Do you know your numbers?

Why get your blood pressure checked?

A healthy blood pressure is critical to long-term health and disease prevention, but many UK adults do not regularly have their blood pressure checked and are therefore at risk of undiagnosed high blood pressure and its many complications.

High blood pressure rarely has noticeable symptoms, but if left untreated leads to serious diseases such as stroke and heart attack. For this reason, high blood pressure is often referred to as a ‘silent killer’. The only way to detect high blood pressure is by having a blood pressure reading taken, ideally by a trained health professional.

High blood pressure is very common

1 in 3 adults in the UK have high blood pressure, and a staggering 1 in 2 don’t know they have it or aren’t receiving treatment for it. That’s an estimated 6 million UK adults living with undiagnosed high blood pressure! [1]

High blood pressure leads to serious, preventable illness

High blood pressure is implicated in 50% of all heart attacks and strokes, and is a leading cause of kidney failure, heart failure, peripheral arterial disease, vascular dementia and visual problems [2]. Every day around 350 people in the UK have a stroke or heart attack associated with high blood pressure that could have been prevented, and high blood pressure is estimated to cost the NHS £2.1 billion every year [3].

What causes high blood pressure?

High blood pressure (hypertension) doesn’t always have a clearly identifiable cause. Most people diagnosed will have ‘primary hypertension’, hypertension without a specific cause but often linked to lifestyle factors (below). A small minority of cases will have a clearly identifiable cause, most often a medical condition, such as certain kidney or endocrine (hormonal) disorders [4].

However, there are known risk factors for developing high blood pressure, many of which are ‘modifiable’ and therefore preventable. These include:

- Excessive alcohol consumption

- Smoking

- Obesity

- Lack of physical activity

- Excessive salt intake

- Poor sleep

In addition, high blood pressure is more common in people over the age of 65, those with a family history, people of black African or black Caribbean descent and those living in deprived areas. However, even in these instances, blood pressure can usually be improved by changes to diet and lifestyle [2][5].

Understanding blood pressure readings

A blood pressure reading contains two numbers, a top number representing ‘systolic’ pressure and a bottom number representing ‘diastolic’ pressure. The systolic pressure is the pressure inside the arteries when the heart muscle contracts, and the diastolic pressure is the pressure in the arteries between contractions (heartbeats), when the heart muscle relaxes. Blood pressure is measured in mmHg (millimetres of mercury), as historically, blood pressure measuring devices contained a column of mercury that moved according to pressure.

When read together, the systolic and diastolic blood pressures provide a useful overall measurement of blood pressure. However, clinicians may also consider the two pressures in isolation because variations in each can be indicative of certain cardiovascular problems. For example, an isolated systolic hypertension may suggest that arteries are excessively stiffened, possibly due to plaque build-up or other condition that damages artery walls, such as poorly controlled diabetes or anaemia.

Conversely, an isolated diastolic hypertension can be associated with an increased risk of adverse cardiovascular events, such as a heart attack, particularly in younger patients. Ultimately, your clinician will consider these factors in the context of your overall health, before deciding on the most appropriate course of action.

Diagnosing high blood pressure

High blood pressure is defined as 140/90 mmHg or higher (150/90 mmHg or higher in people over the age of 80). However, blood pressure naturally fluctuates throughout the day, depending on our activity level, hydration, proximity to eating and various other factors. Therefore, to meet the diagnostic criteria for hypertension several separate blood pressure readings must be taken on different occasions.

The UK National Institute for Clinical Excellence (NICE) recommends taking up to three readings in clinic, followed by a period of either ambulatory or home blood pressure monitoring to confirm the diagnosis [6]. However, getting an initial reading in clinic is a great place to start, and your GP can then decide whether further monitoring is needed to make a formal diagnosis.

Ideal blood pressure for adults is between 90/60 – 120/80 mmHg. If your blood pressure is in this healthy range (and you are non-diabetic), it is still recommended that all adults over 40 have their blood pressure checked at least every 5 years [6].

Readings between 120/80 – 140/90 mmHg may mean you’re at risk of developing high blood pressure if you don’t take steps to keep it under control [5], and your GP may suggest more frequent monitoring if your readings are in this range.

Treating high blood pressure

Treatment for high blood pressure includes changes to diet and lifestyle, and where this is insufficient to reduce blood pressure to a safe level, your doctor may recommend medications in addition.

For more information on how high blood pressure is treated, please visit the NHS website here.

Getting your blood pressure checked

The only way to know if you have high blood pressure is to take a blood pressure reading, ideally performed by a trained health professional. Adults over 40 are recommended to have their blood pressure checked at least once every 5 years, and annually if you are diabetic [6].

You can have your blood pressure checked at several places, including:

• Your GP surgery
• Some pharmacies
• As part of an NHS Health Check
• In some workplaces

In addition to regular checks by a trained professional, you may consider using a home blood pressure monitor to regularly check your readings at home, even if you are not known to have high blood pressure. Home monitors are simple to use, inexpensive and available from most pharmacies.

Home monitoring is especially useful for older adults (over 65) and adults over 40 with a family history of high blood pressure, as regular readings will ensure any sustained increase in blood pressure is detected early. If you regularly check your pressures at home and notice readings consistently close to or above 140/90 mmHg, book in to see your GP who may advise further testing or recommend starting appropriate treatment.

The bottom line

High blood pressure is a preventable cause of serious illness, including stroke and heart attacks, but often has no noticeable symptoms.

High blood pressure can develop due to a range of lifestyle factors, including excessive alcohol consumption, smoking, obesity, lack of exercise and a high salt diet. Additionally, certain non-modifiable factors such as ethnicity and age can increase your risk.

The only way to detect high blood pressure is by taking a blood pressure reading, which can be performed by your GP practice or at certain pharmacies and workplaces.

It is recommended that all adults over 40 have their blood pressure checked by a trained professional at least once every 5 years, to ensure early detection and treatment. In addition, using a home blood pressure monitor to regularly check your readings can be useful, but is not a substitute for ‘in clinic’ readings by a trained professional.

Treatment for high blood pressure includes changes to diet and lifestyle, as well as medications where appropriate.

If you would like to have your blood pressure checked or for further information on maintaining a healthy blood pressure, please book in to see one of our expert GPs. Alternatively, for a comprehensive assessment of your overall health consider booking a holistic Well Man or Well Woman health check with us today.

Useful links

Know Your Numbers! Blood Pressure UK

https://www.bloodpressureuk.org/know-your-numbers/

British Heart Foundation - High Blood Pressure Information

https://www.bhf.org.uk/informationsupport/risk-factors/high-blood-pressure

NHS - High Blood Pressure (Hypertension)

https://www.nhs.uk/conditions/high-blood-pressure-hypertension/

References

1. Blood Pressure UK, "Why is Know Your Numbers! needed?," Blood Pressure UK, [Online]. Available: https://www.bloodpressureuk.org/know-your-numbers/why-is-know-your-numbers-needed/. [Accessed Sept 2022].
2. British Heart Foundation, "High Blood Pressure," British Heart Foundation, [Online]. Available: https://www.bhf.org.uk/informationsupport/risk-factors/high-blood-pressure. [Accessed Sept 2022].
3. Blood Pressure UK, "Know Your Numbers!," Blood Pressure UK, [Online]. Available: https://www.bloodpressureuk.org/know-your-numbers/. [Accessed Sept 2022].
4. Mayo Clinic, "Secondary hypertension," Mayo Clinic, [Online]. Available: https://www.mayoclinic.org/diseases-conditions/secondary-hypertension/symptoms-causes/syc-20350679. [Accessed Sept 2022].
5. NHS, "Overview: High Blood Pressure (Hypertension)," NHS, [Online]. Available: https://www.nhs.uk/conditions/high-blood-pressure-hypertension/. [Accessed Sept 2022].
6. National Institute for Clinical Excellence, "Hypertension in adults: diagnosis and management [NG136], 1.2 Diagnosing Hypertension," NICE, 28 August 2019.[Online]. Available: https://www.nice.org.uk/guidance/ng136/chapter/Recommendations#diagnosing-hypertension.