H8. Hypertension


This is defined as a blood pressure above the normal range. Many women will have lower blood pressures than men of equivalent age.

When the heart pumps, it produces the upper figure known as the systolic blood pressure, and when the heart is relaxed, there is still pressure within the blood vessels and this is called the diastolic blood pressure. For example, 120/80 is a normal blood pressure for adults on average. It is expressed in millimetres of mercury pressure.

Why is high blood pressure important?

Because it means that the heart is working harder to overcome the blood pressure within the blood vessels and this can lead to enlargement and weakness of the heart and actually increase the muscle bulk within the heart. It also causes changes in the blood vessels, which become thicker and narrowed, as hypertension increases the rate of progression of atherosclerosis (‘hardening of the arteries’)

High blood pressure is one of the most important factors that raises the risk of developing so-called hardening of the arteries (atherosclerosis). When it is combined with other risk factors such as smoking or raised cholesterol levels in the blood or diabetes, plaques of cholesterol are most likely to develop within the arteries and blockages of the arteries can result, particularly the arteries of the heart known as the coronary arteries.

What causes high blood pressure?

In many people, we don’t know what the mechanism is, but a large number of people who have high blood pressure will also have other members of their family who have the condition, thus a genetic cause is very likely here. Other lifestyle factors that can cause hypertension include being overweight, having too much salt in your diet, being physically inactive and drinking alcohol at levels generally more than one to two ordinary-sized drinks per day. There are also a few other causes that can be detected by special testing.

What will I feel if I have high blood pressure?

Mostly, you will not feel any symptoms of ill health until your blood pressure is very high or been present for a long time. It is known as “the symptomless disorder”.

The best way to detect high blood pressure is to have routine checks of your blood pressure done by your own doctor.

Hypertension is very common. Nearly one in five New Zealanders has the condition. Only half of these people know that they have the problem and only one in three is on effective blood pressure lowering treatment. Worldwide, it is a major problem.

What can be done for high blood pressure?

Ways in which your blood pressure can be reduced involve both lifestyle approaches and the use of medication.

Getting your weight down to normal is a very good place to start, keeping physically active on most days of the week, having a diverse low-fat diet with plenty of fruit and vegetables and moderate amounts of oily fish, and restricted amounts of salt. Stopping smoking may not lower your blood pressure but it will reduce your risk of hardening of the arteries, heart attacks and strokes. Try to restrict your alcohol intake to one or two normal-sized drinks per day.

Medications have been available to treat high blood pressure since the 1960s and they have become very sophisticated and effective over the years. Most of these treatments will involve taking only one tablet each day, but you may need to have two, or even in some cases three or more, different types of medication.

We all react differently to medications and it is advisable to try and monitor the effect of your new blood pressure tablets on you and the way that you feel so that you can report back to your doctor. Sometimes it takes several weeks for the full benefits of any particular type of medication or the dose in which it is given to have its full effect.

Side Effects

These are not common but they do occur and they vary from patient to patient and often decrease with time or with adjustment of dosage. So when any medication is started for control of blood pressure, it is always an exploration of how you will tolerate it and how effective it will be. You may need to see your doctor every week or so until your blood pressure is stabilised at a normal level.

What are the benefits of treatment?

It has been proven by many research studies done internationally and nationally that controlling hypertension prevents untimely death, heart attacks, stroke and kidney failure.