High blood pressure (hypertension)

High blood pressure is a common condition in which the force of the blood against your artery walls is high enough to cause health problems in the long term, such as heart disease, stroke, and eye or kidney disease. The more blood your heart pumps, and the narrower your arteries, the higher your blood pressure will be. This may be due to an underlying problem (like kidney disease) or maybe due to ageing.

Hypertension that is due to an underlying cause can be cured when the problem is corrected. Still, in most people, hypertension is a lifelong illness managed with medicines, physical activity and diet. Women who start to have high blood pressure during pregnancy will likely develop the disease later in life.

Most people with high blood pressure do not have any signs or symptoms, even if blood pressure readings reach dangerously high levels. However:

• A few people with high blood pressure may have headaches, shortness of breath or nosebleeds, but these signs and symptoms are not specific and usually do not occur until high blood pressure has reached a severe or life-threatening stage.
• The best way to know if you have hypertension is to get regular blood pressure readings.

In most adults, high blood pressure develops over many years, as genes, ageing, lifestyle, diet, smoking tobacco and the environment cause the disease. In a few people, you can identify the cause of high blood pressure (like kidney disease, adrenal gland tumour, thyroid dysfunction, sleep disturbances and other conditions) and treat it.

High blood pressure is widespread among people of African heritage, often developing at an earlier age than it does in others.

• Until about age 64, high blood pressure is more common in men. Women are more likely to develop high blood pressure after age 65.
• High blood pressure tends to run in families.
• Being overweight or obese.
• Physically inactive people tend to have higher blood pressure.
• Not only does smoking or chewing tobacco immediately raise your blood pressure temporarily, but the chemicals in tobacco can damage the lining of your artery walls.
• Too much salt in your diet can cause your body to retain fluid, which increases blood pressure.
• Too little potassium in your diet. Foods that are high in potassium include bananas, spinach, sweet potatoes and peas.
• Drinking too much alcohol.
• High levels of stress can lead to a temporary increase in blood pressure.
• Certain chronic conditions may increase your risk of high blood pressure, such as kidney disease, diabetes, and sleep apnea.
• Pregnant women have a greater chance of high blood pressure (gestational hypertension).  This is usually a temporary condition different from other forms of high blood pressure. It can affect the health of the baby and the mother and should be closely monitored during pregnancy.

• Ensure you visit the doctor to check your blood pressure at least every two years starting at the age of 18. If you are age 40 or older, or you are 18 to 39 with a high risk of high blood pressure, ask your doctor for a blood pressure reading every year.
• If you have already been diagnosed with high blood pressure or have other risk factors, visit the doctor for more frequent checkups.

You can delay developing high blood pressure or reduce its severity by self-care, including eating a heart-healthy diet (like the DASH diet and Mediterranean diet), keeping physically active, quitting smoking, maintaining a healthy weight, dental hygiene and reducing your risk factors for the disease.

Self-care tips:

• Eating a heart-healthy diet with plenty of fruit and vegetables, wholegrain products, lean meat and fish. Be careful with salt.
• Getting regular physical activity.
• Maintaining a healthy weight or losing weight if you are overweight or obese.
• Limiting the amount of alcohol that you drink.

Treatment options:

• Your healthcare provider may recommend an anti-hypertensive medicine for you (like Lisinopril, Amlodipine or a water pill).
• If your high blood pressure is due to another condition, your healthcare provider will treat that condition.
• High blood pressure in pregnancy can be a life-threatening condition to the baby and the mother. Women who have high blood pressure during pregnancy should plan to give birth at a healthcare facility.
• Pregnant women with high blood pressure can ask their healthcare provider about available options if they have pre-eclampsia, a pregnancy complication characterized by high blood pressure and signs of damage to an organ (e.g. liver or kidneys).

If you have risk factors for high blood pressure, you can take steps now to lower your risks for the condition and its complications. Eat a healthy diet that should include vegetables, fruits, wholegrains, poultry, fish, and low-fat dairy foods. Exercise regularly to help manage stress, lower your blood pressure and reduce your risk of health problems.

People with high blood pressure are at significant risks for life-threatening organ damage if their blood pressure is not properly controlled with medicine, physical activity and diet.