High Blood Pressure

High blood pressure, or hypertension, is raised pressure inside the arteries that usually causes no symptoms at all until it has damaged the heart, brain, kidneys or eyes. It is the single most common reason for stroke and heart failure in this district, and it is entirely treatable.

Symptoms

Not everyone gets every symptom, and the pattern can differ in older people, in people with diabetes and in children. These are the ones most often reported.

Usually no symptoms whatsoever — most people are diagnosed on a routine check
Headache, particularly at the back of the head in the early morning
Giddiness or a feeling of fullness in the head
Nosebleeds in some people
Breathlessness or chest discomfort when the heart is already affected
Blurred vision when pressure is very high

When to see a doctor

Do not wait these out

If any of the following applies, arrange to be seen the same day. For anything sudden or severe, call 9281862028 or come straight to the emergency department at SIMS — it is open 24 hours and does not need an appointment.

Blood pressure readings persistently above the range your doctor has set for you
Severe headache with vomiting, confusion or blurred vision — attend the emergency department
Chest pain, breathlessness or one-sided weakness with a high reading
Every adult over 30 should have blood pressure checked at least once a year, even when feeling perfectly well

Tests that may be advised

Your consultant will order only the investigations that change the plan. Most of the following are available on the SIMS campus, so results usually come back the same visit.

Repeated blood pressure measurement on separate occasions, both arms
Home or ambulatory blood pressure monitoring where readings vary
ECG and 2D echocardiography to look for heart strain
Kidney function tests and urine protein
Blood sugar, lipid profile and thyroid function
Eye examination for hypertensive changes in the retina

How it is treated

Treatment is decided case by case — by how advanced the problem is, what else you are being treated for, and what you can realistically sustain. Broadly, it involves the following.

Salt reduction — the single most effective dietary change, and the hardest in a rice-and-pickle diet
Weight reduction, regular walking and limiting alcohol
Regular medication taken daily, not only when the reading is high
Treatment of associated diabetes, cholesterol and kidney disease
Periodic review so the dose can be adjusted rather than abandoned

This page is general information, not a diagnosis

High Blood Pressure can look like several other conditions, and the reverse is equally true. Nothing here can replace an examination, your test results and the judgement of the doctor treating you — and no medicine mentioned by name to a friend or relative should be started on the strength of this page. If you recognise yourself in it, book a consultation with the Cardiology department. If a symptom is sudden or severe, call 9281862028.

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