Know Your Numbers! Week, which runs from 7 to 13 September, is Blood Pressure UK’s annual blood pressure testing and awareness campaign. It exists for a simple but important reason. Around 4.1 million people in England are estimated to be living with high blood pressure without knowing it. Getting a reading is the essential first step.

But for many people, knowing the number is only the beginning. The more useful question is what is causing blood pressure to be elevated in the first place, and what can be done about it.

Why blood pressure becomes elevated

High blood pressure, or hypertension, is often described as a silent condition. It rarely causes noticeable symptoms, yet over time it places sustained strain on the heart, arteries, kidneys and brain. It is one of the most significant modifiable risk factors for stroke, heart attack and heart failure.

For most people, blood pressure is influenced by more than one factor at a time, and these factors interact in ways that a single reading cannot capture. Detection and control also remain a challenge at population level. A BMJ Medicine analysis of hypertension trends across England from 2003 to 2021 found that the proportion of people with hypertension who were undiagnosed fell from 32.6% in 2003 to 23.7% in 2011, but had risen back to 32.4% by 2021. In the same analysis, only 38.3% of people with hypertension had adequately controlled blood pressure in 2021.

Common contributors include excess body weight, particularly visceral fat around the abdomen, which is closely associated with insulin resistance and low-grade inflammation. Dietary patterns high in salt and ultra-processed foods and low in potassium-rich whole foods influence vascular tone and fluid balance. Chronic psychological stress is associated with sustained sympathetic nervous system activation, which can raise blood pressure over time. Poor or disrupted sleep, including undiagnosed obstructive sleep apnoea, is a recognised and frequently overlooked contributor. Physical inactivity and excess alcohol also contribute independently.

Understanding which of these factors are most relevant for an individual patient requires looking beyond the blood pressure reading itself.

The limits of measurement alone

NICE guidance (NG136) recommends offering lifestyle advice to everyone with suspected or diagnosed hypertension, and continuing to offer it periodically, alongside medication where indicated. This reflects a broad consensus that blood pressure is best managed by addressing the conditions that produce it as well as by treating the number.

Standard clinical assessment is designed to identify, classify and treat hypertension, and it does this well. What a longer cardiometabolic consultation can add is time for a more structured exploration of the contributing factors, including body composition, markers of insulin sensitivity, inflammatory markers such as hs-CRP, sleep quality and levels of psychological stress, considered alongside conventional cardiovascular risk assessment. These additional measures are used to inform lifestyle discussion and shared decision-making; they do not replace guideline-based diagnosis and treatment.

This is particularly relevant for patients whose blood pressure remains difficult to control despite medication, or who want to understand what is contributing to their risk alongside, rather than instead of, guideline-based treatment. Decisions about starting, changing or stopping medication should always be made with the doctor responsible for your care.

A cardiometabolic approach to hypertension

Dr Grosser’s consultations at KentCardio consider blood pressure as one element within a broader cardiometabolic assessment. Rather than looking at the number alone, the aim is to build a fuller picture of the factors shaping an individual’s cardiovascular risk and to agree a practical, individualised plan for managing them, in line with current guidelines and in partnership with the patient’s GP.

For a more detailed look at the underlying drivers of blood pressure, book a private consultation with Dr Konrad Grosser at KentCardio: https://kentcardio.com/book/

This article is for general information and does not constitute medical advice. If your blood pressure is significantly raised, or you experience symptoms such as chest pain, severe headache or visual disturbance, please contact your GP urgently or call 111. In an emergency, call 999.

Can’t get through the morning without a mug or two of coffee? While a caffeine fix can help to wake you up and prepare you for the day ahead, it could also be putting you at risk of developing high blood pressure.

Research has linked caffeine intake and high blood pressure, increasing your risk of developing cardiovascular disease. So, how does coffee cause high blood pressure and what do you need to know?

The link between coffee and hypertension

New research published within the American Journal of Clinical Nutrition, has revealed a worrying link between coffee and hypertension. For a short period of time after drinking caffeine, blood pressure experiences a dramatic increase.

Those who consume from 200mg to 300mg of caffeine could see their blood pressure rise by 8.1mm Hg according to the study. It can also raise your diastolic blood pressure by as much as 5.7 mm HG – all within one hour of consuming caffeine.

The increased blood pressure lasts for around three hours, and it is thought to be down to adrenal secretion. When your adrenaline surges, the heart beats faster at the same time as the blood vessels narrow. This increases the pressure in the veins, leading to high blood pressure.

Regular consumption of coffee may decrease the risk

One interesting finding of the latest research is that those who regularly drink coffee may develop a caffeine tolerance. This means it will reduce the hypertensive effects of the substance. Rather than experiencing a dramatic rise in blood pressure, the increase will be small to moderate.

While the study did show a clear link between coffee and high blood pressure, it didn’t show an increase in the risk of heart disease.

Everybody is different, and the effects of caffeine will vary from person to person. In some studies, it has actually shown to have a positive effect on our health. It contains a high level of bioactive compounds, which are renowned for their antioxidant properties.

Vitamin B, Magnesium, and Potassium are all beneficial compounds found in caffeine. Many experts argue that the benefits of drinking coffee outweigh the potential risks.

Seeking treatment for high blood pressure

While coffee is unlikely to lead to heart problems, it can cause high blood pressure. Undergoing an assessment with a specialist will help to determine whether caffeine could be contributing towards hypertension.

Whether or not it is the cause, seeking treatment for high blood pressure is crucial. Over time if it isn’t controlled, hypertension can lead to significant heart troubles.

If you are worried you may have high blood pressure, book an appointment with Dr Konrad Grosser. He will carry out a full heart screening check, including a blood pressure test and will determine what risk it poses to your health. He will advise the best course of action to treat it.