Blood Pressure: Each time the heart beats, it pumps blood around the body. The pressure of blood inside the blood vessels is as its highest after each heart beat, and this is called the systolic blood pressure. The lowest pressure in between heart beats is called the diastolic blood pressure. Blood vessels in the body are elastic, so they stretch and relax during each heart beat.
WHAT IS HIGH BLOOD PRESSURE?
The current definition of high blood pressure is blood pressure greater than 140/90mmHg. (Hypertension is the medical term for high blood pressure)
If someone has diabetes and protein in the urine, many doctors would give treatment if the blood pressure was greater than 130/80.During the later stages of pregnancy, the blood pressure should not raise significantly and a BP of greater than130/ 90mmHg may merit treatment.
HOW SHOULD THE BLOOD PRESSURE BE MEASURED?
The blood pressure varies from minute to minute, according to the demands on the circulation and the need for blood and oxygen to be delivered around the body. Stress can cause high blood pressure, and this is a particular problem when people come to have their blood pressure measured in a hospital or clinic, even if they do not feel “stressed”, though it can still occur if your doctor does not wear a white coat.
Therefore the blood should be measured after someone has been sitting quietly for a few minutes. If someone measures their blood pressure at a home a couple of times a week and keeps a written record of the exact results, this is often more useful than blood pressure levels taken in a clinic or hospital.
WHAT ARE THE CAUSES OF HIGH BLOOD PRESSURE?
The majority of people with high blood pressure have an inherited tendency to the condition. Any type of kidney disease may lead to high blood pressure. This is especially important as high blood pressure can damage the kidneys further, causing a vicious circle of progressive high blood pressure and kidney damage. There are other causes of high blood pressure, such as hormonal conditions, which are very rarely seen in younger people with high blood pressure. A young person who develops high blood pressure and who has no kidney disease and no family history of high blood pressure may have a series of tests performed by a hospital specialist to see if there is a treatable cause for high blood pressure.
WHAT PROBLEMS CAN HIGH BLOOD PRESSURE CAUSE?
However, getting good treatment of the blood pressure is very important to reduce the chances of developing these problems.
If someone has reduced kidney function then high blood pressure can be especially damaging, and effective treatment of the blood pressure is one of the most important things doctors can do to keep people well with stable kidney function, and reduced chances of heart attack or stroke.
Problems that high blood pressure can cause:-
- Kidney damage, especially if the high blood pressure is caused by kidney disease in the first place, a “various circle” of progressive kidney damage and high blood pressure can develop.
- Stroke is more likely to occur with high blood pressure.
- Heart disease may occur, either thickening of the heart muscle because it has to work too hard, or because of narrowing of the arteries supplying the heart, leading to heart attack.
- Hardening and narrowing of arteries anywhere in the body, this could lead to reduce blood flow and gangrene in the feet, or problems with blood flow to the eyes
HOW SHOULD HIGH BLOOD PRESSURE BE TREATED?
Although drugs are often used to treat high blood pressure, they will not work properly if someone does not take general measures to help themselves. For some people with high blood pressure , these general measures may be enough to normalise the blood pressure without the need to use drugs.
The general measures are:-
- Lose weight. If someone is overweight, the blood pressure will be reduced if they lose a significant amount of weight.
- Reduce the amount of salt in the diet.
- Regular alcohol consumption may cause a slight increase in the blood pressure, and people should cut back to below the national recommended alcohol intake levels.
- Take some regular moderate intensity exercise.
Drugs to treat blood pressure are generally used if the blood pressure is 140/80 or more despite the above measures, with the aim being to get the blood pressure down to 130/80, or 120/80 if someone has diabetes or heavy protein urea. There are many different types of blood pressure drug, and they can be used in order to get the best effect that might occur.
For most people with kidney disease, two types of blood pressure drug seem especially good, as they have an extra effect on blood flow inside the kidney. These are ACE inhibitors or ARBs. ACE inhibitors have names which end in-opril (like captopril), and ARBs have names which end in –sartan (like losartan). There are several similar agents in each class, and your doctors will choose whichever one suits you best, or is recommended for use in their locality.