High blood pressure: Managing this common but serious condition

If you’re an Australian aged over 65, there’s a good chance you’ve been told, or will be told at some point, that you have high blood pressure.

That’s because 41 per cent of 65-74-year-olds and almost 47 per cent of 75-pluses have this common condition. High blood pressure doesn’t just put you at greater risk of developing heart disease; it’s also a major cause of strokes, can lead to kidney failure, aneurysms and nerve damage, and is even connected with the development of a type of dementia.

Fortunately, it’s possible to bring your blood pressure within a healthier range and reduce your risk of these serious conditions as a result, but that requires taking a holistic approach to its treatment, Mona Singh, a GP and medical officer at Bupa, the health insurer, says.

“It’s not just ‘take this magic pill and it might help with reducing your blood pressure’,” Dr Singh says. “It also depends on the lifestyle you’re leading.”

The fact that high blood pressure can have serious consequences, yet can also be effectively managed, makes diagnosis vital.

“The older people get, the more at risk they are, so it’s particularly important to manage their blood pressure,” Dr Singh says. “A stroke or heart attack is something that’s going to have a big impact on their lifestyle in retirement so treating their high blood pressure early on in the picture, before it causes more serious health issues, is key.”

It’s important to understand high blood pressure, including whether you have any particular risk factors; and the steps you can take after diagnosis to get yourself back into a healthier blood pressure range. Of course, if you’re concerned about your blood pressure, you should consult your GP.

What is blood pressure?

Your blood pressure is, simply put, the pressure your blood puts on your artery walls as the blood circulates through your body. According to Bupa’s health information, there are two major factors that determine your blood pressure: the force and volume of your blood and the flexibility of your arteries.

Getting a blood pressure reading requires taking two pressure measurements, called systolic (the pressure when your heart beats) and diastolic (the pressure when your heart rests between beats). The systolic number is the first number in a blood pressure reading and the diastolic number the second one.

What’s a healthy blood pressure reading?

Doctors typically consider anyone with a blood pressure reading higher than 140/90 to have high blood pressure, also called hypertension, Dr Singh explains.

Beyond that range, there are several categories of severity but broadly speaking, the Heart Foundation’s guidelines say that a reading between 120/80 and 140/90 is considered normal to high, more than 140/90 is high and more than 180/110 is very high.

What causes high blood pressure?

There are a number of reasons for high blood pressure, including your arteries losing their elasticity or becoming narrow or contracted, or if your heart’s pumping too much blood or you have too much blood in circulation. These changes can occur due to modifiable, or lifestyle, factors, as well as  non-modifiable factors – that is, ones you can’t change.

More than 90 per cent of people with high blood pressure have what’s called primary hypertension, which has no single, clear cause but could be related to modifiable factors such as smoking, being overweight, excessive alcohol intake, a diet high in salt or saturated fats, or a lack of exercise.

One in 20 people, however, have secondary hypertension, meaning their blood pressure can be linked to another, known but non-modifiable health issue such as kidney disease, endocrine disease, the narrowing of the aorta, or simply due to age, ethnicity, gender and family history.

How can I tell if I have high blood pressure?

High blood pressure usually produces no noticeable symptoms, unless it’s extremely elevated or spikes suddenly.

“If it’s really high, a person can experience dizziness and chest pain,” Dr Singh says. “There’s also something called malignant hypertension, which is when the blood pressure is so high that you can have a headache and vomiting, which is considered a medical emergency. But by large, it’s asymptomatic.”

It’s normal for blood pressure to change throughout the day depending, for example, whether you’re resting or active, which is why a single blood pressure reading isn’t enough to diagnose high blood pressure. Instead, several readings at different times over a series of times are usually required.

How do I get my blood pressure tested?

Because high blood pressure rarely produces any symptoms, it’s important to visit a GP or your local pharmacy regularly for a simple blood pressure test. It’s possible to buy at-home blood pressure monitors but doctors don’t tend to recommend that you get one unless you have elevated blood pressure that requires regular monitoring.

The Royal Australian College of General Practitioners recommends that adults should have their blood pressure tested at least every two years and, generally speaking, Dr Singh says over-60s should visit their GP at least once a year for a test or more often if they have lifestyle factors or a health condition that could cause high blood pressure.

If you’re concerned about the possibility high blood pressure is putting you at risk of heart disease, Bupa’s developed a free, online Healthy Heart Check designed to take just 60 seconds. The easy-to-use tool asks questions about your health and lifestyle, so it can tell you whether your risk is low, medium or high.

“The risk factors it looks at are very similar to the standard cardiovascular risk calculators that we use in our GP clinics,” Dr Singh says, adding that people who receive a medium or high reading from the Bupa tool should speak to their GP.

“In that case, they can be better advised on what their risk is, whether they need medication or whether it can be managed with lifestyle interventions,” she added.

How can I reduce my blood pressure?

If your doctor decides your blood pressure could be reduced through lifestyle changes, they’re likely to encourage you to eat less saturated fats and salts, reduce any alcohol and caffeine intake, get regular physical activity, lose excess weight, eat more vegetables, cut down on stress, and stop smoking.

There are also several medications that can be used to reduce blood pressure but it isn’t a one-size-fits-all-approach so your GP will consider your age, other medical conditions and other medications you may be taking before making your prescription.

Blood pressure medication needs to be taken every day, even if you’re feeling fine. In some cases, you may need to try several different medicines or dosages until the right fit is found, and even when you’re on medication, your GP will keep measuring your blood pressure to ensure the treatment is working as it should.

Why is it important to manage blood pressure?

High blood pressure puts strain on your heart, blood vessels and other organs and if left untreated can result in serious damage to your body, often leading to a stroke, heart attack or another serious health condition. That makes it vital to identify and treat high blood pressure before it can take a long-term toll on your health.

When did you last have your blood pressure tested? If you have high blood pressure, how do you manage it?