High blood pressure, also known as hypertension, is a common medical condition that affects millions of people worldwide. It’s essential to understand what high blood pressure is, its potential consequences, and the latest guidelines for managing and preventing it. This information aims to provide you with the knowledge you need to take control of your health and make informed decisions.

Blood pressure is the force of blood against the walls of your arteries as your heart pumps it around your body. It is typically measured as two values: systolic (the pressure when the heart beats) and diastolic (the pressure when the heart is at rest between beats). High blood pressure occurs when the force of blood against your artery walls is consistently too high. Normal blood pressure is generally considered to be around 120/80 mm Hg.

What causes high blood pressure?

 The origins of elevated blood pressure are multifaceted and lack a singular, specific cause. Instead, several factors can raise the likelihood of its development, encompassing:

• A family history of high blood pressure.
• Dietary habits, which encompass the consumption of salty foods.
• Alcohol consumption.
• Smoking.
• Body weight and obesity.
• Levels of physical activity and exercise.

It’s important to note that blood pressure can also experience temporary increases due to various factors such as stress, emotional states, recent physical activity, caffeine intake, or even engaging in conversation.

High blood pressure can lead to several serious health problems, including:

1. Heart Disease: It can damage the arteries and lead to the accumulation of fatty deposits, increasing the risk of heart attacks.
2. Stroke: High blood pressure can damage blood vessels in the brain, leading to strokes.
3. Kidney Problems: Over time, hypertension can damage the kidneys, potentially leading to kidney failure.
4. Eye Issues: It can damage the blood vessels in your eyes, leading to vision problems.
5. Aneurysms: High blood pressure can weaken blood vessel walls, making them more susceptible to aneurysms (ballooning and potential rupture).

The guidelines for diagnosing and managing high blood pressure may evolve over time, so it’s important to stay updated. The Australian guidelines for hypertension management were primarily outlined in the “Guidelines for the Management of Absolute Cardiovascular Disease Risk.” These guidelines were developed by the National Vascular Disease Prevention Alliance, and they provided recommendations for healthcare professionals regarding the prevention and management of cardiovascular diseases, including hypertension

High blood pressure is a common and manageable condition, but it requires attention and care. The latest guidelines emphasize the importance of lifestyle modifications and regular monitoring. Always consult your healthcare provider to create a personalized plan for managing your blood pressure and reducing your risk of associated health problems. By following their guidance and staying informed, you can take control of your health and lead a healthier life.

Australian guidelines to manage high blood pressure.

The National Heart Foundation of Australia has updated the Guide to management of hypertension 2008: assessing and managing raised blood pressure in adults (updated December 2010). It is vital to know that your doctor would prescribe the doses that is best tailored to you even you find the doses not matching with the figures mentioned in the guidelines.

Main recommendations

• For people at low absolute cardiovascular disease risk with persistent blood pressure (BP) ≥ 160/100 mmHg, start antihypertensive therapy.
• The decision to treat at lower BP levels should consider absolute cardiovascular disease risk and/or evidence of end-organ damage, together with accurate BP assessment.
• For patients at moderate absolute cardiovascular disease risk with persistent systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg, start antihypertensive therapy.
• Treat patients with uncomplicated hypertension to a target BP of < 140/90 mmHg or lower if tolerated.

Changes in management as a result of the guideline

• Ambulatory and/or home BP monitoring should be offered if clinic BP is ≥ 140/90 mmHg, as out-of-clinic BP is a stronger predictor of outcome.
• In selected high cardiovascular risk populations, aiming for a target of < 120 mmHg systolic can improve cardiovascular outcomes. If targeting < 120 mmHg, close follow-up is recommended to identify treatment-related adverse effects including hypotension, syncope, electrolyte abnormalities and acute kidney injury.

The reasons behind these modifications are as follows:

1. An analysis conducted in 2015 that examined individuals with uncomplicated mild hypertension (systolic BP range of 140–159 mmHg) revealed the benefits of blood pressure-lowering treatments. These interventions were shown to reduce the risk of stroke, cardiovascular-related deaths, and overall mortality.
2. Additionally, in a 2015 clinical trial that compared lower blood pressure targets to higher ones in specific populations at high risk for cardiovascular issues, it was observed that lower targets resulted in improved cardiovascular outcomes and reduced mortality. However, this improvement was accompanied by an increase in some adverse events associated with the treatment.

What are the indications and signs that blood pressure is high?

High blood pressure typically doesn’t present obvious signs or symptoms, we call this it “asymptomatic” in medical terms. Consequently, you may remain unaware of its presence. This underscores the significance of routine check-ups to monitor your blood pressure levels and acquire strategies for its management.

Why is high blood pressure detrimental to your health?

A clear and established association exists between high blood pressure and an elevated risk of heart disease, specifically the likelihood of experiencing a heart attack or stroke.

How is blood pressure assessed and diagnosed?

To gauge your blood pressure, a device called a “sphygmomanometer” (pronounced as sphig-mo-mano-meter) is employed. This instrument usually features an inflatable rubber cuff encircling the upper part of your arm, connected to a measuring unit. As the cuff becomes fully inflated i.e., when the cuff around your arm is fully tight, an air valve gradually releases the pressure, generating a reading consisting of two numbers displayed one atop the other, for instance, 120/80 mm Hg.

1. The upper number represents your systolic blood pressure, indicating the pressure in your arteries during your heart muscle’s contraction.
2. The lower number reflects your diastolic blood pressure, which denotes your blood pressure between heartbeats when the heart muscle is at rest.

If you buy a personal blood pressure monitor, I would suggest that you take the machine when you go to your doctor. Make sure that the reading in your machine is similar to the machine in the clinic. All medical instruments in a clinic undergoes a process called “calibration” or standardisation to ensure accurate readings.

How can I check my blood pressure at home?

Usually, your healthcare provider will recommend self-monitoring your blood pressure at home. It’s essential to make sure you acquire blood pressure devices that have received approval from the British Hypertension Society. Here are guidelines to ensure accurate readings:

Before you measure your blood pressure:

1. Use a blood pressure cuff that fits your upper arm correctly.
2. Take measurements for at least five days, ideally seven, at the same time each day, either in the morning or evening.
3. Measure your blood pressure before eating, taking medications, or engaging in strenuous exercise.
4. Avoid smoking or consuming caffeine for at least 30 minutes before measuring.
5. Refrain from measuring your blood pressure if you’re feeling uncomfortable, stressed, or in pain.

How can I measure blood pressure assessed and diagnosed?

1. Sit calmly and without any disturbances for a period of five minutes.
2. Make sure both of your feet are firmly planted on the ground, expose your upper arm, and provide proper support for your back and arm.
3. Take measurements in either arms.
4. Document each reading in a physical diary or electronic spreadsheet, which you can then take with you to your upcoming medical appointment.

What should I eat if I have high blood pressure?

‌ The American Heart Association recommends the Dietary Approaches to Stop Hypertension (DASH) diet for reducing high blood pressure. The DASH diet is rich in fruits, vegetables, whole grains, and lean proteins while limiting sodium, saturated fats, and added sugars. Here are some key dietary guidelines for managing high blood pressure according to the American Heart Association:

1. Increase Fruits and Vegetables:

 Aim for 4-5 servings of fruits and 4-5 servings of vegetables each day. They are high in essential vitamins, minerals, and fibre, which can help lower blood pressure.

2. Choose Whole Grains:

 Opt for whole grains like brown rice, whole wheat bread, and oats instead of refined grains. These are higher in fibre and nutrients.

3. Include Lean Proteins:

Select lean protein sources such as skinless poultry, fish, beans, and legumes. These are lower in saturated fat and can help maintain a healthy weight.

4. Limit Sodium (Salt) Intake:

 Reduce your sodium consumption to 2,300 milligrams per day (about 1 teaspoon of salt) or ideally, aim for 1,500 milligrams if you have high blood pressure. Avoid high-sodium processed foods and limit added salt when cooking and at the table.

5. Moderate Dairy:

 Choose low-fat or fat-free dairy products to reduce your intake of saturated fats. These can provide essential nutrients like calcium and vitamin D.

6. Watch Sugars:

 Limit your intake of sugary foods and beverages, as excess sugar can contribute to weight gain and high blood pressure.

7. Healthy Fats:

 Opt for unsaturated fats like those found in olive oil, avocados, and nuts. These fats can have a positive impact on heart health.

8. Portion Control:

 Be mindful of portion sizes to avoid overeating and manage your weight.

9. Limit Alcohol:

 If you consume alcohol, do so in moderation. For women, this means up to one drink per day, and for men, up to two drinks per day.

10. Monitor Nutrients:

 Pay attention to your intake of key nutrients, such as potassium, magnesium, and calcium, as they play a role in blood pressure regulation.

Remember that dietary changes should be made in conjunction with a healthy lifestyle, which includes regular physical activity, maintaining a healthy weight, and managing stress. It’s also important to consult with your healthcare provider for personalized advice and to monitor your blood pressure regularly.