Blood pressure is the measurement of the pressure or force of blood pushing against blood vessel walls. Hypertension or high blood pressure means that your heart is working extra hard to pump blood around the body.
Your blood pressure is generally considered high if the reading is higher than 140/90mmHg. The upper number of your blood pressure measures the pressure in your arteries when your heart contracts. The lower number measures the pressure in your arteries when your heart relaxes. You can have high blood pressure without symptoms, even when your blood pressure has been high for years. Having high blood pressure over years is associated with bad health outcomes such as heart attack, stroke and kidney failure. It is to note that at times, a high blood pressure is a manifestation of an underlying illness such as Preeclampsia – a disorder of pregnancy occurring after 20 weeks’ gestation characterised by new-onset of hypertension, proteinuria and/or impaired organ function.
In certain groups of population such as those with chronic kidney disease and/or diabetes, we aim to achieve a blood pressure target below 130/80mmHg in order to prevent bad health outcomes.
For most people, the cause of their high pressure is not known. However, when they have a family history of high blood pressure, they are considered to have essential hypertension (it is also known as primary hypertension).
Most people with high blood pressure usually have no signs or symptoms even when the reading is very high; unless the very high blood pressure develops acutely or has caused organ damage resulting in stroke, confusion, heart attack or heart failure for example.
Our blood pressure varies throughout the day, and from moment to moment. It may increase when you are seeing a doctor (white-coat hypertension). Therefore, your doctor will likely take a few readings of your blood pressure on separate appointments before diagnosing you having high blood pressure. Generally, you are considered to have high blood pressure if your reading is greater than 140/90 mmHg on 3 separate settings.
Nonpharmacological treatment Lifestyle changes targeted at the risk factors associated with high blood pressure can reduce blood pressure. Weight reduction, exercise and a low salt healthy diet can help to reduce blood pressure. However, sometimes lifestyle changes alone are not enough, and medication is needed to lower your blood pressure to target.
Pharmacological treatment There are many different classes (types) of medications that are available to treat high blood pressure. Generally, it is the amount of reduction in blood pressure rather than a specific type of blood pressure lowering medication, is the major determinant in reducing your cardiovascular risk. The choice of blood pressure lowering agents depends on the patient pre-existing co-morbidities and lifestyles. Therefore, management of high blood pressure can be complex, and thus it is best to seek your doctor’s guidance on this matter.