If this has not been done, a prompt will appear on the doctor's computer.
Last reviewed February 2010.
Last updated February 2010.
I get headaches - is this due to high blood pressure?
The information in this section was compiled by Dr Richard Lehman, Healthtalkonline’s Medical Advisor.
I get headaches - is this due to high blood pressure?
The link between headaches and blood pressure is not as close as many people think. Almost everybody gets headaches from time to time, and headaches are no commoner in people with raised blood pressure. However, they can be a side-effect of some drugs used to lower blood pressure. The commonest drugs to cause headache are calcium channel blockers (see section on 'treatments') such as amlodipine and felodipine.
Getting a headache does not mean that your blood pressure is going out of control. Only in rare and extreme circumstances can high blood pressure itself cause headache.
Last reviewed February 2010.
Last updated February 2010.
Why does blood pressure vary so much?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
Why does blood pressure vary so much?
Our blood pressure varies from minute to minute and from day to day. This is to make sure that the right amount of oxygen and nutrients are delivered to various organs in the body according to the level of activities the body is undertaking. If an emergency occurs, or is expected, the body prepares itself with the 'fight or flight reaction'. The muscles need more blood, so blood is diverted away from other parts such as the skin and gut. The stress hormones (adrenaline, and adrenal gland steroids) that help achieve this diversion have the effect of increasing the blood pressure. This may be useful if you are doing some strenuous exercise or heavy lifting, but it serves no purpose if you are just stuck in a traffic jam and getting stressed out. By contrast when you are mentally and physically relaxed, as in sleep, your body needs less oxygen and nutrients, and your blood pressure tends to be lower. If the pressure is measured continuously for twenty-four hours many people with essential hypertension (a persistent high blood pressure problem) are found not to have this normal night-time fall in blood pressure.
The normal variability of the blood pressure is one reason your blood pressure should be measured several times on different occasions before deciding whether you need treatment or not.
Last reviewed February 2010.
What is low blood pressure?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
What is low blood pressure?
In the UK the diagnosis of low blood pressure is rarely made. Low blood pressure is usually considered to be a sign of good health. Not many people have a blood pressure below 110/60 but those who do are usually quite healthy. Some symptoms, such as feeling faint and seeing stars after getting out of a hot bath or after bending down for some time get attributed to low blood pressure. These symptoms rarely last long and do not require treatment. When they continue they are likely to be caused by anaemia rather than low blood pressure, but they can occur as a side effect of some of the drugs taken for high blood pressure.
The blood pressure drops suddenly when there is either a fast reduction in blood volume, for example after rapid blood loss, or if the tension in the blood vessel walls is suddenly reduced as a result of acute poisoning by a toxin such as wasp venom. The immediate effect of this drop in blood pressure is that the person loses consciousness (faints). In a mild and reversible form it can occur after a sudden shock (for example when witnessing a horrific sight like a road accident).
Last reviewed February 2010.
Why do some people develop high blood pressure?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
Why do some people develop high blood pressure?
In the vast majority of people with high blood pressure it has no single clear-cut cause, and the condition is called 'essential hypertension'. This medical term is confusing because there is nothing good or 'essential' about hypertension. It was chosen to describe people whose high blood pressure just seems to be an integral or 'essential' part of their make-up. This tendency can run in families. Factors that contribute to a raised BP include: being overweight, salt added to the diet (in processed foods, when cooking or at the table), being a heavy drinker, physical inactivity, having high BP in your family.
In a small number of people a cause is found - and this may include damage to the kidneys through disease, damage to the kidneys due to obstruction of their blood supply, or abnormal production of hormones from the adrenal glands. Occasionally some medicines such as corticosteroids may cause a rise in blood pressure.
Last reviewed February 2010.
Could my high blood pressure be due to stress or my job?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
Could my high blood pressure be due to stress or my job?
Contrary to popular myth, high BP is not a disease of the nervous or highly strung, or simply the result of a stressful lifestyle. Even a stock exchange worker, a mountaineer or a mother of triplets will have a normal BP at night and much of the day. A transient rise in BP can occur in anyone who is rushing around feeling stressed, as this reflects the body's natural response when it prepares for an emergency. The current understanding is that a BP problem develops when certain chemical substances alter the blood vessels. The vessels become less elastic and so the pressure of the blood within the vessel increases. This change may take many years and usually high BP appears gradually. In people who do have a high BP problem, however, stress will probably aggravate it unless they are on sufficient treatment.
Anxiety or strong mental effort can cause a temporary rise in blood pressure. This is a normal response and healthy blood vessels can cope with these transient changes. However, if your arteries have to suffer prolonged or repeated episodes of high pressure, this may cause their walls to thicken and lose their elasticity.
Last reviewed February 2010.
Last updated February 2010.
Does blood pressure go up with age?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
Does blood pressure go up with age?
Yes, blood pressure normally increases with age. What is regarded as an acceptable BP in a 70 year old may not be regarded as acceptable in a 20 year old. This is important because it means that it is not always possible to specify an exact BP level for which tablet treatment should be started. Many different factors play a part, which is why doctors sometimes disagree about the exact level of blood pressure that requires treatment.
Last reviewed February 2010.
Can my children inherit high blood pressure?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
Can my children inherit high blood pressure?
Your genes are determined at conception, when the sperm from the father meets the egg from the mother, and nothing will affect this. The exact causes of high blood pressure are not yet understood but we know that a number of factors combine to raise the blood pressure, of which a family history is one of the most important - high blood pressure tends to run in families. The most common blood pressure disorder, called 'essential hypertension' tends to come on in adulthood before the age of 50. If you have high blood pressure it would be worthwhile for your children to have a blood pressure check every five years, and more frequently if their blood pressure becomes borderline or obviously high. It will be particularly important for them to ensure they lead a healthy lifestyle, avoiding smoking, taking regular exercise, eating a 'low fat, low salt, lots of fresh vegetables' diet, so that they can postpone and possibly even avoid the development of hypertension.
A very small percentage (5%) of hypertensive people have 'secondary hypertension', meaning that their hypertension is caused by a recognised kidney or hormone disorder. Some of these disorders are inherited, so if you have a strong family history of some health problem associated with high blood pressure make sure that you discuss it with your doctor.
Last reviewed February 2010.
Why should blood pressure be treated?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
Why should blood pressure be treated?
Many people go through life with high blood pressure, without ever knowing they have it. However people whose high blood pressure has not been controlled run a significantly greater risk of suffering a heart attack or stroke than people with normal blood pressure or than people whose high blood pressure has been brought down to a normal level.
When blood pressure is high for a long time, it speeds up the wear and tear to the lining of the blood vessels, increasing the chance that blood clots will form and cause heart attack, stroke or damage to the kidney. People with untreated high blood pressure are definitely at greater risk of these problems.
Blood pressure should be considered along with other risk factors for stroke and heart disease. These include smoking, blood fats, age and gender. Decisions about treatment should include assessment of overall risk and of the options for taking action on other risk factors.
What tests may need to be done?
- ·Your doctor will take your blood pressure, listen to your heart and to your chest, and may examine your eyes to see if the vessels at the back of your eyes have been affected by high blood pressure.
- ·Your weight and height will be measured.
- ·Your urine will be tested for protein and blood to see if your kidneys are affected.
Your blood will be tested for:
- ·levels of sodium and potassium (salts)
- ·creatinine, which indicates whether your kidneys are functioning normally
- ·glucose to see if you might have diabetes
- ·cholesterol to see if you have too much fat in your blood
- ·You may have an electrocardiogram (ECG) to check out your heart
- ·You may need to have your kidneys checked with an ultrasound scan.
Can high blood pressure be cured?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
Can high blood pressure be cured?
If your blood pressure is mildly raised - losing weight, reducing salt in your diet, and taking exercise may bring it back into the normal range and no other treatment is necessary. However once you have seriously raised blood pressure you will probably have to take tablets for the rest of your life, if you want to keep your blood pressure down, as if you stop taking your tablets, your blood pressure is very likely to rebound to its previous high level.
In a very few people (around 5%) a specific recognised cause for high blood pressure is found, and removal of the cause can produce a 'cure'. This is called 'secondary hypertension' and is most commonly due to kidney disease. Less common causes are furring up of the arteries to the kidneys (renal artery stenosis), and an excess of hormone from the adrenal gland (primary hyperaldosteronism). To screen for these rare conditions your doctor will at some stage test your urine and perform some blood tests.
Last reviewed February 2010.
Will having high blood pressure shorten my life or affect my general health?
The information in this section was compiled by Dr Richard Lehman, Healthtalkonline’s Medical Advisor.
Will having high blood pressure shorten my life or affect my general health?
The level of a person's blood pressure is just one of many factors that can determine how long that person lives. Other important factors include smoking, weight, family history, exercise and blood sugar. Blood pressure control becomes more, not less, important if there are other risk factors present. For example, if you have diabetes, control of blood pressure is the most important way to prevent serious complications, more so even than control of blood sugar. Similarly, if you have already had a stroke, it is not "too late" to have blood pressure treatment; on the contrary, it is even more important to prevent another stroke.
By treating other risks, for example by giving up smoking and taking more exercise, you do not avoid the need for blood pressure control, but you do gain yourself added years of life expectancy. You should also try to keep to your ideal weight and waist circumference, and know your blood cholesterol level. If that is high, then you may well need extra treatment to lower it. We know that by improved control of these factors, rates of heart disease and stroke are falling throughout the UK, though much more could be done.
For you as an individual, there are many different ways of calculating your risk of heart attacks and stroke (cardiovascular disease) but these do not lessen the importance of controlling blood pressure, which has proven benefits right up to the age of 80 and beyond. In fact some doctors have suggested that everybody over the age of, say, 55 years old should be on blood pressure lowering medication, regardless of the blood pressure level. We know that for people with raised blood pressure, treatment lowers the risk of stroke by about 40% and of major heart problems by 20%.
For more information about calculating your overall cardiovascular risk, you can visit the
NHS Choices website.
Last reviewed February 2010.
Last updated February 2010.
Why are people with high blood pressure more likely to have strokes and heart attacks?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
Why are people with high blood pressure more likely to have strokes and heart attacks?
Over time high pressure damages the lining of your blood vessels causing fatty material to be deposited on it; this narrows the diameter of your blood vessels and raises your blood pressure further. Blood may then form clots on the irregular surface of the fatty plaques and can obstruct blood flow through the vessel, causing a stroke or heart attack.
Last reviewed February 2010.
What is the treatment for high blood pressure?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
What is the treatment for high blood pressure?
Many different drugs can help to lower blood pressure, some suit some people and some suit others. If one does not work or gives you side effects there are lots of others to try. Discuss it with your doctor who will be able to try you on another type of drug until you find one, or a combination of drugs, that suits you. Sometimes you may need to take a combination of different tablets.
Last reviewed February 2010.
Last updated February 2010.
Do I need drug treatment for ever?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
Do I need drug treatment for ever?
Most but not all people with high blood pressure need to take treatment for ever, so you do need to carry on taking the tablets once your blood pressure has come down. Unfortunately high blood pressure does not get cured like a sore throat. Once you stop the tablets your blood pressure will almost certainly gradually go up again. However occasionally, after major changes in lifestyle or years of effective treatment doctors find that treatment is no longer necessary but this is unusual and it is best to commit yourself to being on treatment indefinitely. You should expect to be on a treatment that causes you no problems and although you may not feel any different on treatment, you will be less likely to suffer a heart attack or stroke.
Last reviewed February 2010.
Does it matter if I forget to take a dose?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
Does it matter if I forget to take a dose?
Do not worry if you forget to take an occasional blood pressure tablet. There is no need to take an extra one to make up for it. Blood pressure tends to rise slowly after stopping the tablets so the occasional missed pill is unimportant. If you keep missing them try to work out a routine like taking them when you clean your teeth, or in association with some other activity you do every day.
Last reviewed February 2010.
How is the choice of treament best made?
The information in this section was compiled by Dr Richard Lehman, Healthtalkonline’s Medical Advisor.
How is the choice of treament best made?
Last reviewed February 2010.
Last updated February 2010.
What are the different medications used to reduce the blood pressure?
The information in this section was compiled by Dr Richard Lehman, Healthtalkonline’s Medical Advisor.
What are the different medications used to reduce the blood pressure?
Several kinds of drugs are used to lower blood pressure, and they are often used in combination with each other. It is not at all unusual for three or more drugs to be used together. The aim of treatment is to reduce the risk of stroke, heart attacks and other complications in the long term - which often means taking several drugs for many years.
All drugs can have side effects, but it is usually best to use low doses of several drugs rather than high doses of a single drug. Often people with raised blood pressure have to go through a period of visiting the doctor every few weeks until a suitable combination is found which lowers the blood pressure to target without significant side effects. Once this point is reached, blood pressure checks often only need to be done twice a year.
Most drugs now come in packets which contain information leaflets listing many potential side effects including some which can be serious. Taking medication for blood pressure is usually a lifelong commitment, so if you are significantly affected by your drug treatment, or worried that a serious effect is developing, you need to see your doctor to check this out. However, almost all drugs used to lower blood pressure have been in use for many years and are known to be safe and beneficial for all but very few people, for example those who develop allergies to particular medicines.
The following list covers most of the classes of drug used to lower blood pressure, together with their most common or serious possible side effects:
Thiazide diuretics - low-dose "water tablets"
Bendroflumethiazide is the most widely used in the UK. Others include chlortalidone, cyclopenthiazide, indapamide and xipamide. The commonest side effects are passing urine more frequently and sexual difficulties in men. They can also cause indigestion, faintness on getting up, and generalised weakness due to lack of potassium or sodium. Gout can occur due a build up of uric acid, and the blood sugar may be raised, though it falls again on stopping the drug. Despite these potential adverse effects, this group of drugs has the greatest known benefits of any blood pressure lowering class.
Beta-blockers
These are drugs with names ending in -olol. The most widely used in the UK for blood pressure lowering are atenolol and bisoprolol; there are 12 others licensed in this country. They block some of the actions of adrenaline and slow the heart as well as lowering blood pressure. They should not be used in people with asthma and should be stopped if they cause wheezing or shortness of breath. Common side effects include cold hands and feet, tiredness and sometimes sexual difficulties in men.
Alpha-blockers
The most commonly used blood pressure lowering drugs in this group are doxazosin and prazosin; others are indoramin and terazosin. They can cause dizziness on getting up, mood disturbances and tiredness; on the other hand, they can reduce the symptoms of prostate enlargement in men.
ACE inhibitors
These are drugs with names ending in -pril. The two most commonly used to reduce blood pressure are ramipril and lisinopril; there are nine others licensed in the UK. They work by blocking the conversion of one chemical (angiotensin) into its more active form, but they also stop the breakdown of the chemicals which cause coughing. Most people taking ACE inhibitors therefore tend to cough for longer when they get a cold, and a small percentage find that they have a dry tickly cough all the time. A very small number also get swelling of the lips or face. Otherwise, the commonest reason for stopping ACE inhibitors is feeling faint on getting up, but this is uncommon after the first dose.
ARBs - angiotensin receptor blockers, also known as A2RAs
These are drugs ending in -sartan. Losartan and candesartan are widely prescribed, and there are also irbesartan, eprosartan, olmesartan, telmisartan and valsartan in the UK. These work one step further along the chemical pathway from the ACE inhibitors in the previous section, with the advantage that they do not cause cough. They have the fewest side effects of any blood pressure lowering group.
Calcium channel blockers - also known as calcium antagonists
Most of these drugs have names ending in -dipine, and the most commonly used for blood pressure lowering are amlodipine and felodipine. There are nine others in the UK, including the older drugs verapamil and diltiazem, which have more adverse effects and are usually only used in particular situations. Calcium channel blockers do not affect calcium in the bones, but work by opening up small blood vessels. Thus they all tend to cause flushing and warm peripheries and the commonest reason for stopping these drugs is headache.
Other drug classes
In certain situations additional blood pressure lowering needs to be achieved with drugs that work in different ways from those listed above. These include spironolactone, hydralazine, minoxidil, clonidine and methyldopa. Each has its own range of possible adverse effects.
Last reviewed February 2010.
Last updated February 2010.
What about complementary therapies for high blood pressure?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
What about complementary therapies for high blood pressure?
Herbal remedies
Claims are made that certain herbal remedies are effective in lowering high blood pressure. Unfortunately most of these treatments have not as yet been tested scientifically so we do not really know how effective they are.
Promising results in small studies have often been disproved in larger, longer trials. For example, Gingko biloba was once thought to improve "circulatory disorders" and prevent dementia, but recent carefully conducted double-blind trials have shown no effect.
Biofeedback and Yoga
The effect of biofeedback or yoga on long-term control of hypertension is not known at present. They may well complement and enhance the effect of conventional treatment, but may not be sufficient on their own.
Last reviewed February 2010.
Last updated February 2010.
Do I need to take the tablets while I am on holiday?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
Do I need to take the tablets while I am on holiday?
Yes. The factors that keep your blood pressure high don't go away when you are on holiday and for the treatment to be effective it is necessary to continue without breaks.
Last reviewed February 2010.
Might my body become resistant to the tablets?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
Might my body become resistant to the tablets?
Fortunately, this does not seem to happen. Some people can be treated with the same dose of the same tablet indefinitely. However with increasing age, blood pressure steadily rises and for this reason higher doses or an increase in the number of drugs may become necessary.
Last reviewed February 2010.
How much alcohol is it safe to drink?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
How much alcohol is it safe to drink?
The exact way alcohol effects blood pressure is not known. 2-3 alcoholic drinks a day do no harm, and may even be good for your heart. People who drink heavily do on average have higher blood pressure, so if you are a heavy drinker it is a good idea to cut down.
Last reviewed February 2010.
How much exercise is OK?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
How much exercise is OK?
The amount of exercise necessary for better health is much less than that needed to develop high levels of physical fitness. You need take 30 minutes of moderate intensity activity on at least five days of the week. Broadly speaking, 'aerobic' exercise means dynamic activities during which you become slightly breathless but can comfortably speak a three word sentence. For many people brisk walking is sufficient, or cycling or swimming. Avoid very strenuous games like squash or so-called 'isometric' exercise like weight-lifting. You don't need to become an athlete or competitive sportsman. Yet in the UK, 60% of the population are completely inactive, which is one of the reasons why we have the highest death rate from heart disease of the developed nations. Exercise will help you, no matter what your age or present state of fitness. The main challenge is to find some form of exercise that you can enjoy.
Regular aerobic exercise has the following benefits:
- it lowers your blood pressure
- it helps lessen the risk of dying from a stroke or heart attack
- if you have diabetes it reduces its severity
- it improves blood fat levels
- it helps you lose weight
- it reduces stress and improves your psychological well-being
Last reviewed February 2010.
Is it dangerous to do too much exercise?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
Is it dangerous to do too much exercise?
Regular exercise is good for your blood pressure and for your health generally. Exercise like walking, low-level aerobics, swimming, jogging, cycling and use of rowing machines are all recommended and should not cause any problems provided you build up gradually. However your blood pressure can rise for a short time during some activities. For this reason it is worth taking your doctor's advice before starting a new very strenuous activity, and you should perhaps avoid very intense 'burst' sports like squash or competitive weight-lifting which can produce a marked rise in blood pressure and therefore could be dangerous. This is particularly important if you have a heart condition as well as high blood pressure. If any exercise gives you chest pain (angina) or severe breathlessness you should avoid it and discuss it with your doctor.
Last reviewed February 2010.
I have a heart condition as well, is it still OK to exercise?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
I have a heart condition as well, is it still OK to exercise?
Doing some exercise is in general a good idea even if you have a heart problem as well as high blood pressure. As you gradually increase the amount of exercise you do you will find that you become fitter. You will get less tired and breathless and experience less angina (heart pain). By doing this you will be reducing your risk of having a future heart attack or stroke. However if any exercise gives you chest pain (angina) or severe breathlessness you should stop it and discuss it with your doctor.
But some people with a heart condition are at greater risk than others of suffering a heart problem during exercise. If you have severe angina, are in heart failure, or you have had a massive heart attack in the past and your heart has stopped (cardiac arrest) you should take advice from a doctor about how much and what exercise to do.
Last reviewed February 2010.
What effect does losing weight have?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
What effect does losing weight have?
Being overweight is an independent risk factor for the development of heart disease. There are no magic plans for weight reduction. Sadly you are either eating too much or not using up enough energy. Very few people have a medical reason for being overweight. Most of us are just out of balance. We slow down as we get older, take less exercise and eat more. The result is a slow gain in weight. There are two ways to lose weight. Take more regular exercise and eat less. By eating 100 calories too much per day (i.e. two biscuits) you may put on 5kg or nearly 1 stone every year. All you need to do is to eat a little less and you will lose weight.
Last reviewed February 2010.
Should I change the type of foods I eat?
The information in this section was compiled by Dr Richard Lehman, Healthtalkonline’s Medical Advisor.
Should I change the type of foods I eat?
We know very little about the way that diet interacts with blood pressure. Some websites and advice booklets contain very specific dietary recommendations as if these are based on firm evidence, but this is not the case. Even seemingly obvious measures such as lowering salt and avoiding saturated fat in the diet have not been proved to benefit people with high blood pressure.
We know that in countries with Western-style diets, half of the population has increased blood pressure by the age of 65. Some people claim that this is a result of too high an intake of salt, especially in processed food, but the evidence is mixed. We lack really good long-term trials to settle the question.
Apart from the effect of diet on blood pressure directly, there are possible effects of diet on other risk factors for heart disease and stroke, such as cholesterol and overweight. For example, because animal-derived fats are rich in cholesterol, it is often thought that such fats are "unhealthy". In fact the blood level of cholesterol is only slightly influenced by diet, and then not always as one might expect. For example, an Atkins-type diet allows unlimited amounts of animal protein and fat, but it produces a favourable balance of cholesterol and other fats in the blood. This diet also often leads to weight loss. But so do many other kinds of diet, and there is no one diet which suits everybody.
Raised blood pressure is a fact of life for a large proportion of people as they pass middle age. It would not be reasonable to expect half the population over 60 to make drastic changes to the food they eat and enjoy. It is true that by going on a very low-salt, low-fat (DASH) diet, it is possible to reduce blood pressure by as much as taking an extra tablet. However, most people would find it very difficult to maintain such a diet over a long period, and there is no need to feel guilty if you cannot.
Reducing blood pressure is not an end in itself but one of several things we can do to stay healthier for longer and reduce the likelihood of heart disease and strokes. Fortunately there are many enjoyable diets which have been shown to help this, especially the so-called Mediterranean diet, with a high intake of fresh fruit and vegetables, quite a lot of fish, and not much meat. As mentioned, the evidence that salt and animal fat is harmful is not straightforward, but we do know that olive oil is positively beneficial and that oily fish is too.
Foods containing sugar, and carbohydrates like bread and potatoes which are rapidly turned into sugar in the body, tend to cause weight gain. They are not bad in themselves but the important thing is to balance intake with exercise and not to let weight creep up, because the body's balance systems then make it difficult to lose it.
Last reviewed February 2010.
Last updated February 2010.
How do I cut down on salty foods?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
How do I cut down on salty foods?
Almost all foods contain salt but some have more than others. You do not have to cut out these foods altogether but it is important to cut down on some of them. Most of the salt we eat is hidden in processed foods, e.g. tinned or packet soups, breakfast cereals, bread, tinned or processed fish, crisps, nuts, hamburgers and pre-packaged meals. Salt is also found in high amounts in hard cheese, bacon, ham, sausages and corned beef. Look at the labels on the food that you eat. If the label says sodium chloride (NaCl), sodium benzoate or monosodium glutamate then you may be eating extra salt without realising it. Some supermarkets do sell low salt bread.
For many people, the other major intake of salt comes from the salt added to food in cooking or at table. Salt should be used only very sparingly in cooking if at all. If you feel that you cannot do without salt, you might try a salt substitute, e.g. Lo Salt (after checking with your doctor). Rock salt and sea salt are not salt substitutes
Conveniently, a low salt diet avoids some of the foods that contain a lot of saturated fat (like cheese, hamburgers, sausages) which add to the risk of heart disease, whilst encouraging the intake of fresh fruit and vegetables that have an additional protective effect against heart disease.
Last reviewed February 2010.
Can I continue to smoke?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
Can I continue to smoke?
It's not a good idea to carry on smoking. Smoking doubles your risk of heart disease and trebles your chance of dying before reaching retirement. Treating your blood pressure is still worthwhile even if you are still smoking. Do not be discouraged if you have tried to give up smoking in the past and have taken it up again later. It is worth trying again as the majority of smokers give up more than once before they succeed in giving up forever. Nicotine replacement doubles the chance of successful quitting. More help and information from National Quitline telephone 0800 002200.
Last reviewed February 2010.
Will high blood pressure affect my sex life?
The information in this section was compiled by Healthtalkonline with the help of the British Heart Foundation.
Will high blood pressure affect my sex life?
There is no evidence that having sex has any long term effect on your blood pressure, though it does go up during sex as with any other form of intense exercise. On the other hand, some of the medicines used to control your blood pressure may have an effect on a man's ability to have or sustain an erection. Weak diuretic such as bendroflumethiazide and beta-blockers such as atenolol are the drugs most likely to do this. If you have a problem with this, then it is worth discussing an alternative drug to control your blood pressure that does not give you this problem. People who have high blood pressure without any complications can use Viagra and similar drugs which help to maintain an erection unless they are taking a 'nitrate' or have had a recent stroke or heart attack.
Last reviewed February 2012
Last updated February 2010.
