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Blood preassure a4 x3.indd
SMOKING AND HYPERTENSION
You should reduce your salt intake to about 6 grams
Smoking has no direct effect on blood pressure but,
a day (one teaspoonful); most people eat at least
like high cholesterol, is another important risk factor
12 grams daily and this has a direct effect on blood
in heart disease and stroke. Smoking increases the
pressure. At least _ of the salt we eat is “hidden” in
amount of narrowing in your arteries and stopping
processed foods and you should cut down on these
smoking will reduce your chance of a heart attack
and always read the labels. Food high in salt includes
by 50% in the ﬁrst year. Clearly, stopping this habit
bread, breakfast cereals, processed meats, soups,
may be very difﬁcult and requires a great deal of
sauces and pre-prepared and instant meals.
will power. A genuine desire to stop is essential and often “cold-turkey” is best but treatments for
EXERCISE AND WEIGHT REDUCTION
nicotine addiction are available such as nicotine gum,
Being overweight increases blood pressure and leads
patches and sprays. The drug Zyban (bupropion) and
to many other health problems such as diabetes,
specialist clinics, hypnosis and acupuncture may also
heart disease and some cancers. Weight reduction
by dieting and regular exercise is essential to the management of hypertension and may prevent or postpone the need to take blood pressure medication.
ALCOHOL AND HYPERTENSION
The best guide to your weight is the BMI (body mass
Regular, heavy drinking may cause your blood
index, calculated from your height and weight), which
pressure to be too high and more difﬁcult to control
should ideally be less than 25. Anybody can lose
if you are on medication. A small amount of alcohol
weight by reducing the number of calories they eat
may be beneﬁcial, however, and may increase your
or burning off more calories by exercise. Crash diets
HDL cholesterol (the “good” type of cholesterol.) The
or meal replacements are usually difﬁcult to sustain
recommended maximum weekly intake of alcohol is
and it is better to begin a healthy diet and aim for a
21 units for men and 14 units for women (one unit is
target of about 1 lb (0.45 kg) per week. Weight lifting
equivalent to _ pint of beer, a small glass of wine or
and vigorous sports such as squash are not advised if
a single tot of spirits.) This should be spread over the
you have hypertension and if you are very overweight
week and binge drinking should be avoided.
you should check with your doctor before starting an exercise programme.
HOW SHOULD I CHANGE MY DIET?
Your doctor at the Roodlane Medical will be happy to
You should eat at least 5 portions of fruit and
vegetables every day and reduce your salt intake. Fruit and vegetables are a good source of ﬁbre and also of potassium, which has the opposite effect of salt and may help reduce your blood pressure. They
are also full of anti-oxidants such as vitamins C and
E, which help prevent heart disease.
The Blood Pressure Association www.bpassoc.org.uk
WHAT IS BLOOD PRESSURE?
WHAT ARE THE SYMPTOMS OF HIGH BLOOD
treatment. Once the decision is made that you need
Blood pressure is the pressure of blood in your
drugs it is likely that these will have to be continued
arteries. The systolic pressure (“top” reading) is the
Since it usually causes no symptoms, hypertension
for many years, if not for life. Modern hypertension
pressure at which blood is pumped around your body
is often called the “silent killer” but a few people
drugs are effective and safe but most people would
when your heart contracts and the diastolic pressure
with high blood pressure may notice headaches,
prefer to try to control their lifestyle than start long-
(“bottom” reading) is the pressure while your heart is
dizziness and nose bleeds. Low blood pressure is not
relaxing and ﬁlling with new blood from your lungs.
generally important in otherwise healthy people with
Normal blood pressure varies greatly but average
WILL I NEED TO TAKE TABLETS?
readings are between 110/70 and 130/80.
In many people lifestyle changes are difﬁcult to achieve or do not reduce the blood pressure
WHAT INVESTIGATIONS MAY BE NEEDED?
adequately and drugs become necessary. There
WHY IS BLOOD PRESSURE IMPORTANT?
Your doctor will take a personal and family history
are many different types of anti-hypertensive drugs
High blood pressure (“hypertension”) is diagnosed
from you and give you a physical examination. He will
and the initial choice depends on several factors,
when the blood pressure is consistently above
also do urine and blood tests to check for any kidney
which your doctor will discuss with you. He will
140/90. Hypertension increases the chance of
problems or other causes of secondary hypertension.
also monitor your response closely to begin with to
developing hardening of the arteries and subsequent
He may also do an ECG (electrocardiograph), which
ensure that the blood pressure is responding and
strokes, heart and kidney problems. Since blood
checks the electrical activity of the heart and may
that you are having no side effects from the pills.
pressure varies greatly through the day a single
show changes if the blood pressure has been elevated
If your initial response is not satisfactory he may
slightly high reading is not necessarily a cause for
for some time. Increasingly, home monitoring is used
increase the dose or change the medication to ﬁnd
concern. Many people get “white coat” hypertension
to assess whether blood pressure elevations are
one that suits you. Whichever medication you are on
when visiting their doctor and home blood pressure
sustained. Good quality digital home blood pressure
it is still important that you continue to modify your
monitoring may be useful to exclude this.
monitors are accurate if used correctly and it is often
lifestyle as mentioned above. Low dose aspirin and
useful to take a written record of your blood pressure
statin treatment to lower cholesterol may also be
recommended if your doctor thinks you have a high
WHAT CAUSES HIGH BLOOD PRESSURE?
In most people with hypertension the cause is unknown (“essential hypertension”) but a few
HOW WILL MY HYPERTENSION BE TREATED?
The British Hypertension Society recommends that
people have “secondary” hypertension due to
Unless your blood pressure is extremely high when
medical therapy be started if the systolic blood
problems with the kidneys or adrenal glands (small
hypertension is diagnosed, the initial treatment is
pressure is sustained above 160 mmHg and the
glands near the kidneys). Hypertension can affect
invariably by modiﬁcation of lifestyle. Reduction of
diastolic blood pressure is sustained above 100
anyone, but is more common in people with a family
weight, taking more regular exercise and cutting
mmHg. Treatment in people with levels of 140-
history of hypertension, strokes and heart attacks.
down on salt and alcohol intake all help to reduce
159/90-99 depends on whether other risk factors
Being overweight, eating too much salt, drinking
blood pressure. The incentives to achieve these
are present such as evidence of heart disease or
too much alcohol and taking too little exercise are
lifestyle changes should be great since, apart from
a high-risk assessment. In diabetics, treatment is
all likely to increase your blood pressure and these
lessening the possibility of severe, or even fatal heart
started if the blood pressure is sustained over 140/90.
factors, unlike your family history, are all modiﬁable.
attacks or strokes, the only other alternative is drug
Treatment goals should be to reduce blood pressure
treatment. Once the decision is made that you need
to less than 140/85 mmHg (130/80 in diabetics.)
Nutritional Therapy Approach and Case Study Struggling to Control Weight The fol owing information is for GPs only. It is not intended for use by the general public. It is not intended to promote the services of any nutritional therapist but is provided for GPs to better understand how a nutritional therapist may work. Nutritional therapy is recognised as a complementary medicine.
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