What Is High Blood Pressure?

Have a low salt intake

The amount of salt that we eat can have an effect on our blood pressure. Government guidelines recommend that we should have no more than 5-6 grams of salt per day. (Most people currently have more than this.) Tips on how to reduce salt include:

  • Use herbs and spices rather than salt to flavour food.
  • Limit the amount of salt used in cooking, and do not add salt to food at the table.
  • Choose foods labelled ‘no added salt’, and avoid processed foods as much as possible.

Restrict your number of caffeine drinks

Caffeine is thought to have a modest effect on blood pressure. It is advised that you restrict your coffee consumption (and other caffeine-rich drinks) to fewer than five cups per day.

Drink alcohol in moderation

A small amount of alcohol (1-2 units per day) may help to protect you from heart disease. But if you already have established heart disease then better to stop alcohol intake, which ultimately increases the cardiac workload hence detoriate the cardiac condition. One unit is in about half a pint of normal-strength beer, or two thirds of a small glass of wine, or one small pub measure of spirits. However, too much alcohol can be harmful.

Cutting back on heavy drinking improves health in various ways. It can also have a direct effect on blood pressure. For example, if you are drinking heavily, cutting back to the recommended limits can lower a high systolic blood pressure by up to 10 mm Hg.

Lifestyle – in summary

It is estimated that dietary and exercise interventions discussed above can reduce blood pressure by at least 10 mm Hg in about 1 in 4 people with high blood pressure.

Treatment with medication

When is medication treatment started for high blood pressure?

Medication to lower blood pressure is usually advised for:

  • All people who have a blood pressure that remains at 160/100 mm Hg or above after a trial of any relevant lifestyle changes.
  • People with a blood pressure that remains at 140/90 mm Hg or above after a trial of any relevant lifestyle changes AND who have:

1.Diabetes; or

2.An existing cardiovascular disease; or

3.A 2 in 10 risk or more of developing a cardiovascular disease within the next 10 years

  • People with a blood pressure of 130/80 mm Hg or more who have certain diseases. For example, people who have certain complications from diabetes, people who have had a recent heart attack, stroke or transient ischaemic attack (TIA) – sometimes called a mini-stroke. Also, some people with certain chronic (ongoing) kidney diseases.

What is the target blood pressure to aim for?

If you are taking medication to lower high blood pressure:

  • For most people who are otherwise well, the target is to reduce blood pressure to 140/90 mm Hg or below.
  • In some people, the target is to get the blood pressure to an even lower level. This generally applies to people who have diseases where very good blood pressure control is important. This includes:

1.People who have a cardiovascular disease.

2.People with diabetes.

3.People who have a chronic kidney disease.

What medicines are used to lower blood pressure?

There are several medicines that can lower blood pressure. The one chosen depends on such things as: if you have other medical problems; if you take other medication; possible side-effects of the medicine; your age; your ethnic origin, etc. Some medicines work well in some people, and not so well in others. One or two medicines may be tried before one is found to suit. One medicine reduces high blood pressure to the target level in less than half of cases. It is common to need two or more different medicines to reduce high blood pressure to a target level. In about a third of cases, three medicines or more are needed to get blood pressure to the target level. In some cases, despite treatment, the target level is not reached. However, although to reach a target level is ideal, you will benefit from any reduction in blood pressure.

How long is medication needed for?

In most cases, medication is needed for life. However, in some people whose blood pressure has been well controlled for three years or more, medication may be able to be stopped. In particular, in people who have made significant changes to lifestyle (such as having lost a lot of weight, or stopped heavy drinking, etc). Your doctor can advise you. If you stop medication, you should have regular blood pressure checks. In some cases the blood pressure remains normal. However, in others it starts to rise again. If this happens, medication can then be started again.

Smoking and high blood pressure

Smoking does not directly affect the level of your blood pressure. However, smoking greatly adds to your health risk if you already have high blood pressure. If you smoke, you should make every effort to stop. If you smoke and are having difficulty in stopping, then see your practice nurse for help and advice.

 

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