Everyone has blood pressure. Our blood pressure is simply the amount of work that our hearts have to do to pump our blood around the body.

What is blood pressure, exactly?

High blood pressure (or hypertension) usually has no symptoms. If it’s not treated or kept under control, it is one of the major risk factors for heart disease and stroke. Treatment and detection is very possible but it starts with you.

Blood pressure is measured by two numbers

The first number records blood pressure when the pressure is at its highest i.e. when the heart muscle squeezes out the blood – this is called systolic pressure.

The second number is when the heart relaxes and allows the blood to flow back into the heart – this is called diastolic pressure.

What’s the normal level?

The normal level of blood pressure is usually about 120 (systolic) over 80 (diastolic). If your blood pressure is 140 over 90 or higher (or 140 over 80 if you have diabetes) you should discuss this reading with your doctor.

Why is blood pressure important

The higher your blood pressure, the greater your risk of heart attack or stroke, heart failure, kidney failure and poor circulation in your legs. These problems can be avoided if your blood pressure is controlled.

Over half of all adults in Ireland over 45 years of age have high blood pressure. About 4 in every 5 men and 2 in every 3 women with high blood pressure are not being treated. Keep reading and we’ll help change that.

If you are diagnosed with high blood pressure, it means your blood pressure is consistently higher than it should be. Thankfully, there are several ways to help reduce it which we will talk you through below.

Are there any signs or causes?

There is often no single cause of high blood pressure. A number of factors can combine to raise blood pressure, and high blood pressure tends to run in families.

Someone with high blood pressure may look and feel well, and rarely has any symptoms. The only way to find out if you have high blood pressure is to have it measured.

As we grow older, our blood pressure also increases. Also, being overweight, drinking too much alcohol, eating too much sodium (found in salt) and not eating enough fresh fruit and vegetables may lead to an increase in blood pressure.

However, contrary to popular opinion, high blood pressure is not a disease of the nervous or highly strung person – nor is it caused by a stressful lifestyle.

In a very small number of people, there is a specific underlying cause for high blood pressure such as kidney problems, adrenal gland tumours and thyroid problems. Treating these conditions may result in your blood pressure returning to normal.

Getting checked, what to expect

Our blood pressure varies with age and depends on how active you are before it is measured. If you are nervous or anxious, the measurement can be higher than usual. One high reading does not necessarily mean that you have seriously high blood pressure.

Your doctor will usually want to check your blood pressure several times first. The more blood pressure readings you have, the more accurate your diagnosis will be, particularly as blood pressure fluctuates throughout the day and night.

Technically, you have high blood pressure if your systolic blood pressure is 140 mmHg or higher, or if your diastolic blood pressure is 90 mmHg or higher – after several readings. But again, remember high blood pressure can be treated.

If your blood pressure is more than 140 over 90, it’s recommended to have it monitored over 24-hours. This monitoring uses a small device on a belt at your waist attached to a blood pressure cuff on your arm. This gives your doctor many more readings to help decide if you need treatment.

When & how to check my blood pressure

Try to get your blood pressure checked regularly and ask what your reading is. The only way to look after – and to know – if you have high blood pressure is to have it measured. If it is high, ask your doctor how best to bring it down.

If you are over 30, it’s best to have your blood pressure checked every year. If your blood pressure is borderline high (around 140 over 90), you’ll need to get it checked more often by a doctor or nurse.

Many pharmacies are now offering blood pressure checks and some do 24-hour blood pressure monitoring. Sometimes your doctor will suggest you buy a reliable blood pressure monitor and measure your blood pressure regularly at home.

How to improve your blood pressure

These small steps or lifestyle changes may help to reduce your blood pressure and can sometimes bring blood pressure that is mildly high to a normal level; but for most people, tablets that lower blood pressure will be required also.

1. Know your blood pressure level

The first step to improving your blood pressure is to know it. High blood pressure is best managed by you and your doctor. Make a note now to have your blood pressure checked or simply call into your pharmacist today for two minutes – it could save your life.

2. Aim for a healthy weight

Keep your weight at a level that is right for your height and build. If you are overweight, even losing 10% of excess weight can help lower your blood pressure. See our section on how to lose weight for tips and motivation.

3. Eat less salt & processed food and eat more fruit & veg

It is the sodium in salt which causes the problems associated with high blood pressure. All types of salt, including sea salt, iodised salt, garlic salt and onion salt all contain sodium and so they have the same effect on your health as common table salt.

Using low sodium salt may mean you use more to get the salty taste and therefore still consume the same amount of salt. The best advice is to use alternative flavourings like black pepper, spices or lemon juice.

To make sure that your blood pressure stays at a healthy level, cut down – or cut out – adding salt to your food, and eat less processed foods which are high in salt. Our Food Shopping Card will help you understand food labels and make smarter choices. Also, add more fresh vegetables, fruit and wholegrain cereals to your everyday meals.

4. Drink less alcohol

Drinking a lot of alcohol can increase your blood pressure and may damage the liver and heart. Small amounts of alcohol may provide some protection against heart disease, but there is not enough evidence to recommend including alcohol as part of a heart healthy diet.

If you do drink, please spread your drinking over the week and keep some days alcohol-free. Do not drink more than the recommended upper limits: 17 standard drinks (SD) a week for men and 11 standard drinks a week for women.

• 1 pint = 2 standard drinks
• 1 small glass of wine (100 ml) = 1 standard drink
• 1 spirit – pub single measure = 1 standard drink
• 1 bottle of wine (750 ml) = 7 standard drinks

5. Be more active

We all need to be physically active at a moderate intensity for at least 30 minutes 5 days a week. Increasing our activities to 60 minutes brings even greater health benefits.

Activities such as walking, cycling, swimming and dancing are all excellent and the 30 – 60 minutes can be spread over two to three sessions in the day.

Our bodies and heart were designed to be active. An added bonus is that any activity, such as walking, promotes both heart health and relaxation.

See our section on getting active for tips and motivation. If you have very high blood pressure, consult your doctor before you start doing any form of activity.

6. Avoid other risk factors

The more cardiovascular risk factors you have, the greater the urgency in getting your blood pressure controlled. This is also the case for people with a history of a heart attack or stroke.

Smoking – Smoking and high blood pressure are two serious factors that can cause a heart attack or stroke. You can greatly reduce this risk by stopping smoking. View our section on Quitting Smoking or get expert help from the National Smokers’ Quitline.

There are now many aids available to help you stop. Simply ask your family doctor, pharmacist, local HSE office or freephone the National Smokers’ Quitline 1800 201 203. If you are not ready to stop smoking, try to reduce the number of cigarettes you smoke and make a plan to quit.

High Cholesterol – High cholesterol is often associated with high blood pressure. If you have high blood pressure you should have your cholesterol checked by your doctor. Eating less fatty foods as well as lots of fruit and vegetables will help keep your cholesterol at a healthy level.

Diabetes – Diabetes can also be associated with high blood pressure and your doctor will test your urine (or blood) for sugar.

7. Low blood pressure

If your blood pressure drops when you stand up, making you feel dizzy or faint, this is called postural hypotension (or low blood pressure). If this happens, you should tell your doctor and have your blood pressure taken when you are standing up. These symptoms can be made worse by blood pressure tablets.

8. Always take your tablets

Tablets that lower blood pressure prevent early ageing of the blood vessels and heart and reduce your risk of stroke. If you have been prescribed tablets for high blood pressure, you will usually have to take them for life. Always take your tablets as prescribed and never stop taking them without telling your doctor. Evidence shows that tablets for high blood pressure will reduce your risk of having a stroke.

In general, blood pressure tablets have few side effects. After a month or so you will usually know how they suit you. If you find that a tablet doesn’t suit you, or if you are reluctant to take a number of tablets daily, please tell your doctor rather than suffer in silence. Your doctor has the option of switching you to a different type of tablet, or to one tablet which acts in a number of different ways.

Sometimes the tablet will not control your blood pressure; your doctor may then increase your dose, add another tablet, or switch you to a different tablet.

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