Hypertension

Known as the “silent killer”, high blood pressure rarely has obvious symptoms but can damage organs and lead to kidney (renal) failure, aneurysm, stroke, heart attack and heart failure. Blood pressure measures how strongly blood presses against the walls of the arteries as it is pumped around the body by the heart. If the pressure is too high it puts a strain on the heart.

It is measured in millimetres of mercury (mmHG) and recorded as two figures: systolic pressure (when the heart is beating) and diastolic pressure (when the heart rests in between beats). You are said to have high blood pressure if readings on separate occasions consistently show it to be 140/90mmHg or higher. A reading below 130/80mmHg is normal.

In 90% of cases the causes of high blood pressure are unknown (the other 10% are the result of various painkillers such as ibuprofen; the oral contraceptive pill; or an underlying condition such as kidney disease or diabetes). What is known, however, is that your chances of having high blood pressure increase as you get older. Other risk factors include being overweight, having a relation with high blood pressure, being of African or Caribbean descent, eating a lot of salt, smoking, not eating enough fruit and vegetables, not exercising enough and drinking a lot of caffeine and/or alcohol.

Coronary Heart Disease

CHD is generally caused by atherosclerosis, when the heart’s supply is blocked or interrupted by a build-up of fatty substances also known as plaque in the coronary arteries. Smoking, high cholesterol, hypertension and diabetes are all to blame. Over time the artery walls can become furred up and become so narrow that not enough blood can flow to the heart. This can cause the heart muscle to die and lead to a heart attack. The plaque can also break off and cause a clot somewhere else in the circulatory system, such as the brain, which can give rise to a stroke.

Your doctor can assess your risk of CHD by asking you questions about your lifestyle and your family’s medical history. To confirm a diagnosis, an electrocardiogram, X-ray, MRI scan, CT scan and a coronary angiography may be needed.

Symptoms

High blood pressure usually has no obvious symptoms although in rare cases, where a person has very high blood pressure, they can experience a persistent headache, blurred or double vision, nosebleeds and shortness of breath.

Of the 2.7m people in the UK living with CHD, 2m are affected by angina pectoris or chest pain, which is the most common symptom. The other symptoms of CHD are palpitations, breathlessness, heart attacks (myocardial infarction) and heart failure. Angina, which is often triggered by physical activity or stressful situations, is characterised by a feeling of heaviness or tightness which can spread to the arms, neck, jaw, back or stomach but it usually passes in a few minutes. Heart attacks occur when the arteries become completely blocked and can be fatal if not treated immediately. The pain is more severe than angina and sweating, nausea, breathlessness and lightheadedness are common.

Treatment

Your doctor will recommend changes and adjustments to your lifestyle to reduce the risks of hypertension. As well as the obvious, such as losing weight and giving up smoking, he might suggest relaxation therapies (eg yoga) and medication, including ACE inhibitors, calcium channel blockers, diuretics, beta-blockers and alpha-blockers.

CHD cannot be cured but symptoms can be managed and reduce the chances of a heart attack. Treatment can include lifestyle changes, (regular exercise and healthy diet amongst them), medication and surgery. It is possible to resume a normal life following a heart attack and heart surgery.

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Did You Know?

* About 30% of people in England have hypertension (high blood pressure) but since it rarely has obvious symptoms, many don’t realise it. The only way to find out is to have your blood pressure measured.

* Coronary Heart Disease (CHD), also known as ischaemic heart disease, is the UK’s biggest killer, causing around 82,000 deaths each year. About one in five men and one in 8 women die from it.

* From the age of 50 the chances of developing CHD are similar for men and women.