General blood pressure issues

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Answers to the most common general questions about high blood pressure and low blood pressure.

General blood pressure issues

I'm fit and healthy, so why do I have high blood pressure?

For many people there is no specific cause for their high blood pressure.  It seems to be just one of those things.  However, by leading a healthy lifestyle you reduce your risk of complications from the high blood pressure.  If you are also taking medicines to treat your blood pressure then being fit and healthy will help medications work more effectively.

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Can high blood pressure be cured?

There are a small number of people who do have an underlying condition causing their high blood pressure.  Unfortunately, only a few of these conditions can be treated, but this does mean in a very few people blood pressure can be returned to normal.  You are more likely to have an underlying cause if you have very severe blood pressure or blood pressure that is resistant to treatment or if you have underlying kidney disease.

For most people, however, there is no cure as such, but both lifestyle changes and tablets are very effective in lowering blood pressure.  If you do manage to lower your blood pressure, then your risk of developing a stroke or heart attack is considerably reduced.

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Can high blood pressure kill me?

High blood pressure is the major cause of stroke, dementia, heart attacks and heart failure and is responsible for more than half of these.  These are the major causes of death and disability in the UK.  It is, therefore, vital that everyone knows what their blood pressure is and take steps to prevent them developing high blood pressure later in life - by lifestyle and dietary changes, as well as making sure their blood pressure is well controlled if it is raised.

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What tests should I have done if I have high blood pressure?

As well as having your blood pressure measured several times it may also be necessary for you to have some simple tests done.  Doctors will usually ask you about you family and medical history, will often give you a urine and blood test and may also ask you to have a recording of the electrical activity of your heart (ECG).  Some people may also have blood pressure monitoring over a 24-hour period.

These tests will help you doctor to:

  • Establish your level of blood pressure
  • See whether having high blood pressure has affected your body
  • See whether there is an underlying cause for your high blood pressure
  • Check whether there are any other factors which may affect your treatment

A few people may need more detailed investigations but your doctor will discuss these with you.

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Do I need to get my cholesterol checked too?

High blood pressure is a ‘risk factor’ for heart disease and stroke. This means that if you have high blood pressure you have a greater chance of having these conditions. 

A raised blood cholesterol is also a risk factor for the same conditions.  If you have both a high blood cholesterol level and a high blood pressure your risk is multiplied.  Therefore, many doctors also arrange for people with high blood pressure to have a blood sample taken to measure cholesterol, particularly if they are overweight, inactive or smoke as well.

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As you get older is it still necessary to get below 140/90mmHg?

Yes. Blood pressure does rise in many people as they get older but the levels to aim for with treatment are the same for all ages, unless you have diabetes, kidney disease or have already had a heart attack or stroke.  If this is the case you are aiming to get your blood pressure even lower, to 140/80mmHg or below.  Some people can find it difficult to get their blood pressure down to these levels, especially if their blood pressure is very high to begin with.  However, almost everyone should, with the right treatment and lifestyle, be able to get down to these levels.

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Can I get a specialist opinion?

If you have high blood pressure then you may at some time be referred on to a specialist.  The reasons why your doctor might do this are:

  • If you need to be treated very quickly, for example if your blood pressure is very high
  • Your doctor thinks you may have secondary hypertension (an underlying illness causing the high blood pressure)
  • If you have problems keeping your blood pressure controlled, for example problems with medication
  • In certain special circumstances, such as if your blood pressure varies a lot or during pregnancy

Your GP can refer you through the NHS or you can be seen privately.

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Can high blood pressure give you headaches?

It is unusual for people to have symptoms from high blood pressure but some people do say that they can tell when their blood pressure is raised.  If you have a very high blood pressure you may have some symptoms and headache can be one of them. Most people have no symptoms.

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I have diabetes, why do I have a lower target level?

In 1998 the United Kingdom Prospective Diabetes Study (UKPDS) reported its findings. One area it had studied was the effect of blood pressure on the complications of diabetes. The report found that by keeping your blood pressure under 140/80mmHg you could reduce your risk of death from diabetes complications (such as heart attack and stroke) by up to 30 per cent. This is why it is vital for people with diabetes to control and manage their blood pressure to these lower levels, if at all possible. 

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