HEALTH & WELLBEING
Dr Jo Coldron Tavyside Health Centre, Tavistock
Blood pressure Jo Coldron explains why it is important to have your blood pressure checked regularly to avoid long-term problems. As a GP I must send out so many messages to patients to update their blood pressure (BP) – some days I feel like I’m obsessed with it, but that’s because it’s both very important for our long-term health, and usually causes no early identifying symptoms - so unless you’re looking for it a high blood pressure can go unnoticed for many years. The reason it’s important is that a high blood pressure, ongoing for months or years, puts extra strain on the body’s systems and is a risk factor for heart attacks, strokes, dementia and kidney disease among other things. Because high blood pressure can exist for many years without causing any symptoms, even though it’s gradually causing problems in the background, we are asked to try and make sure we take a blood pressure reading every 5 years or so for all our patients who are over 40. So, if we send you a message asking you to ‘update your BP’, that may be the only reason. For many patients we strive to have much more regular BP checks. Patients who have illnesses that already put them at a higher risk of heart attacks, strokes and kidney disease, for example diabetes, schizophrenia, previous mini-stroke, rheumatoid arthritis and many others. Patients who are on certain medications, for example the combined contraceptive pill or HRT, and of course anyone who has already been identified as having high or borderline blood pressure, whether or not they are on blood pressure medication should have their BP monitored at least yearly. What we do with the BP results depends on two things – the result AND the patient. There is no one number that is a definite threshold for saying below this your BP is fine and above this your BP is high and you need medicines. Blood pressure is part of the complex story for each individual patient and only one of the risk factors impacting our long-term health. So we would be much more likely to want to treat BP with medications in a young diabetic, than we would in a fit and healthy 92-year-old – even though the numbers may be the same. However, there are some useful guidelines for when to
prompt a review by your GP if you are checking your own blood pressure at home but are otherwise well: •
If your BP is over 180/120 on repeated testing you should make contact with your GP that day to assess you.
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If your BP is between 140-180/90-120 you might have high blood pressure and you should alert your GP so that over a few weeks they can assess you and arrange appropriate blood pressure and blood tests to be able to advise you appropriately.
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If your BP is between 120-140/80-90 you may be at higher risk of developing high blood pressure.
These people especially, but also everyone can do lots of things to reduce blood pressure and long-term risk of disease: •
Decrease the salt in your diet and increase the fibre
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Limit your alcohol to the recommended 14 units per week
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Lose weight if you are overweight
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Increase activity in any way you can, but 150 minutes of moderate activity per week like brisk walking is ideal
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Decrease caffeine if your intake is high
And to complete this classic list of things your GP will tell you is important whatever you go to them about – stop smoking. Smoking doesn’t actually cause high blood pressure but hugely increases the risk of arterial disease and therefore raises the risk of significant illness associated with high blood pressure There are some great resources on the NHS and the British Heart Foundation websites that contain lots of useful resources and information. www.nhs.uk/conditions/high-blood-pressure-hypertension www.bhf.org.uk/informationsupport/risk-factors/ high-blood-pressure 13
