High Blood Pressure (Hypertension)

High Blood Pressure (Hypertension)

Medically reviewed and updated byHussain Abdeh MPharm: 2211840

Updated on: 15/06/2021


Your blood pressure level relates to the pressure in your blood as it is pumped away from the heart. In order to reach other organs, the blood needs to be pumped with an appropriate amount of pressure.

If the pressure is too high, however, it can present several health risks and you may experience hypertension. This can lead to serious health problems like a stroke or heart attack.

In this article, we will cover what high blood pressure is and any associated risks that come with it. We will also be looking at medicines that are used to treat high blood pressure as well as lifestyle changes that are known to reduce the risks of developing high blood pressure.

Today, we will be looking at the causes of high blood pressure, what level is considered dangerous and how you can treat hypertension.

What is high blood pressure and what are the risks?

When blood moves around your body, it needs adequate pressure in order to move through your arteries. If your blood pressure is too high, it puts extra strain on your blood vessels and your heart. The kidneys, eyes and brain can also be put under additional strain due to high blood pressure.

Because of this, high blood pressure can increase your risk of developing a number of other health problems, including:

  • Angina
  • Heart attack
  • Stroke
  • Heart failure
  • Kidney disease
  • Vision problems
  • Vascular dementia
  • Peripheral artery disease

All these conditions are serious, and some can be life-threatening, which is why it is imperative you seek medical attention straight away.

High blood pressure also has a complicated relationship when it comes to gout. Many high blood pressure medications increase the uric acid levels in the body. As gout is primarily caused by increased levels of uric acid, high blood pressure can help to cause this condition.

What causes high blood pressure?

In short, blood pressure is the measurement of force that your heart uses when pumping blood around the body.

It is measured in millimetres of mercury and displayed as 2 figures, often referred to as a top and bottom number

The top number relates to Systolic Blood Pressure which is the pressure and force your heart uses when pumping blood around your body.

The bottom number relates to Diastolic blood pressure which is the blood pressure reading when your heart rests in between beats.

A healthy blood pressure is generally considered to be between 90/60mmHg and 120/80mmHg.

If your blood pressure is 140/90mmHg or higher, it is considered to be high. If you are over 80 years old, hypertension may not be diagnosed unless your blood pressure reaches 150/90mmHg.

There are various factors which can cause or contribute towards high blood pressure. While there are some genetic features which may make you more prone to hypertension, there are also several lifestyle factors that can make it more likely.

These include:

  • Smoking
    • Not doing enough exercise
    • Eating too much salt
    • Obesity
    • Not eating enough fruit and/or vegetables
    • Drinking too much alcohol
    • Disturbed sleep
    • Not getting enough sleep
    • Being under stress
    • Drinking too many caffeinated drinks, such as tea and coffee

Although lifestyle choices can make hypertension more likely, there are other factors which may put you at risk of developing high blood pressure. These include:

  • Being over 65 years of age
  • Being of Caribbean or African descent
  • Being overweight
  • Having a relative with high blood pressure

In some cases, high blood pressure may be caused by an underlying medical condition, such as:

  • Diabetes
  • Pregnancy
  • Kidney disease
  • Chronic kidney infections
  • Glomerulonephritis
  • Obstructive sleep apnoea
  • Hormone problems, including thyroid disorders
  • Scleroderma
  • Lupus

Certain medicines can cause high blood pressure as a side effect. Therefore, it is possible that your hypertension symptoms may be associated with other medication you are taking.

Medicines which are known to increase blood pressure in some patients include:

  • Steroids
  • NSAIDs, such as ibuprofen
  • Some herbal remedies
  • Some cough and cold medications
  • Contraceptive pill
  • Some SSNRIs, such as venlafaxine

In 2018 a study into the relationship of blood pressure and genetics found an additional 500 genes that influence peoples blood pressure. This was the largest study of its kind, before then; the relationship between genetics and blood pressure was not fully understood. Scientists now understand how over 1,000 genetic signals play a role in influencing blood pressure.

High blood pressure symptoms

When you develop high blood pressure, it puts your body under extra stress. As a result, you can suffer from a range of symptoms and health complications.

Common symptoms associated with high blood pressure include:

  • Pounding in your ears, neck or chest
  • Severe headache or head pain
  • Confusion or fatigue
  • Flushing
  • Vision problems, such as blurred vision
  • Chest pain
  • Breathing difficulties
  • Shortness of breath
  • Blood in your urine
  • Irregular heartbeat
  • Nosebleeds

Although some people do experience symptoms due to hypertension, many people with high blood pressure do not experience any noticeable symptoms at all. Despite this, hypertension carries significant health risks.

As the condition may not cause symptoms, it is very important that you have your blood levels checked at regular intervals, so that high blood pressure can be treated quickly.

High blood pressure treatment

Lifestyle changes

Depending on how severe your hypertension is, lifestyle changes may be the first line of treatment. As unhealthy habits can be a leading cause of hypertension, a significant number of people are able to reduce their blood pressure naturally by changing their day-to-day activities.

Your doctor may advise you to make specific changes to your lifestyle, including:

  • Reducing your salt intake
  • Doing more exercise
  • Losing weight
  • Eating fewer fatty foods
  • Reducing alcohol consumption
  • Giving up smoking
  • Drinking fewer caffeinated drinks
  • Eating a healthier diet

You can find more information on the results of the study and the DASH diet eating plan by visiting the NHLBI (National Heart, Lung and Blood Institute) website.


If you have severely high blood pressure, or if your blood pressure is not reduced after making these lifestyle alterations, you may be prescribed a high blood pressure medication.

Medicines which are commonly prescribed to treat high blood pressure include:

ACE Inhibitors:

ACE inhibitors (angiotensin converting enzyme inhibitors) work by lessening how much angiotensin is produced by the body. This is a chemical that makes the blood vessels and artery walls narrow and become tighter.

ACE inhibitor medicines include:

  • Lisinopril
  • Ramipril
  • Enalapril

Calcium channel blockers

This type of medication blocks some of the calcium from entering the cardiac muscles of the heart, which means the heartbeats are less forceful and your blood pressure can lower. Calcium channel blockers also help to relax the blood vessels, which can also lower blood pressure.

Some calcium channel blockers include:

  • Amlodipine
  • Felodipine

Angiotensin-II receptor blockers (ARBs)

ARBs work by reducing the action of angiotensin II, which is a hormone that causes the blood vessels to restrict.

Your doctor may prescribe one of the following ARB medicines:

  • Candesartan
  • Irbesartan
  • Losartan

Thiazide diuretics

This type of medicine works on the kidneys to promote the flow of urine. It works to increase the urine flow, which in turn reduces how hard the heart needs to work to pump blood around the body.

Thiazide diuretics include:

  • Bendroflumethiazide

Although beta blockers are no longer a first-line medication for high blood pressure, you may be prescribed them if you are unable to take any of the medications listed above, or if they do not provide the desired results.

While treating your hypertension, your doctor will monitor your blood pressure on a regular basis. As well as taking your blood pressure manually, they may request that you wear a blood pressure monitor for 24 hours, so that it can be monitored throughout the course of the day and night.

In addition to this, you may be encouraged to monitor your own blood pressure on a daily basis using a blood pressure monitor.

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