High blood pressurethe silent strain on the heart.
High blood pressure (hypertension) means the pressure in your arteries stays higher than it should. It rarely causes symptoms, but over the years it strains the heart, brain, kidneys and blood vessels. It is one of the most treatable risk factors there is.
At a glance
- Often noticed as
- Usually nothing: it is found by measuring
- Confirmed with
- Home or 24-hour blood pressure readings
- Aim of care
- Reach a target that protects the heart and brain
- Followed up in
- Hypertension clinic
Symptoms
Symptoms vary from person to person, and some people have none. These are the most common.
- Most people have no symptoms at all
- Headaches, usually only when it is very high
- Blurred vision or nosebleeds, rarely
- Found at a routine check or a pharmacy reading
Causes and risk factors
- Family history and increasing age
- Salt, excess weight and inactivity
- Alcohol and smoking
- Diabetes and kidney disease
- Some medicines, such as painkillers and decongestants
- Less often, a hormone or kidney cause, especially in younger people
How it is diagnosed
The diagnosis starts with your history and an examination. These are the tests most often used to confirm it.
- 24-hour blood-pressure monitoringHospital referral
- ECGAvailable in clinic
- EchocardiographyAvailable in clinic
- Cardiac risk assessmentAvailable in clinic
How it is managed
Confirm the numbers
A clinic reading can be misleading. Home or 24-hour readings show your true blood pressure.
Lifestyle
Less salt, more activity, weight loss and less alcohol can lower pressure as much as a tablet.
Medicines
Most people need one or two tablets, chosen to suit their age and other conditions.
Check for effects
An ECG, blood and urine tests, and sometimes an echocardiogram, show whether pressure has affected the heart or kidneys.
General information, not a treatment plan. Your treatment is decided with you after an assessment.
Get emergency help now if you have
Call emergency services or go to the nearest emergency department. Do not wait for a clinic appointment.
- A reading of 180/120 or higher with chest pain or breathlessness
- A sudden severe headache, confusion or change in vision
- Weakness of the face, arm or leg, or difficulty speaking
- Chest pain
Common questions
Why is my blood pressure higher in clinic?
Many people have higher “white-coat” readings in clinic. That is why home or 24-hour monitoring is used to confirm the diagnosis.
Once I start tablets, is it for life?
Usually, but not always. If lifestyle changes bring your pressure down, the dose can sometimes be reduced.
What should my blood pressure be?
For most adults the target at home is below 135/85, but your own target depends on your age and other conditions.
Other conditions
All conditions- Heart failureThe heart muscle is not pumping or filling as well as it should, so the body receives less than it needs.
- Atrial fibrillationAn irregular, often fast heartbeat that starts in the upper chambers and raises the risk of stroke.
- High cholesterolToo much cholesterol in the blood, which can build up in artery walls over many years.
- Coronary artery diseaseThe arteries that supply the heart muscle become narrowed by fatty plaque.
- CardiomyopathyA disease of the heart muscle itself, which may become thickened, stretched or stiff.
- Heart valve diseaseOne of the heart's four valves does not open fully or does not close properly.
- AnginaChest discomfort, usually on exertion, when the heart muscle briefly gets too little blood.
- ArrhythmiaA heartbeat that is too fast, too slow or irregular, caused by a problem in the heart's electrical system.
- Diabetes and the heartDiabetes raises the risk of heart and blood vessel disease, so the two are best managed together.
Living with this, or worried you might be?
Book a consultation or send a question on WhatsApp. Your history, results and treatment are reviewed in person, and the plan is explained to you before you leave.
This page explains a condition in general terms. It cannot diagnose you or replace an examination, and it is not a treatment plan. Do not change or stop a medicine without talking to your doctor. If your symptoms are severe, sudden or happening now, seek emergency care immediately.