Q and A on High Blood Pressure

March 2013

Who should measure blood pressure?

All of us should know our blood pressure measurements. This is a good piece of information about our health. High blood pressure can be silent (without any symptoms). We can prevent and manage high blood pressure only if we know our measurement values.

What is high blood pressure?

High blood pressure – also known as ‘raised blood pressure’ or ‘hypertension’ – is a condition in which the blood circulates at persistently raised pressure. Blood is carried from the heart to all parts of the body in arteries and veins. Each time the heart beats, it pumps blood around the body. Blood pressure is created by the force of blood pushing against the inside of blood vessels as it is pumped by the heart.

What is the normal range of blood pressure?

Blood pressure is expressed in millimetres of mercury (mm Hg). It is recorded as two numbers usually written one above the other: the first (or top) number is the ‘systolic’ blood pressure – the highest pressure in blood vessels, which occurs as the heart contracts (heart beat). The second (or lower) number is the diastolic blood pressure – the lowest pressure in blood vessels in between heart beats, when the heart muscle relaxes.

Normal adult blood pressure is defined as a systolic blood pressure of 120 mm Hg and a diastolic blood pressure of 80 mm Hg. However, cardiovascular benefits extend to lower systolic (105 mm Hg) and lower diastolic blood pressure levels (60 mm Hg). Hypertension is defined as a systolic blood pressure equal to or above 140 mm Hg and/or diastolic blood pressure equal to or above 90 mm Hg. Maintaining normal ranges of both systolic and diastolic blood pressure are particularly important for the efficient function of vital organs such as the heart, brain and kidneys and for overall health and well-being.

What are the symptoms of high blood pressure?

There is a common misconception that people with high blood pressure will always experience symptoms. Most people with high blood pressure actually have no symptoms at all, and may not even know they have it. Sometimes high blood pressure can cause symptoms such as headache, shortness of breath, dizziness, chest pain, palpitations of the heart or nose bleeds. If people ignore measuring blood pressure because they think symptoms will alert them to the problem, it can be dangerous because high blood pressure is often a ‘silent killer’. Everybody should know their blood pressure numbers.

What are the risk factors for high blood pressure ?

High blood pressure is the result of many factors. Demographic transition, rapid and unplanned urbanization and globalization are the underlying determinants. They contribute to unhealthy behavioural risk factors. High blood pressure is one of the metabolic risk factors that leads to many NCDs.

Main factors contributing to high blood pressure and its consequences are given below.

How can high blood pressure be prevented?

High blood pressure is both preventable and treatable. The chances of developing high blood pressure and its adverse consequences can be minimized by making healthy choices about:

  • Diet
    • Adopt a healthy lifestyle throughout the life course with emphasis on balanced nutrition and regular physical activity, including for infants and young people.
    • Eat five servings of fruit and vegetables every day.
    • Decrease saturated and total fat intake, such as by eating low-fat products.
  • Salt
    • Reduce salt intake; consume less than 5 grams of salt per day (about 1 teaspoon).
  • Physical activity
    • Take regular physical activity. WHO recommends physical activity for at least 30 minutes each day.
  • Alcohol
    • Avoid harmful use of alcohol.
  • Tobacco
    • Stop tobacco use and exposure to tobacco smoke

How can high blood pressure be controlled?

People who already have high blood pressure can actively participate in managing their condition. They need to:

  • Adopt healthy behaviours (as listed above).
  • Monitor blood pressure at home (if possible).
  • Check blood sugar, blood cholesterol and urine albumin levels
  • Get their cardiovascular risk assessed using a risk assessment tool
  • Follow advice given by doctor(s) and health workers.
  • If medicines for lowering blood pressure have been prescribed, take them regularly, and as instructed.

What can Governments do?

Governments may consider a minimum set of actions in planning and/or implementing interventions for the prevention and control of NCD in their countries:

Tobacco use

  • Reduce affordability of tobacco products by increasing tobacco excise taxes;
  • Create by law completely smoke-free environments in all indoor workplaces, public places and public transport;
  • Warn people of the dangers of tobacco and tobacco smoke through effective health warnings and mass media campaigns;
  • Ban all forms of tobacco advertising, promotion and sponsorship

Harmful alcohol use

  • Increase excise tax on alcoholic beverages;
  • Comprehensively restrict and ban alcohol advertising and promotion;
  • Restrict the availability of retailed alcohol

Unhealthy diet and physical inactivity

  • Reduce salt through mass-media campaigns/reduced salt content in processed foods; Replace trans-fats with polyunsaturated fats;
  • Create public awareness programmes about diet and physical activity

Cardiovascular disease and diabetes

  • Provide multi-drug therapy (including glycaemic control for diabetes mellitus) to individuals who have had a heart attack or stroke, and to persons with a high risk (> 30%) of a CVD event in the next 10 years
  • Provide aspirin to people having an acute heart attack

Cancer

  • Prevent of liver cancer through hepatitis B immunization;
  • Prevent of cervical cancer through screening (visual inspection with acetic acid [VIA]) and treatment of pre-cancerous lesions
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