Blood pressure

The force of blood exerted on the inside walls of blood vessels. Blood pressure is expressed as a ration (eg 120/80) The first number is the systolic pressure, or the pressure when the heart pushed blood out into the arteries. The second number is the diastolic pressure, or the pressure when the heart rests.

High blood pressure : 140/90,

Types of high blood pressure
Primary hypertension
More than 9 in 10 people with high blood pressure have what's called 'primary' or 'essential hypertension'. This means that there's no single clear cause of it.
Although the exact cause of high blood pressure isn't fully understood, it's known that some factors to do with your lifestyle can contribute. These include:
smoking
your family history
obesity (being very overweight)
drinking a lot of alcohol - especially if you binge drink
a lack of exercise
your diet
Secondary hypertension
Around 5 in 10 people with high blood pressure have 'secondary hypertension'. This means your condition can be linked to a recognised cause - in fact, it may be a symptom of another underlying disease or factor such as:
kidney disease
endocrine disease
narrowing of the aorta
steroid medicines
the contraceptive pill
pregnancy, which can cause pre-eclampsia
Symptoms
Most people with high blood pressure don't have any symptoms.
People with severe high blood pressure or a rapid rise in blood pressure may also experience headaches, blurred or impaired vision, fits or black-outs.
Complications
People with high blood pressure have an increased risk of major illnesses including:
cardiovascular disease such as angina, stroke, heart attack or atrial fibrillation
kidney damage
damaged sight
Diagnosis
As most people with high blood pressure don't have any symptoms, they are diagnosed when they have their blood pressure taken as part of a medical examination. That's one good reason to have a regular check-up with your doctor, especially if you're over 50.
Your doctor may request that you come back for repeat measurements over a number of weeks before suggesting that you have treatment. This is so he or she can check that the high reading is an ongoing problem and not a one-off.
You may also need some tests to see if high blood pressure is having an effect on the rest of your body. These may include:
an analysis of your urine (protein in your urine may be the first sign of a kidney problem)
a blood test, to check your cholesterol and blood sugar levels as well as the condition of your kidneys
an ECG (electrocardiogram), which records the electrical changes happening in your heart
Monitoring
24-hour ambulatory monitoring
You may need 24-hour testing to measure your blood pressure over 24 hours. A monitoring device will be strapped round your waist and it will be attached to a cuff wrapped around your upper arm. The cuff will inflate and deflate throughout the 24 hours and take blood pressure recordings.
Blood pressure monitors
You might consider getting a blood pressure monitor to use yourself at home - discuss this option with your doctor, who should be able to help you choose a suitable one. The Blood Pressure Association (see Further information) also has advice and a list of suppliers.
It is important to take readings on different days - for example you should not just measure yourself when you feel stressed. Set days in the week to take the measurement so that you can get an objective reading.
You should continue to get your blood tested regularly by your doctor even if you use a blood pressure monitor at home.
Treatment
Slightly raised blood pressure may not need to be treated so aggressively, but regular monitoring is important.
If you have very severe high blood pressure, you may need to go to hospital for treatment. But it's much more likely that you will be cared for by your GP and/or a nurse.
Lifestyle changes
First, your doctor or nurse is likely to discuss lifestyle changes which might help lower your blood pressure. He or she might, for example, advise you to:
stop smoking - for more information on quitting smoking please see the separate BUPA factsheet, Giving up smoking
change your diet to a low fat, low salt diet that includes fruit and vegetables - for more information about healthy diet, please see the separate BUPA factsheet, Healthy eating
cut down on alcohol
get some regular moderate exercise - for more information, please see the separate BUPA factsheet, Physical activity
lose any excess weight
It may also help to try to reduce the stress in your life to avoid short-term rises in blood pressure - try relaxation techniques or meditation.
Drug treatments
If your blood pressure remains high, your doctor may prescribe you one or more of the following antihypertensive drugs.
ACE inhibitors or angiotensin II receptor antagonists (eg ramipril, losartan) - these make the walls of the blood vessels relax and widen.
Calcium channel blockers (eg amlodipine) or alpha blockers (eg doxazosin) - these help widen the blood vessels.
Diuretics (eg bendroflumethiazide) - these increase the amount of water and salt removed from your blood by your kidneys. This triggers hormones which lower blood pressure.
Beta-blockers (eg atenolol) - these drugs reduce the work your heart has to do, by reducing your pulse rate at times when it may beat too forcefully such as during exercise or when you are feeling stressed..........