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Dr Miriam Stoppard's Health Focus: UNDERSTANDING HIGH BLOOD PRESSURE, Part 1; Dr Miriam Stoppard's Health Focus.

YOUR blood pressure is the pressure of blood surging through the main arteries each time the heart beats and empties. It's measured as the height of the column of mercury it can hold up - mmHg.BLOOD pressure varies during the day and goes up as a response to stress and physical activity, and down when you rest and sleep.

But a person with high blood pressure, or hypertension, has a high blood pressure even at rest.

People can have hypertension without realising it because you don't get symptoms unless your blood pressure's very high.

But hypertension increases the chance of having a stroke or of developing heart disease, so you should have regular medical checks from the age of 30 so that hypertension can be detected and treated as early as possible.

HOW COMMON IS IT?

HYPERTENSION is an extremely common condition, affecting one in seven adults. It is more common in men than in women, particularly in the middle-aged and elderly.

WHY IT HAPPENS

BLOOD pressure rises when resistance to the flow of blood in both large and small blood vessels increases.

RESISTANCE increases in the large vessels as they become more rigid with age - "hardening of the arteries".

RESISTANCE in the smaller vessels depends on the extent to which they're constricted, which is under nervous and chemical control.

BLOOD PRESSURE TESTING

YOUR blood pressure varies a lot during the day and can even change from minute to minute, so a single measurement can't be taken as your "normal" blood pressure.

It may need to be measured several times on different days and then the average is taken.

When your blood pressure is measured, many things can affect the result. You may be anxious or have rushed for your appointment, and this could temporarily make your blood pressure higher.

A decision on whether you need to take blood pressure tablets is usually made using the average of many measurements, sometimes over several months. You should always rest for five minutes, sitting down, before a blood pressure reading, otherwise the result is meaningless.

MEASURING AVERAGE LEVEL

BEFORE tablets are started, your blood pressure needs to be checked many times, sometimes over months, and it's the average reading that is important.

If your blood pressure is consistently very high, say over one or two weeks, treatment must be started immediately. This can be time consuming as you may need to visit your doctor often.

To help make a decision about treatment more quickly, small automatic machines can be used to accurately measure blood pressure without a doctor or nurse. These are called ambulatory blood pressure monitors (ABPM).

AMBULATORY BLOOD PRESSURE MONITORS

THESE can give your doctor two advantages:

1 THE large number of readings helps decide how high your blood pressure really is. The average is more exact than any single clinic or surgery measurement.

2 ABOUT one in five people with mild high blood pressure in the clinic or surgery have levels at home or work low enough for drug treatment not to be needed.

HOME OR SELF MONITORS

YOU may be lent a monitor to use at home for several days and your doctor or nurse will show you how to use it.

1 YOU put the cuff around your arm while sitting, and rest the arm on a firm surface.

2 PRESSING a button on the monitor starts the measurement.

3 A PUMP inflates the cuff, and as it deflates slowly your blood pressure is recorded.

4 YOUR blood pressure can usually be seen on the monitor.

You'll be asked to make a note of your readings. You will be asked to take readings at different times, and to take at least 20 readings in total.

BUYING A MACHINE

IF you wish to buy a machine for your own use, check with your doctor or the British Hypertension Society first.

Once your blood pressure is well controlled, there's no need for frequent measurements and your doctor will advise you on the need to buy a monitor.

WHAT IS NORMAL BLOOD PRESSURE LEVEL?

WHEN the heart contracts, or beats, it forces blood into the arteries giving the highest pressure reading, the systolic blood pressure - that's the first number your doctor records.

WHEN the heart relaxes between beats, the lowest pressure is recorded, the diastolic blood pressure, and this is the second number.

BLOOD pressure readings put the first number over the second e.g. 120/80.

NORMAL BLOOD PRESSURE

SYSTOLIC (first level) should be less than 140 mmHg

DIASTOLIC (second level) should be less than 90 mmHg

BLOOD pressure tends to increase with age, but this isn't normal" or healthy.

The lower your blood pressure is, the healthier you are, and in the UK we never treat low blood pressure. The increase in blood pressure with age is partly due to lifestyle.What can I do about it?BLOOD pressure of less than 159/99 is mild high blood pressure. Blood pressure above 160/100 is high blood pressure.

With mild high blood pressure, changing your lifestyle may be enough to lower your blood pressure by 20 per cent, so it's worth doing. Here's what to do:

LOSE weight, you give your heart less work to do.

CUT DOWN on drinking, alcohol increases your heart rate.

STOP smoking, nicotine constricts the blood vessels.

CUT out salt, salt causes fluid retention.

TAKE exercise, and take up relaxation exercises or yoga.

If you have high blood pressure, and measures such as weight loss, reducing your alcohol and salt intake and increased exercise don't lower your blood pressure to acceptable levels, you'll almost certainly be advised to take tablets regularly. If it's very high you may need to start tablets immediately.Tablets cut the riskALTHOUGH it is commonly believed that high blood pressure causes symptoms such as headache or dizziness, in fact it doesn't usually make you feel unwell.

Taking tablets won't therefore usually make you "feel better" but will help to prevent illnesses such as stroke, heart attack or kidney problems that may happen in the future.

Blood pressure isn't the only cause of stroke and heart attacks, it is only one of a number of risk factors. Other important elements are your age, your sex (women before menopause are at lower risk because they are protected by their oestrogen), whether you smoke, your blood cholesterol level and other medical problems.

FOR factsheets only, write to The British Hypertension Society Information Service, Blood Pressure Unit, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE or telephone 020-8725 3412.
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Article Details
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Title Annotation:Features
Author:Stoppard, Miriam
Publication:The Mirror (London, England)
Date:Mar 9, 2000
Words:1088
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