Heart information Managing high blood pressure Contents Page3 Page4 Page4 What is high blood pressure? Page3 How do I know if I have high blood pressure? How is blood pressure measured? What is ‘normal’ blood pressure? What causes high blood pressure? Page5 Why is it important to manage high blood pressure? Page6 What harm does high blood pressure do? Page5 How can I manage my high blood pressure? Page7 Lifestyle changes Page9 Blood pressure-lowering medicine Page6 Page 10 Page 10 Page 11 Page 10 Page 11 Page 2 How can I monitor my blood pressure? Where can I have my blood pressure checked? Will I need to measure my blood pressure at home? Why does my blood pressure vary? What happens next? Heart Foundation Managing high blood pressure What is high blood pressure? High blood pressure is one of the most common disorders affecting the heart and blood vessels. Blood pressure is the pressure of the blood in your arteries (the blood vessels that carry oxygen and nutrients to the body) as it is pumped around the body by the heart. As the heart pumps, the flow of blood in the arteries and the blood pressure rises and falls in a regular ‘wave’ pattern. Blood pressure peaks when the heart pumps – called systole (sis-tol) – and falls when the heart relaxes – called diastole (di-as-tol). Quick tip High blood pressure rarely gives warning signs and can be a silent killer. Ask your doctor to check your blood pressure regularly – it’s easy and quick to do. We recommend that all adults know their own blood pressure level and what it means for their health. Blood pressure depends on two main things: the amount of blood pumped by the heart and how easily the blood can flow through the arteries. Your blood pressure will go up and down throughout the day, depending on the time of day and what you are doing. However, high blood pressure is a condition where your blood pressure is consistently high, potentially causing damage to your heart, brain and other important organs. The medical term for persistently high blood pressure is hypertension (hi-pur-ten-shun). It is not nervous tension, which is a different medical condition. How do I know if I have high blood pressure? To find out if you have high blood pressure it is important to have your blood pressure measured regularly. The serious effects of high blood pressure usually develop only after it has been high for some years. In the meantime, there are often no symptoms to warn you. Heart Foundation Managing high blood pressure Page 3 How is blood pressure measured? Blood pressure is usually measured by wrapping an inflatable pressure bag or ‘cuff’ around the upper arm. The bag is connected to a pressure-measuring device. The entire instrument is called a sphygmomanometer (sfig-mo-mah-nom-eh-ter). As the doctor pumps up the bag, the pressure in the bag rises and it squeezes the main artery in the arm so that no blood flows through it. When air is released from the bag, the pressure slowly falls. The doctor watches the readings of pressure in the bag and listens over the artery with a stethoscope. When the falling pressure in the bag just equals the peak pressure in the artery, the heartbeat forces some blood through the artery. This causes a regular thumping sound. As soon as the thumps begin, the doctor checks the pressure level reading. This is recorded as systolic (sis-tol-ik) pressure. The thumps continue until the pressure falls to equal the lowest pressure in the artery, when the sounds fade away. The doctor then takes another reading. This is recorded as diastolic (di-as-tol-ik) pressure. If your systolic blood pressure was 120mm Hg (millimetres of mercury) and your diastolic was 70mm Hg, your doctor will record it as 120/70, that is ‘120 over 70’. What is ‘normal’ blood pressure? There is no ‘normal’ or ‘ideal’ blood pressure reading. The following figures should only be used as a guide. Page 4 Normal Less than 120/80 High/Normal Between 120/80 and 140/90 High Equal to or more than 140/90 Very high Equal to or more than 180/110 Heart Foundation Managing high blood pressure What causes high blood pressure? The exact cause of high blood pressure is often not clear. Normally, your blood vessels detect temporary changes in your blood pressure and send messages to your brain to keep the pressure within healthy limits. If your blood pressure stays high for long enough, your system adjusts to a higher level. Your family history, eating patterns, alcohol intake, weight and level of physical activity have a strong influence on blood pressure. In some people, medicines, including the oral contraceptive pill, contraceptive ‘depot’ injections, steroids (cortisone-like medicines) and arthritis medicines, can also raise blood pressure. Why is it important to manage high blood pressure? It is important to manage your blood pressure because having high blood pressure is one of the main risk factors* for heart, stroke and blood vessel disease. Others include: • smoking • having a high blood cholesterol level • being physically inactive • having diabetes • being overweight • having depression • being socially isolated. Increasing age, being a male and having a family history of early death from coronary heart disease (i.e. in a first-degree relative less than 60 years old) also increase the risk of developing heart disease. * ‘Risk factors’ for heart, stroke and blood vessel disease are characteristics that increase your chance of having these diseases. Heart Foundation Managing high blood pressure Page 5 What harm does high blood pressure do? If it is not managed, high blood pressure can overload the heart and blood vessels and speed up the artery-clogging process known as atherosclerosis (ath-e-ro-skle-ro-sis). This can lead to problems such as heart attack and stroke. A stroke can also happen because high blood pressure causes weaknesses in the walls of the blood vessels in the brain, leading these weakened blood vessels to burst. This is known as a ‘cerebral haemorrhage’ (ser-u-brul hem-ur-ij). High blood pressure can also affect arteries to other parts of the body, such as the eyes, kidneys and legs. In addition, the higher your blood pressure is, the harder your heart must work to pump blood around the body. If high blood pressure is not treated, the heart may weaken because of the constant extra demand, and then it will not be able to do its job properly. This may cause ‘heart failure’, a serious condition with symptoms such as tiredness, shortness of breath and swelling of the feet and ankles. How can I manage my high blood pressure? Many people need medicine to manage their high blood pressure, but other people can manage it just by making some healthy lifestyle changes. To help to lower your blood pressure, it is important that you: • reduce your excess body weight • be physically active • limit your alcohol intake • quit smoking Quick tip If you have high blood pressure, your doctor can give you a personalised plan to help you to reduce and manage it. Page 6 • decrease your salt/sodium intake • increase your potassium intake. Even if you take medicine to manage your blood pressure, it is still important that you make changes to your lifestyle to help you to manage your blood pressure and improve your health. Heart Foundation Managing high blood pressure Lifestyle changes Some people can lower their blood pressure to normal levels by making the following lifestyle changes. If you try these things, you will still need your doctor’s ongoing help to manage your blood pressure. Enjoy healthy eating Healthy eating is particularly important in managing high blood pressure and reducing your risk of heart disease. Enjoying a variety of foods from the different food groups is the key to healthy eating. Choose mainly plant-based foods, such as vegetables, fruits, legumes (e.g. chick peas, kidney beans, baked beans, and lentils) and plain unsalted nuts. Also choose wholegrain cereal foods, such as breakfast cereals, bread, pasta, noodles and rice. Consume moderate amounts of lean unprocessed meats, skinless poultry and reduced fat dairy products. Include a 150 g serve of oily fish in two to three meals every week. Use margarine spreads made from canola, olive, sunflower and soybean oils, or lower saturated fat dairy spreads instead of butter or other dairy blends. Salt/Sodium One way to help to avoid high blood pressure is to enjoy a healthy eating plan that contains less than 6 g of salt a day (approximately 2300 mg of sodium a day). But if you have high blood pressure, aim for 4 g of salt a day (approximately 1550 mg of sodium a day). Quick tip Low salt and low sodium foods have a sodium content of no more than 120 mg/100 g (or 120 mg/100 mL for liquid foods). However, foods that are labelled ‘salt reduced’ are not necessarily low salt foods. Read the nutrition information panel on the label to check the actual amount of salt/ sodium in the food. Quick tip To reduce your sodium intake: • choose foods normally processed without salt, or choose low salt foods • avoid high salt processed foods • avoid salty snacks and take-away foods high in salt • avoid adding salt during cooking and at the table. Potassium Increasing your potassium intake can help to lower your blood pressure. To increase your potassium intake, consume: • a wide variety of fruits and vegetables • plain, unsalted nuts (however, limit the quantity that you eat and how often you eat them, because nuts can contribute to excess kilojoules) • dried peas, dried beans or lentils. Heart Foundation Managing high blood pressure Page 7 Maintain a healthy weight If you are overweight, achieving and maintaining a healthy weight is an important step to reducing your risk of developing high blood pressure. If you have high blood pressure, losing excess weight will help to manage it. Losing weight can sometimes even make taking medicines unnecessary. To achieve a healthy body weight, balance the kilojoules coming into your body through food and drinks with the kilojoules being used up by your body through regular physical activity. To lose weight, you need to use up more kilojoules through physical activity and consume fewer kilojoules from food and drinks. Limit your alcohol intake Drinking too much alcohol can increase your blood pressure. If you have high blood pressure, you should limit your alcohol intake to no more than two drinks per day (for men) or one drink per day (for women). Alcohol can also interact with some medicines, including complementary products (such as herbal remedies). If you are taking medicine for high blood pressure, alcohol can reduce its effectiveness. Ask your health professional if you have any questions about your medicine and drinking alcohol. Did you know? Some specific types of exercise should be avoided by people with high blood pressure. These include body presses and lifting weights, which can actually raise your blood pressure too much. Ask your doctor about the best kind of physical activity for you. Page 8 Be active every day Being physically active is an important part of leading a healthy lifestyle and can help to lower blood pressure. At any age, physical activity provides a range of health benefits. And the good news is that the physical activity doesn’t have to be vigorous – moderate physical activity, such as brisk walking, is great for your health! Try to do at least 30 minutes or more of moderate physical activity on all or most days of the week. You can do it in bouts of 10 minutes or more if this is more convenient. Try to be active during your day by walking to the bus stop, cycling to work or to the shops, doing some gardening, swimming, or participating in games such as tennis and golf. You could also join a club or learn a new sport. Do anything that you enjoy. Heart Foundation Managing high blood pressure Be smoke-free If you smoke, your doctor will strongly advise you to quit smoking. Smoking greatly increases the risk of heart attack, stroke, gangrene of the legs and other diseases. Once you stop smoking, the extra risk is reduced quickly. Avoid exposure to other people’s smoke, because second-hand smoke is also dangerous to your health. Call the Quitline on 13 QUIT for information and support on quitting smoking. Blood pressure-lowering medicine Many people will also need to take blood pressure-lowering medicine to reduce their high blood pressure to safe, managed levels. There are a large variety of medicines available to lower and manage high blood pressure. Your doctor might call them ‘anti-hypertensives’. Blood pressure-lowering medicines do not cure high blood pressure, but they do manage it. Once you start to take medicines to manage your blood pressure, you will probably have to continue to take them for the rest of your life. Sometimes, after your blood pressure has been well-managed for a long time, the amount (dose) of medicines that you need to take may be able to be reduced. Other medicines • Some medicines and complementary products interact with blood pressure-lowering medicine. Before you start taking other medicines, talk to your health professional. • If you are buying other medicines from a place (such as a supermarket) where you can’t speak to a health professional, check the label for information about possible interactions with your blood pressurelowering medicine. If you need to take medicine, your doctor will start you on a small dose and note its effect. If necessary, the dose will be gradually increased or other medicines used, until your blood pressure is well managed. Two or more different medicines are often needed to manage blood pressure and to keep any side effects to a minimum. Your doctor will make every effort to find the most suitable medicine or combination of medicines for you. To make sure that your medicines work properly, you need to take them regularly. Some things you could try to help you to remember to take your medicines are to take it at the same time every day, take it at meal times, use a weekly pill box with separate compartments, mark it on a calendar, or ask friends or family to remind you. We recommend that you always carry a list of your medicines and their doses with you. Heart Foundation Managing high blood pressure Page 9 Serious side effects If you suspect that your medicine has caused a serious side effect, see your doctor immediately. What about side effects? Blood pressure-lowering medicines are effective and their benefits generally far outweigh the problems that can occur. While the medicines may cause side effects in some people, many people don’t have any. You are most likely to experience side effects when you start taking a new medicine. If you have any concerns, don’t stop taking your medicine, but tell your doctor about them. He or she can change the type of medicine and the dose to keep side effects to a minimum, or to prevent them altogether. It is important that you work closely with your doctor to find the medicine that works best for you. How can I find out more information about my medicine? Speak to your doctor to make sure that you understand your medicines, including what they do and how much you should take. Your medicines will come with a detailed product information sheet and your pharmacist, nurse or doctor can answer any other questions that you may have. How can I monitor my blood pressure? Where can I have my blood pressure checked? It is best to have your blood pressure checked for the first time during a routine visit to your doctor, community health centre, hospital or clinic. Your results will be assessed in relation to your age, family history and other factors, such as whether you smoke or have high blood cholesterol. You may be referred to a specialist physician or clinic. Will I need to measure my blood pressure at home? Measuring your blood pressure at home is a good way to see how your blood pressure changes during the day, from one day to the next, and in response to treatment. Your doctor may recommend that you take regular measurements of your blood pressure at home and bring your records of the measurements with you to the clinic. The home measurements may be used to help your doctor to make decisions about your treatment. Discuss this with your doctor. Page 10 Heart Foundation Managing high blood pressure Why does my blood pressure vary? Blood pressure varies from moment to moment. It is affected by various factors including body position, breathing or emotional state, exercise and sleep. It is usually lowest when we sleep and higher when we are excited, stressed or exercising. Temporary rises are natural and blood pressure will return to normal when we rest. These constant changes can make it difficult to get a true picture of your blood pressure. To get a more accurate result, your doctor may measure your blood pressure several times. It is best to be in a relaxed state when your blood pressure is being measured. Anxiety can make blood pressure rise temporarily and give inaccurate high readings. Your doctor may arrange for you to wear a blood pressure monitor for 24 hours (during day-to-day activity and sleep). This light-weight, easy-to-wear monitor will help your doctor to get accurate information about your blood pressure. More information If you’ve got any questions or just want some more information about blood pressure, call our Health Information Service on 1300 36 27 87 and talk to one of our trained health professionals. What happens next? Your doctor will probably tell you to have your blood pressure checked regularly, maybe weeks or a few months apart. It’s important to keep appointments because your blood pressure and medicines need to be monitored. Your doctor may also ask you to measure your own blood pressure at home and to bring your measurements to the clinic to help them to make decisions about your treatment. Take your blood pressure tablets as advised. If you think that you are having problems with your medicine, tell your doctor so that your treatment can be adjusted to minimise side effects. Try to maintain a healthy weight, have a healthy eating pattern, do regular physical activity, limit your alcohol intake and be smoke-free. Heart Foundation Managing high blood pressure Page 11 For heart health information 1300 36 27 87 www.heartfoundation.org.au Key points to remember about high blood pressure High blood pressure is one of the main risk factors for heart, stroke and blood vessel disease. High blood pressure rarely gives warning signs. To find out if you have high blood pressure, you should have your blood pressure measured regularly. Your family history, eating patterns, alcohol intake, weight and level of physical activity have a strong influence on your blood pressure. To help to lower your blood pressure: • reduce your excess body weight • be physically active • limit your alcohol intake • quit smoking • decrease your salt/sodium intake • increase your potassium intake. Many people will need to take blood pressurelowering medicine to reduce their high blood pressure. Work closely with your doctor to find the medicine that works best for you. © 2008–2012 National Heart Foundation of Australia ABN 98 008 419 761 CON-059.v2 IPM Terms of use: This material has been developed for general information and educational purposes only. It does not constitute medical advice. Please consult your health care provider if you have, or suspect you have, a health problem. 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