Managing hypertension

Estimates show that e.g in the UK out of the 12 million people that have high blood pressure half of them are unaware of the problem. Since I am one of those, this is a subject that is literally “close to my heart”.

When Pamela was diagnosed as having high blood pressure, I bought a monitor which we used for a while. In her case, the results showed that she did not have a problem to be concerned about. My results were high but not critical so we stopped monitoring. That was a mistake because unbeknown to me, my pressure was going off the scale. It was only when I went for a medical to get a new driving license that I discovered just how high my blood pressure had risen. So now I keep an eye on it by measuring my pressure at monthly intervals.

High blood pressure (hypertension) matters because it prematurely ages the lining of arteries, increasing the risk of problems including heart disease, stroke, kidney damage, and erectile dysfunction. The World Health Organisation estimates that it is now responsible for half of cases of coronary heart disease and three quarters of strokes in the UK.

Luckily in my case the heart valves and the arterial linings only show mild deteriation as a result of my hypertension. Hopefully, I was saved in time to prevent more serious problems.

Reports show that, in most cases, hypertension is due to a combination of ageing and lifestyle factors (particularly a high salt intake) but the underlying mechanisms remain poorly understood. Identifiable causes, such as kidney disease, are found in fewer than 5 per cent of people. My mother and my grand mother used to ladle the stuff into cooking and we always sprinkled salt on our food especially fish and chips! Now, we don't have a salt cellar in the house and Pam never adds salt when cooking. Still there is a lot of salt, along with a lot of sugar, added to the foods that you buy.

How do you know if you are suffering from hypertension?

A normal reading in the surgery is generally regarded as anything below 140/90 millimetres of mercury (mmHg), where the lower figure (diastolic) is the constant pressure within the arteries, and the higher (systolic) one the peak reached during each beat of the heart. At home, the readings should be lower.

However, it’s not just where it’s taken that matters. Other factors influence the readings, ranging from the time of day — it normally peaks in the evening and drops by as much 20 per cent during the early hours of the morning — to how bad the traffic was on the way to the surgery, which is why it’s standard practice to recheck high readings.

For those of us who suffer from hypertension, the treatment is likely to be lifelong, with around a third of patients needing one drug, another third requiring two, and the remainder needing three drugs to get their pressures down to target levels. The current upper limit for good control is set at 140/90 for most people, but studies suggest that the lower the better, with optimum level for long-term health likely to be closer to 120 for the upper figure.

Of course, taking tablets to reduce pressure is only one part of the solution to the problem. It is necessary to try to reduce your blood pressure naturally by cutting out salt, losing weight and doing more exercise and to take steps to minimise additional hazards that may compound the problem — giving up smoking, for instance, won’t lower blood pressure, but will slash the odds of someone with hypertension going to an early grave because of a heart attack.

Blood pressure facts

•A third of men and a quarter of women in the UK have high blood pressure — at least half are receiving no treatment.

•Eating more fruit and veg, exercising and losing weight may be all that is required in milder cases. Cutting out salt is particularly important.

•The equivalent of two glasses of wine a day may be beneficial, but heavier drinking raises blood pressure.