This article explains what high blood pressure is, some of its causes and what we can do to help. 

You may download our blood pressure diary here.

What is high blood pressure?

Imagine a hosepipe and the pressure of water running through it... that's how I often explain blood pressure. Your body has its own network of "pipes" (your blood vessels), with your heart acting as the pump behind it all. When the pressure within these vessels increases beyond normal levels, it is referred to as hypertension (raised blood pressure). Raised blood pressure can be damaging to blood vessels and because it may not cause any obvious symptoms, it's often called the "silent" disease. The only way to know your numbers is to check them.

What causes high blood pressure?

The causes fall broadly into two categories: things you can't change, and things you can.

Non-modifiable factors:

• Increasing age
• Genetics and family history

Modifiable factors:

• Smoking (and yes, vaping counts)
• Excess weight
• Raised cholesterol
• Lack of exercise

A number of other things can play a role too: stress, kidney disease, diabetes, and, perhaps surprisingly, certain medications, including some used to treat ADHD.

Why does it matter?

Raised blood pressure increases your risk of cardiovascular disease, including angina (chest pain caused by reduced oxygen supply to the heart muscle), heart attack and stroke. These are conditions that can seriously affect quality of life, can be fatal, and are costly in both time and resources to manage. And it isn't just about the heart. Over time, high blood pressure damages blood vessels wherever they are found in the body:

• Kidneys - contributing to chronic kidney disease
• Brain - increasing the risk of dementia as well as stroke
• Eyes - leading to vision problems

What you can do about it

The encouraging news is that the modifiable risk factors respond well to lifestyle changes.

• Get moving:  Set realistic goals - ideally exercise that gets your heart beating faster and your breathing quicker. Running is excellent, and a brisk walk is a perfectly good alternative if running isn't accessible to you right now. Start with a few minutes a day and build gradually towards 30 minutes of cardio exercise, five times a week - a widely accepted benchmark.
• Stop smoking: This includes vaping. Speak to your GP, who can signpost you to the right support, or look into self-referral. A search for "smoking cessation NHS" will bring up guided pages to get you started.
• Work on weight management: Exercise helps, but without also looking at your diet, progress often stalls. Set realistic targets, and pay particular attention to sugar intake, fried foods, and portion sizes of carbohydrates.

Is there a "normal" target?

Not one that fits everyone. As a general guide, for home readings we want your average to sit below 135/85. An average at or above that level is the threshold at which hypertension is usually diagnosed. Your target should always be agreed with your clinician, based on your individual health picture.

How to check your blood pressure at home

• Use an upper-arm cuff monitor where possible
• Sit comfortably, back supported, feet flat on the floor
• Rest for a few minutes before measuring
• Keep the cuff at roughly heart level

You can find a list of clinically validated monitors on the British and Irish Hypertension Society (BIHS) website: bihs.org.uk

Home Blood Pressure Readings

A reliable approach is to take readings twice a day- morning and evening for 5 to 7 days. Your clinician can then calculate your average and discuss what it means for you. You can download our blood pressure diary here to record your readings.

This article is for general information only and is not a substitute for personalised medical advice. If you're concerned about your blood pressure, book an appointment with a clinician. If you experience chest pain, sudden weakness, facial drooping, or difficulty speaking, call 999 immediately.

Dr Tobi Adesanya

GP & Medical Director, Marpe Wellbeing