Hypertension (High blood pressure)

High blood pressure is the single biggest risk factor for heart attacks and strokes. Watch this video by a GP which explains what the numbers mean, what causes it, how to manage it with lifestyle and medications, plus a step by step guide on how to properly measure your blood pressure at home.

Home Blood Pressure Monitoring

If you have high blood pressure, it’s a good idea to have a BP (blood pressure) monitor at home. At PSM Medical Group we are encouraging our patients to buy one of these if they don’t already have one.

If you have high blood pressure you will need a review each year which will always include a blood pressure check. If your blood pressure is not in a good range we will want to check you more often. This is because having high blood pressure can increase your risk of having a heart attack or stroke.

If you have a BP monitor at home, you can tell us your results, which helps us to see if your treatment is working well for you. It is common to find that BP readings taken at home are lower than BP readings taken in places like hospitals or GP practices.

There are many BP monitors to buy online, or in supermarkets or pharmacies. We have listed a few that are available and are known to work well. We took this information from the British and Irish Hypertension Society:

• Omron M2 Basic Upper Arm BP Monitor. Around £25
• Boots Upper Arm BP Monitor. Around £19.99.
• A&D UA-611 Upper Arm BP Monitor. Around £19.99.

You could also ask your community pharmacist to suggest a good monitor. Unfortunately, if you have an irregular heartbeat, the home monitors might not work very well. Instead, you would need to have your blood pressure checked by a healthcare professional.

How to check your blood pressure at home:

1. Take your blood pressure only when you are resting and feeling relaxed.
2. Sit upright in a chair with your legs uncrossed and your feet flat on the floor.
3. Your arm should be rested on a table ideally.
4. Put the cuff on your upper arm, with the tube leading down the centre of the arm. You will be able to see a picture of this in the manual. Make sure it fits well, snug to the arm with space to slide two fingertips underneath. Most monitors come with a medium sized cuff, and you might need to buy a separate cuff if it doesn’t fit.
5. Press the start button and continue to relax, without talking. The cuff will inflate and it might feel tight for a few moments. It will then deflate. If it feels too uncomfortable just press the stop button so it deflates quickly.
6. The monitor will show your reading. Take a note of your blood pressure reading and your pulse rate too.
7. It is best to check your blood pressure three times in a row and keep a record of the lowest reading. Use a diary for this so it is easy to keep track of. Alternatively, some BP monitors have “memory” and can store a few of your results for you.

Your GP may ask you to send in your most recent BP reading. Or your GP might ask you for a set of BP readings, to get an even better guide to your blood pressure. To do this it is best to note down your BP in the morning and evening for 3-4 days.

If you have been asked to send us your blood pressure, you can send it using our secure Blood Pressure form. Please include your name, date of birth and your email on the form. We will check your readings and get in touch with you if we need to review your medication. This will likely be 1-2 weeks after receiving your BP readings.

Introduction

A blood pressure test is a simple way of checking if your blood pressure is too high or too low.

Blood pressure is the term used to describe the strength with which your blood pushes on the sides of your arteries as it’s pumped around your body.

High blood pressure (hypertension) can put a strain on your arteries and organs, which can increase your risk of developing serious problems such as heart attacks and strokes.

Low blood pressure (hypotension) isn’t usually as serious, although it can cause dizziness and fainting in some people.

A blood pressure test is the only way to find out if your blood pressure is too high or too low, because most people won’t have any obvious symptoms. Having a test is easy and could save your life.

When should I get my blood pressure tested?

You can ask for a blood pressure test if you’re worried about your blood pressure at any point.

You can get your blood pressure tested at a number of places, including:

• at your local GP surgery
• at some pharmacies
• in some workplaces
• at home (see home blood pressure monitoring below)
• at an NHS Health Check appointment offered to adults in England aged 40-74

It’s recommended that all adults over 40 years of age have their blood pressure tested at least every five years so any potential problems can be detected early.

If you’ve already been diagnosed with high or low blood pressure, or you’re at a particularly high risk of these problems, you may need to have more frequent tests to monitor your blood pressure.

Ambulatory blood pressure monitoring

In some cases, your doctor may recommend 24-hour or ambulatory blood pressure monitoring (ABPM).

This is where your blood pressure is tested automatically around every 30 minutes over a 24-hour period using a cuff attached to a portable device worn on your waist.

ABPM can help to give a clear picture of how your blood pressure changes over the course of a day.

You should continue with your normal daily activities during the test, although you must avoid getting the equipment wet.

Understanding your blood pressure reading

Blood pressure is measured in millimetres of mercury (mmHg) and is given as two figures:

• systolic pressure – the pressure when your heart pushes blood out
• diastolic pressure – the pressure when your heart rests between beats

For example, if your blood pressure is “140 over 90” or 140/90mmHg, it means you have a systolic pressure of 140mmHg and a diastolic pressure of 90mmHg.

As a general guide:

• normal blood pressure is considered to be between 90/60mmHg and 120/80mmHg
• high blood pressure is considered to be 140/90mmHg or higher
• low blood pressure is considered to be 90/60mmHg or lower

A blood pressure reading between 120/80mmHg and 140/90mmHg could mean you’re at risk of developing high blood pressure if you don’t take steps to keep your blood pressure under control.

Find out more about what your blood pressure result means.

Controlling your blood pressure

If your blood pressure is found to be too high or too low, your GP or the healthcare professional performing the test can advise you about ways to control it.

This may involve:

• adopting a healthy, balanced diet and restricting your salt intake
• getting regular exercise
• cutting down on alcohol
• losing weight
• stopping smoking
• taking medication, such as angiotensin-converting enzyme (ACE) inhibitors or calcium channel blockers

In some cases, you may be referred to a doctor such as a cardiologist (heart specialist) to discuss treatment options.

Read more about treating high blood pressure and treating low blood pressure.