Home truths about high blood pressure
High blood pressure, or hypertension, rarely has noticeable symptoms. But if untreated, it increases your risk of serious problems such as heart attacks and strokes.
Around a third of adults in the UK have high blood pressure, although many will not realise it.
The only way to find out if your blood pressure is high is to have your blood pressure checked.
It was on a routine visit to the doctor that my GP uttered the phrase every middle-aged man dreads: "Your blood pressure is a little raised." In fact my BP was 140/90mm Hg, well above the current "risk" threshold that the National Institute for Clinical Excellence (Nice) deems acceptable.
My elevated reading came as a shock, not least because I had always assumed I was in a low-risk group for stroke and heart disease. I've had high blood pressure for years...I used to take medication, but I tried to cope with diet and exercise, I am not overweight, I eat a lot of green vegetables. It didn't work, so I've been living with 140/90 for a long time. Indeed, until my mid-40s my BP had always hovered around 120/80, which used to be considered perfect (about which more later). Now, all of a sudden at the age of 47, I was being diagnosed with stage one hypertension and being assessed for a course of blood pressure reducing medications.
According to Professor Graham MacGregor, the chairman of the Blood Pressure Association and professor of cardiovascular medicine at Barts and the London School of Medicine, I'm one of the "lucky" ones. Hypertension affects a quarter of the British adult population and accounts for 60% of all strokes in the UK and half of all heart attacks, but because the condition is usually symptomless most people have no idea they are at risk until it is too late. "Hypertension is a silent killer," says MacGregor. "You're bloody lucky to have discovered it at an early age and been given the opportunity to do something about it."
MacGregor is probably right but I do not feel lucky. Having always enjoyed rude health, I did not wish to be admitted to the "kingdom of the sick". Nor did I relish the prospect of having to take two, three, or however many pills every day for the rest of my life. My dilemma was not helped by the fact that defining hypertension is far from straightforward. Fifteen years ago, a BP reading of 150/95 would not have been a cause of particular concern (the threshold then was 160/100). But in the UK the bar is now set a 140/90 while in the United States the American Medical Association recently introduced a new category of "pre-hypertensive" for patients whose BP ranges between 120/80 and 140/90.
Then there is the intriguing question of the extent to which blood pressure is conditioned by environmental stresses and one's temperament. For instance, it has long been known that the kidneys play a key role both in the regulation of blood pressure and the "fight or flight" response, a relationship that suggests a deeper evolutionary connection between blood pressure and our various emotional and psychological states. As the phenomenon known as "white coat syndrome" attests, the mere fact of having one's blood pressure taken by a medical professional is sufficient to send some people's readings soaring, while meditation and acupuncture have been shown to lower BP, albeit temporarily. Moreover, it is well known that people who report higher levels of stress at home or work, or have suffered a recent "life" blow, such as the death of a spouse, are more likely to suffer stroke or heart attack (in one study of work-related stressors, for instance, approaching deadlines were associated with a sixfold increase in myocardial infarction). Frequent anger and hostility have also been shown to predict coronary events. Thus in one community study patients with normal blood pressure but high anger temperament scores (as characterised by frequent or long-lasting anger reactions with little or no provocation) were shown to have an odds ratio of 2:3 for fatal or non-fatal cardiac events. While expert opinion differs over the extent to which blood pressure may be a factor, Rothwell points out that it is well known that stress raises BP and that people who are exposed to stressful situations experience greater blood pressure volatility. "I know that when I have to chair an important meeting or give a series of lectures my systolic reading can be as high as 180. That's almost certainly due to stress," says Rothwell. But while the bond between blood and emotion is embedded in everyday language – we talk of people being "sanguine" or "hot-blooded" – the average GP tends to have little time for such insights.
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When we are young our bodies can more easily accommodate sudden fluctuations in blood pressure, but as we get older our blood vessels become stiffer and less flexible.
This is particularly a problem in the west and in Asian societies such as Japan. The question is why? Many experts believe the answer is salt.
"The salt industry is trying to create the belief that there's a controversy out there, and if the experts can't agree how on earth can the man in the street make an informed decision," says MacGregor. "But the fact is we have seven or eight different types of evidence that all point to the role of salt and I know that if I cut your salt intake by half it reduces blood pressure."
To the coalition government's credit, Britain now leads the way in salt reduction, with more than 40 food manufacturers having agreed to reduce the salt content of supermarket foods by 40% by 2012, followed by a further 15% cut thereafter. At the same time, Nice has called for the acceleration of national salt reduction targets, with the aim of reducing the average British adult's intake to 6g a day by 2015, and 3g by 2025.
In the end, I came to the conclusion that I had no choice but to enroll in a course of treatment and now take a supplement every day!
The good news is that after the first day of supplementation, I was almost within the normal range. After just 6 days on this supplement, I'm constantly running 127/73. I can no longer hear my heart beating in my head. This supplement is simply amazing!
Around a third of adults in the UK have high blood pressure, although many will not realise it.
The only way to find out if your blood pressure is high is to have your blood pressure checked.
It was on a routine visit to the doctor that my GP uttered the phrase every middle-aged man dreads: "Your blood pressure is a little raised." In fact my BP was 140/90mm Hg, well above the current "risk" threshold that the National Institute for Clinical Excellence (Nice) deems acceptable.
My elevated reading came as a shock, not least because I had always assumed I was in a low-risk group for stroke and heart disease. I've had high blood pressure for years...I used to take medication, but I tried to cope with diet and exercise, I am not overweight, I eat a lot of green vegetables. It didn't work, so I've been living with 140/90 for a long time. Indeed, until my mid-40s my BP had always hovered around 120/80, which used to be considered perfect (about which more later). Now, all of a sudden at the age of 47, I was being diagnosed with stage one hypertension and being assessed for a course of blood pressure reducing medications.
According to Professor Graham MacGregor, the chairman of the Blood Pressure Association and professor of cardiovascular medicine at Barts and the London School of Medicine, I'm one of the "lucky" ones. Hypertension affects a quarter of the British adult population and accounts for 60% of all strokes in the UK and half of all heart attacks, but because the condition is usually symptomless most people have no idea they are at risk until it is too late. "Hypertension is a silent killer," says MacGregor. "You're bloody lucky to have discovered it at an early age and been given the opportunity to do something about it."
MacGregor is probably right but I do not feel lucky. Having always enjoyed rude health, I did not wish to be admitted to the "kingdom of the sick". Nor did I relish the prospect of having to take two, three, or however many pills every day for the rest of my life. My dilemma was not helped by the fact that defining hypertension is far from straightforward. Fifteen years ago, a BP reading of 150/95 would not have been a cause of particular concern (the threshold then was 160/100). But in the UK the bar is now set a 140/90 while in the United States the American Medical Association recently introduced a new category of "pre-hypertensive" for patients whose BP ranges between 120/80 and 140/90.
Then there is the intriguing question of the extent to which blood pressure is conditioned by environmental stresses and one's temperament. For instance, it has long been known that the kidneys play a key role both in the regulation of blood pressure and the "fight or flight" response, a relationship that suggests a deeper evolutionary connection between blood pressure and our various emotional and psychological states. As the phenomenon known as "white coat syndrome" attests, the mere fact of having one's blood pressure taken by a medical professional is sufficient to send some people's readings soaring, while meditation and acupuncture have been shown to lower BP, albeit temporarily. Moreover, it is well known that people who report higher levels of stress at home or work, or have suffered a recent "life" blow, such as the death of a spouse, are more likely to suffer stroke or heart attack (in one study of work-related stressors, for instance, approaching deadlines were associated with a sixfold increase in myocardial infarction). Frequent anger and hostility have also been shown to predict coronary events. Thus in one community study patients with normal blood pressure but high anger temperament scores (as characterised by frequent or long-lasting anger reactions with little or no provocation) were shown to have an odds ratio of 2:3 for fatal or non-fatal cardiac events. While expert opinion differs over the extent to which blood pressure may be a factor, Rothwell points out that it is well known that stress raises BP and that people who are exposed to stressful situations experience greater blood pressure volatility. "I know that when I have to chair an important meeting or give a series of lectures my systolic reading can be as high as 180. That's almost certainly due to stress," says Rothwell. But while the bond between blood and emotion is embedded in everyday language – we talk of people being "sanguine" or "hot-blooded" – the average GP tends to have little time for such insights.
Advertisement
When we are young our bodies can more easily accommodate sudden fluctuations in blood pressure, but as we get older our blood vessels become stiffer and less flexible.
This is particularly a problem in the west and in Asian societies such as Japan. The question is why? Many experts believe the answer is salt.
"The salt industry is trying to create the belief that there's a controversy out there, and if the experts can't agree how on earth can the man in the street make an informed decision," says MacGregor. "But the fact is we have seven or eight different types of evidence that all point to the role of salt and I know that if I cut your salt intake by half it reduces blood pressure."
To the coalition government's credit, Britain now leads the way in salt reduction, with more than 40 food manufacturers having agreed to reduce the salt content of supermarket foods by 40% by 2012, followed by a further 15% cut thereafter. At the same time, Nice has called for the acceleration of national salt reduction targets, with the aim of reducing the average British adult's intake to 6g a day by 2015, and 3g by 2025.
In the end, I came to the conclusion that I had no choice but to enroll in a course of treatment and now take a supplement every day!
The good news is that after the first day of supplementation, I was almost within the normal range. After just 6 days on this supplement, I'm constantly running 127/73. I can no longer hear my heart beating in my head. This supplement is simply amazing!