Blood pressure is considered high if the upper value of the blood pressure (known as systolic value) is 140mmHg or more, or the lower value of the blood pressure (known as the diastolic value) is 90mmHg or more, or both.

Hypertension or high blood pressure refers to the condition in which the blood is pumped around the body at too high a pressure. Blood pressure is not the same throughout the day. It varies with time of day or night, exercise, excitement or stress. Because of this normal variation, it is important to measure the blood pressure a few times on different occasions.

High blood pressure is a common condition in which the long-term force of the blood against your artery walls is high enough to cause health problems, such as heart disease.

Blood pressure is determined both by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure.

In 95% of cases, the cause of hypertension is unknown. In 5% of cases, hypertension may be due to causes such as kidney disease, narrowing of certain blood vessels or hormonal imbalance.

Obesity, diabetes, smoking, excessive salt and alcohol consumption, physical inactivity and frequent psychological stress are risk factors that increase the chance of developing hypertension.

People who have a family history of hypertension are also more Iikely to develop hypertension. Your risk doubles if you have one or more close family members with high blood pressure before the age of 60. A very strong family history means you have 3 or more relatives who had high blood pressure before 60. It is important to understand that a family history of high blood pressure does not mean you will have high blood pressure, but it increases your chances.

Hypertension is often called the ”silent killer.” Even when severe, it may not give rise to any symptoms. Occasionally, you may have headaches or giddiness when the hypertension is severe. However, these symptoms are not specific to hypertension; they are also present in other diseases. Sometimes, hypertension is only discovered when complications set in, for example, a stroke or a heart attack.

Hypertension increases the risk of developing ‘atherosderosis’ (hardening and narrowing of the arteries). If untreated or inadequately treated, hypertension can cause the following problems:

• Coronary heart disease
• Heart failure
• Stroke
• Peripheral artery disease (narrowing of the blood vessels of the limbs)
• Kidney failure
• The risk of suffering from the complications of hypertension is increased in people who:
• Smoke
• Are overweight (BMI of 23kg/m2 or higher)
• Have high blood cholesterol
• Suffer from diabetes mellitus

Heart attacks and strokes are common emergencies related to hypertension and can be life threatening. It is crucial to recognise the signs of a heart attack or stroke if you have hypertension. Signs of an impending stroke include slurred speech and blurry vision. If you begin to experience these symptoms or someone with you notices that you are acting out of sorts, you should contact emergency services immediately.

The signs of heart attack may differ for men and women. Men often experience chest pressure, nausea with or without vomiting, and cold or clammy skin. Women, more often than not, complain of sudden-onset shortness of breath with or without chest pressure, generalised fatigue, and nausea with or without vomiting. Click here to learn more about heart attack in women. (Link to article, Heart Attack in Women)

Lifestyle modification forms the foundation for the treatment of hypertension and other metabolic disease. Very often losing weight, exercising, eating less salt, quitting smoking and avoiding excessive alcohol is all that is needed to control blood pressure. When changing lifestyle does not help control blood pressure, anti-hypertensive medications may be prescribed. Even when taking medication, healthy lifestyle should be continued. Appropriate treatment of high blood pressure has been known to reduce death rates from strokes and coronary heart disease.

You have been diagnosed with having high blood pressure (hypertension), and will most likely be prescribed drugs that belong to these 5 main groups:

• Diuretics
• Beta-blockers
• Calcium channel blockers
• Angiotensin converting enzyme inhibitors
• Angiotensin II receptor blockers

Prescription of medication is individualised depending on the person’s age, sex and coexisting medical conditions. More than one drug may be prescribed to keep the blood pressure (BP) at an acceptable level. Single drugs which combine medications from 2 of these groups are also available.

• • Treatment is life-long (involving life style modification with or without drugs).
  • Medication should not be stopped or the dose of medication changed without consulting the doctor.
  • For effective blood pressure control, regular blood pressure measurement and follow up with the doctor is essential. More frequent blood pressure monitoring at home with an electronic blood pressure monitor will contribute to better control.

• DO control your weight to keep your BMI less than 23kg/m2 but not below 18.5kg/m2. Reducing excess weight will help lower total and LDL-cholesterol and triglyceride levels.

• DO maintain a regular healthy diet by limiting intake of all types of fats. Try to replace saturated with unsaturated fats.

• DO limit cholesterol intake. Major sources include organ meats (e.g. liver; brains, kidney, intestines and heart), egg yolk, squid, fish roe, shellfish, prawns, crabs and animal fats.

• DO increase fibre intake. Fibre is found in oats, oat bran, barley, fruits, vegetables, legumes and whole grains and can speed up the removal of cholesterol from the blood.

• DO exercise for at least 30 minutes for 5 or more days per week. Lack of exercise is associated with a low HDL-cholesterol (good cholesterol) level.

• DO limit alcohol intake to no more than 2 standard drinks per day. That is equivalent to two thirds of a small can of beer (220ml) or 1 glass of wine (100ml) or 1 nip of spirit (30ml)

• DO NOT smoke.