What Causes High Blood Pressure

High blood pressure is not a disease, but it is a major cause of heart disease and strokes. If you have high blood pressure and you also smoke, have high blood cholesterol or are generally unfit, the risk of you having a stroke or heart attack increases.

How Is Blood Pressure Measured?

Blood pressure is quoted as two numbers, for example, 140/85 mmHg. The top number is the pressure in the arteries as the heart is pumping the blood around the body. The bottom number is the pressure when the heart is being filled with blood before it next beats and pumps blood. Blood pressure levels are normal or high as follows:

• Less than 140/85 is desirable

• Between 140/85 and 160/90 is borderline high blood pressure

• 160/90 and over is considered high

Blood pressure varies considerably throughout the day and is affected by your thoughts and actions. So your doctor should take at least three readings at different times to confirm you have high blood pressure.

What Causes High Blood Pressure?

In about 10 per cent of cases, the cause of high blood pressure can be related to another medical condition - this can be confirmed by your doctor. However, for most people, there is no specific cause for their high blood pressure, and it's likely to be affected by a combination of things including:

• a family history of high blood pressure

• lack of physical activity

• obesity

• high alcohol intake

• high intake of salt

• smoking

Making changes to your lifestyle to address some of those factors can lower your blood pressure and reduce the need for medications.

Should You Change Your Eating Habits?

Don't feel guilty about indulging yourself now and then - it's OK to enjoy your favourite foods in moderation. Just remember that your diet plays a vital role in managing and reducing your blood pressure. One of the most important things you could do is to lose weight (if you are overweight).

For every kilogram of body fat you lose, you can reduce your blood pressure by two points. To lose weight, you need to reduce your fat intake and increase physical activity. Some simple tips for improving your eating habits are listed below.

• Use low-fat dairy foods, such as skimmed milk, low-fat cheese and low-fat yoghurt

• Choose grilled or baked lean meat and skinless chicken and fish instead of fried, fatty foods

• Choose fresh fruit instead of biscuits, cakes and pastries

• Drink low-alcohol beer or dilute your drink with soda water or low-calorie lemonade. Alternate water and alcoholic drinks and try limiting alcohol to two units a day

• Lowering the amount of salt you eat can help reduce your blood pressure and help your medication work better

Try To Do The Following To Help You Cut Down On salt And Fat:

• Add herbs (oregano, basil, parsley) and spices (mustard powder, paprika, pepper) to casseroles or grilled meat instead of salt

• Add lemon juice to vegetables and vinegar or 'no oil' dressings to salads

• Choose 'reduced salt' canned foods

• Avoid bread and biscuits as they both have a high salt content. Some supermarkets sell reduced-sodium bread

• Avoid pickled or cured foods

• Choose low-salt takeaways like souvlaki with salad instead of fried, spicy chicken or pizza

How Exercise Can Help

Regular exercise lowers blood pressure by about 5 to 10 points in people who haven't been active before. Your blood pressure can be most effectively lowered by exercises such as walking, swimming, cycling and running. The ideal activity is one that you enjoy, so take the time to decide what you like best. There is no need to puff and sweat to benefit from exercise. Simply try to do regular, moderate exercise, preferably every day. The more exercise you do the better, but remember that any exercise (such as walking up the stairs instead of taking the lift) is better than none at all. If you're on medication, be sure to discuss your exercise plan with your doctor. If you're planning to do vigorous exercise, see your doctor if you:

• have or suspect you have heart disease

• are a man aged over 35 or a woman over 45 who hasn't been active recently

• smoke

• have high blood pressure

• have high blood cholesterol

• are significantly overweight

Safety Tips

• Try not to exercise too hard

• Don't exercise immediately after eating or drinking alcohol

• Avoid exercise when it's very hot, humid or cold

• Stop exercising if you feel unusual chest pain, dizziness or discomfort. Tell your GP if you have any of these symptoms when exercising

Stress

Too much physical and emotional stress can raise your blood pressure, so find out what's causing your stress (both at work and at home), think positively to work out your priorities and goals, and try to relax both mentally and physically.

Medication

Many people need medication to keep blood pressure under control. There are a number of medications available, so discuss the choices with your doctor. If you're on medication, take it as prescribed and be sure to discuss any problems with your doctor.

Lifestyle Tips To Control Your Blood Pressure

• Stop smoking

• Keep to a healthy weight

• Limit the amount of alcohol you drink

• Reduce your intake of salt

• Take regular exercise

It is important for your GP or practice nurse to check your blood pressure regularly to make sure that the changes you are making to your lifestyle are helping to reduce your blood pressure.

By Dr Michael Colquhoun, BSc, MB BS, FRCP, MRCGP, DRCOG.

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