Under Pressure: high blood pressure is the silent killer
High blood pressure is known as the silent killer in medicine, as it often has done the most damage before you even feel any symptoms. We take you through the signs to look out for, and the treatments to expect if you have high blood pressure.
Hypertension, as high blood pressure is also known, refers to a higher pressure on the blood vessel walls.
Diseases of the heart, kidneys and brain are the most common outcomes from prolonged, untreated hypertension. It is the most important known risk factor in stroke and heart disease.
Blood pressure is measured using two figures: the systolic blood pressure which represents the pressure when your heart starts beating; and the diastolic or second (and lower) figure, which is the blood pressure when your heart is resting between beats. A healthy reading is around 110/70 or 120/80 or below. Systolic readings of over 120 and diastolic readings of over 80 are considered high, and regular systolic readings over 140 often indicate an underlying problem.
According to Epworth cardiologist Dr Tony Walton, most people start experiencing high blood pressure in their 50 and 60s, and men are more likely to experience hypertension than women. Diabetes is also a common association of hypertension.
“It is unusual to get high blood pressure when you are younger, unless it is inherited. It can run in families, and that is when you need to be monitored regularly at a younger age. You should consult your GP regularly if you have any family history of high blood pressure under the age of 40, or have diabetes at a young age,” Tony says.
People aged over 50 should have their blood pressure checked regularly by the GP to identify whether any ongoing testing is required. If a problem is identified, patients will often wear a 24-hour monitor to measure blood pressure at regular intervals throughout the day and night.
The standard checks for an underlying problem after a blood pressure monitor include urine tests to check whether the kidneys are under stress, a blood test for diabetes, and cholesterol tests.
“Before we resort to medication, we encourage patients to make positive lifestyle changes such as weight loss, cutting out smoking, reducing salt intake and alcohol consumption, and trying a healthy diet which can have a significant impact on blood pressure.”
Tony says there is a range of medications available to treat high blood pressure, and many patients may take a combination of mediations to keep their blood pressure in check.
“It is not uncommon in patients with high blood pressure to be taking two or three different medications daily,” Tony says.
He says that once you start medication, you will be on it for life, so trying to make positive change before starting medication can make a significant difference in your life.
In general, the GP is the main contact person to treat blood pressure. The GP will often refer on to a cardiologist where a patient is on three different drugs and their blood pressure is still not under control.
While most blood pressure issues are related to diet, exercise, salt intake and stress, there are also people who have a condition known as ‘White Coat Hypertension’, which relates to a person’s blood pressure increasing when they are with a doctor or in hospital.
“Where people have white coat hypertension it is more difficult to diagnose an ongoing problem, as it is often just the interaction with the doctor that brings on episodic high blood pressure. In these situations, we often get the patients to wear a 24-hour blood pressure monitor to look at how they are when they are out of a medical environment,” Tony says. “They may not require treating at all, so it is important to check.”
Tony says that early intervention is the key to avoiding significant health problems from this silent killer. “Make lifestyle changes, and consult your GP regularly.”
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