High blood pressure

High Blood Pressure

I care for many patients with hypertension, approaching blood pressure not as an isolated reading but within the wider clinical and functional context of each individual.

Through root cause analysis—considering lifestyle, metabolic, genetic, and environmental factors—I aim to uncover and address the true drivers of raised blood pressure.

Often, in-depth functional testing is required to better understand underlying causes and modifiable biomarkers, allowing us to target interventions more precisely. Using this integrative lens, I set blood pressure goals that are optimal for each patient’s background and health profile, with the aim not only of controlling but, where possible, reversing hypertension.

My combined expertise in interventional cardiology and functional medicine enables me to deliver the highest standards of conventional care alongside a personalised, root-cause approach for long-term cardiovascular health.

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Around 16 million people in the UK have high blood pressure – also called hypertension. It is responsible for more than half of all strokes and heart attacks.

It is also a major risk factor for heart disease, kidney disease and vascular dementia. However, with no obvious symptoms it is not always easy to tell and many adults may not be aware that they are at risk.

For this reason it is sometimes called ‘the silent killer’. It is believed that as many as half of all people with high blood pressure are undiagnosed.

In the UK, high blood pressure is the third biggest risk factor for all disease after smoking and poor diet. Thirty one per cent of all men in England and 26% of all women have high blood pressure. In 2015, high blood pressure was the cause of around 75,000 deaths in the UK.

Doctors recommend that adults over 40 should get their blood pressure checked regularly and not less than every five years. If you know that you have high blood pressure you can take steps to bring it down, which can significantly reduce your chance of serious illness and even death.

High blood pressure in more detail

The reason high blood pressure is a cause for concern is that it puts extra strain on your heart, blood vessels and other organs, including the brain, kidneys and eyes. If left untreated, it is linked to an increased risk of heart disease, heart attack and heart failure. It can also cause strokes, peripheral arterial disease, aortic aneurysm, kidney disease and vascular dementia.

The precise causes of high blood pressure aren’t known but certain factors can increase your risk of developing it. These include:

  • Age – you are more likely to have high blood pressure over the age of 65
  • Weight – the risks increase if you are overweight or obese
  • Ethnicity – your risks are higher if you are of African or Caribbean descent
  • Family history – if a relative has high blood pressure you are more likely to have it too
  • Diet – high blood pressure is associated with a poor diet, high in salt and low in fruit and vegetables
  • Lack of exercise – alongside diet and weight, lack of exercise is another lifestyle factor linked to high blood pressure
  • Alcohol and coffee – drinking too much alcohol, coffee or other caffeine-based drinks increases your risk
  • Smoking – alongside many other detrimental health impacts, smoking raises blood pressure
  • Lack of sleep – consistent lack of sleep or disturbed sleep is another risk factor

Having your blood pressure checked will ascertain whether or not it is high. Blood pressure is recorded with two numbers – the systolic pressure, which is the force at which your heart pumps blood around your body, and the diastolic pressure, which is the resistance to the blood flow within the blood vessel. Both are measured in millimetres of mercury (mmHg). Systolic pressure (the higher number) is shown first, followed by diastolic pressure (the lower number).

Ideally, your blood pressure should be between 90/60mmHg and 120/80mmHg. High blood pressure is 140/90mmHg or higher. Low blood pressure is 90/60mmHg or lower. However, if your blood pressure is over 120/80mmHg your doctor is likely to recommend taking steps to bring it down.

If you have high blood pressure, your doctor will assess the best way to reduce it. In many cases, making lifestyle changes is sufficient. However, depending on how big a risk it poses to your health, you may also be advised to take medication or to follow a specific diet.

Lifestyle

Changing your lifestyle, even in small ways, can help to reduce your blood pressure, and prevent the many complications that can occur as a result of high blood pressure. Evidence suggests that every 10mmHg reduction in systolic blood pressure reduces the risk of a major cardiovascular event by 20%.

Here are some ways that you can help to bring your blood pressure down:

  • Stop smoking – there are many sources of help and support to help you. Talk to your GP.
  • Cut back on alcohol and caffeine – reducing the amount of alcohol you drink will have multiple health benefits, including bringing your blood pressure down.
  • Maintain a healthy weight – not only will you look and feel better, but you will reduce your risk of developing serious illnesses.
  • Reduce the amount of salt you consume – beware hidden salt in many processed foods and sauces. Always read the label.
  • Aim for a minimum of six hours’ sleep a night.
  • Exercise regularly – this needn’t mean joining a gym. You can increase the amount of exercise in your day-to-day life by making small adjustments, such as taking the stairs instead of the lift or parking a little further away from work or taking the dog for a longer walk.
  • DASH Diet

The DASH (Dietary Approaches to Stop Hypertension) diet was developed by the National Heart, Lung and Blood Institute in the US to prevent and control high blood pressure. The diet is rich in fruit and veg, whole grains, low-fat dairy foods, lean meat, fish, poultry and nuts. It limits intake of sugar, red meat and refined fat. In patients with slightly higher than normal blood pressure, the DASH diet was shown to reduce systolic blood pressure by 6mmHg and diastolic blood pressure by 3mmHg. In patients with high blood pressure, the drop was 11mmHg and 6mmHg respectively.

In US News & World Reports’ annual Best Diets rankings, DASH was named as number one in the Best Diets Overall category as well as the For Healthy Eating and Best Heart-Healthy Diets. It tied at number two in the For Diabetes category. It was tested against 40 other high profile diets.

Medication

Not everyone with high blood pressure can regulate it by lifestyle changes alone. Depending on factors like your age and how high your blood pressure is, you may also need to take medication. Common medications are:

  • beta-blockers – such as atenolol and bisoprolol
  • alpha-blockers – such as doxazosin
  • ACE inhibitors – such as enalapril, lisinopril, perindopril and ramipril
  • angiotensin-2 receptor blockers (ARBs) – such as candesartan, irbesartan, losartan, valsartan and olmesartan
  • calcium channel blockers – such as amlodipine, felodipine and nifedipine or diltiazem and verapamil.
  • diuretics – such as indapamide and bendroflumethiazide
  • renin inhibitors – such as aliskiren
  • other diuretics – such as amiloride and spironolactone

Monitoring

You will need to have your blood pressure regularly monitored to ensure that it is coming down as expected. Your doctor will advise you how often it needs to be checked.

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