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High blood pressure (hypertension) is a common condition and a significant risk factor for heart attacks, heart failure, irregular heart rhythms, strokes and kidney damage. It is a major cause of premature death globally, but can be easily diagnosed, treated and monitored.
Dr Sundeep Kalra gives his top tips to maintain a healthy blood pressure, which apply to managing patients with an existing diagnosis of hypertension, but also to patients with a normal blood pressure, to prevent developing hypertension.
Check your blood pressure
High blood pressure is defined as a blood pressure >140/80mmHg, and very commonly patients do not have any symptoms.
If you do not have hypertension, it is still important to have your blood pressure periodically checked – normal today does not mean it will always be normal, because our blood pressure can change with age and other individual/environmental factors.
If you have a diagnosis of hypertension, it is important to regularly monitor it, to ensure it is adequately controlled. Home blood pressure machines are readily available and are a good way to keep an eye on your blood pressure, although often an ambulatory blood pressure monitor (a blood pressure monitor that you wear for 24 hours) with a Cardiologist is more informative.
The health benefits of exercise are wide ranging, including maintaining a healthy blood pressure.
Our busy lives often make it difficult to fit in regular exercise to our daily schedules. Regular moderate intensity exercise (e.g. a brisk walk) is important to help control blood pressure in patients with a diagnosis of hypertension. Exercise is also essential to maintain a healthy blood pressure in individuals with a normal blood pressure.
We are all aware of the medical benefits of eating a healthy and balanced diet, and this is particularly important to maintain a healthy blood pressure. The following all form part of a healthy and balanced diet:
- carbohydrates – choose wholegrain and higher fibre options, and reduce sugar intake
- protein – choose oily fish, lean meat and pulses
- fats – choose low fat and unsaturated options
- fresh fruit and vegetables
Eating healthy does not mean you have to cut out certain foods altogether, but moderate how often you eat them.
Reducing salt intake is one of the most well known tips to maintain a healthy blood pressure. Salt consumption can be better controlled with home cooked food, but this is not always possible in contemporary lifestyles. When eating out, or consuming processed food, always try to choose lower salt options and reduce frequency.
Moderate the vices
Smoking, alcohol and caffeine may contribute to hypertension, although these associations are still debated. For an overall healthy lifestyle, aim for modest caffeine and alcohol consumption, and stop smoking.
The causes of hypertension are a complex combination of genetics and lifestyle factors. Despite adequately modifying the above lifestyle factors, medications may still be necessary to maintain a healthy blood pressure. There are a broad range of blood pressure medications, which are well tolerated and have low side effect profiles.
There are several types of blood pressure medications, which are often effective as single agents but sometimes need to be used in combination. Examples of these are enzyme inhibitors, beta-blockers and diuretics. It is usually best to use the maximum tolerated dose of a blood pressure medication before adding in another agent.
GPs usually start patients on blood pressure medications, but will refer to a Cardiologist when multiple agents are required.
It is essential to take your blood pressure medications regularly as prescribed, to maintain a healthy blood pressure. If medications are not taken as directed, your blood pressure will not be well controlled and associated health issues related to hypertension may still occur.
Historically, operations on a special group of nerves involved in the regulation of blood pressure (the sympathetic nerves) were carried out in the neck to treat difficult to control hypertension (called “resistant hypertension”). The results from these operations were variable, and they are no longer routinely undertaken.
Over the last 10 years, Cardiologists have developed a keyhole procedure to treat hypertension, called renal denervation. This involves a tube being inserted through an artery in the groin under local anaesthetic, through which the sympathetic nerves in the kidneys can be modified, to lower blood pressure. Currently this procedure is being used in patients with resistant hypertension. The early experience of this technique is promising, and Cardiologists predict that it will be used in a wider range of patients with hypertension in the future, and not just resistant hypertension.
See the wider picture
Hypertension is an important risk factor for cardiovascular disease and should not be considered in isolation. If you have a diagnosis of hypertension, it is important to explore other risk factors for cardiovascular disease such as diabetes and high cholesterol – the possibility of a heart attack or stroke is higher, the more risk factors you have. Early identification and treatment of your risk factors by a Cardiologist can help lower your risk of a cardiovascular event, such as a heart attack or stroke.
Get in touch today
If you would like to speak to one of our specialists about managing your own blood pressure, or any other concerns you might have regarding your heart health, please get in touch with us today. You can easily book online, or simply contact us through our online form or via telephone.
Written by Dr Sundeep Kalra, Consultant Cardiologist at OneWelbeck Heart Health, specialising in coronary artery disease, chest pain assessment, cardiac risk and hypertension.