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High blood pressure is also known as hypertension, and is defined by the blood pressure in the arteries being deemed too high in relation to other risk factors

High Blood Pressure

Understanding high blood pressure

Blood pressure is a measure of the driving force in the arteries that propels the blood to the tissues and organs. Ideally, someone has a blood pressure that is high enough to drive blood to the organs, but not so high that it puts excessive load on the heart and blood vessels (10).

There is a key difference between chronic and malignant high blood pressure, and it is chronic blood pressure that is discussed most commonly. However, malignant hypertension is an emergency, as it is characterised by the rapid rise of blood pressure, and can lead to cardiac failure. Chronic hypertension is a slow rise in blood pressure over a long period of time, and frequently has no symptoms though sometimes it can cause headaches and other “heady” sensations (14).

Blood pressure is measured in two numbers, one over the other (e.g. 118/76). The first number is a measure of the pressure in the arteries when the heart is in contraction, or beating. This is called the systolic pressure. The second number is a measure of the pressure in the arteries when the heart is not contracting, or between beats. This is called the diastolic pressure (2). Both the systolic and diastolic pressure inform the diagnosis of hypertension.

Chronic high blood pressure is a very common condition, with 1 in 4 people in England affected (2).  The occurrence of hypertension increases with age, and half of people over 60 experience it (13). Socio-economic factors are significant in predicting outcomes as well, with people who are in more deprived areas 30% more likely to have high blood pressure than those who are in less deprived areas (2).

There are measures of blood pressure that are considered to be higher than normal. The blood pressure reading can be taken by a health provider, and high blood pressure should be assessed on the existence of other risk factors that the patient may have (13). There is however an increased acceptance  and value of home blood pressure monitoring from health professionals. This is very useful in claiming back some autonomy over this condition, and makes it easier to introduce more self-management.

Optimal Blood Pressure120/80
Mild Hypertension140/90
Moderate Hypertension160/100
Severe Hypertension180/110

Generally 140/90mmHg or higher is considered to be hypertension. Or if you are over the age of 80 then 150/90mmHg or higher is considered high blood pressure. The ideal blood pressure is considered between 90/60mmHg and 120/80mmHg (17).

The types of medication that are used to reduce high blood pressure are called anti-hypertensive drugs and there are several categories that are defined by their mechanisms of action. These drugs are selected on the bases of age, co-morbidities, and ethnic background as well as cost. Frequently, medications are combined (13).

  • Thiazide and other diuretics – These drugs inhibit sodium reabsorption in the kidneys, and a low dose is used for high blood pressure management (7). 
  • ACE inhibitors – These drugs inhibit the conversion of angiotensin I to angiotensin II. Their side effects include a cough, rash, and kidney dysfunction (13). They are frequently the type of medication initially prescribed for patients with high blood pressure, however they are not appropriate for pregnancy (7).
  • Angiotensin receptor blockers – These have similar effects to ACE inhibitors. Combining them with ACE inhibitors for controlling blood pressure is not recommended (7).
  • Calcium channel antagonists – These are considered well-tolerated and especially appropriate for patient over 55 who do not have Type 2 diabetes (7).  Their side effects include flushing, palpitations, and fluid retention (13).
  • Beta-blockers – These drugs block receptors that are involved in vasodilation and bronchodilation. They are no longer routinely used as a first line therapy for hypertension (14).
  • Beta and alpha-adrenoreceptor antagonists – These can be used when beta-blockers are not sufficiently effective. Labetalol is used for malignant hypertension (15).
  • Vasodilators – There are several drugs that act directly on the smooth muscle of the blood vessels. The side effects can be postural hypotension (dizzy on standing), headache, irregular or fast heart beat, and fluid retention (13).

Many herbs are suitable for self-care. However if a health condition does not resolve with home remedies we recommend using the information in Herbal Reality along with your health advisors, especially herbal practitioners from the professional associations listed in our Resources page (‘If you want to find a herbalist”). When buying any herbal products, you should choose responsible manufacturers with independently assured quality standards and sustainability practices. Check the label carefully for the appropriate safety and sustainability information.

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