What exactly is 'high blood pressure'? and why should we care? - Osler Health International

What exactly is ‘high blood pressure’? and why should we care?

By: Dr Trisha Upadhyaya
Posted on: 19 Nov 2021

Having ‘high blood pressure’ is a term that is often used in medical analysis, however some patients may not be clear on exactly what it means. We asked Dr Trisha to explain all:.

What is ‘high blood pressure’?

Blood pressure (BP) is the pressure of the blood against the inner walls of blood vessels, otherwise known as arteries.

We measure two numbers when measuring BP: systolic (the pressure in blood vessels when our heart contracts) and diastolic (the pressure in blood vessels when our heart relaxes). These numbers are then usually quoted as systolic over diastolic, i.e., if systolic BP is 120 and diastolic is 80, this is read and written as 120/80 mmHg.

A normal BP is considered as 120/80 mmHg or less.

Typically, a persistently raised BP of 140/90 mmHg or more is classified as high blood pressure, otherwise known as hypertension. There are some variations in the diagnoses of hypertension. For example, the American College of Cardiology classifies individuals with BP 130-139/80-89 mmHg in the ‘first stage’ of hypertension, whereas, the European Society of Cardiology (ESC) and British NICE guidelines diagnose hypertension with BP readings of 140/90 mmHg or more.

Sometimes a lower threshold of BP is used to diagnose and treat hypertension for individuals with other conditions (such as diabetes mellitus or renal disease).

To really tailor to your individual needs, please speak to a General Practitioner to understand further about this condition.

How is this diagnosed and what are common symptoms?

Usually essential hypertension – hypertension with no other underlying cause – is found on asymptomatic individuals during a health screening or picked up during a routine consultation by your doctor. Most people do not notice they have any symptoms of high BP.

What causes high blood pressure?

Hypertension often develops with time. Some contributing factors are:

  • Unhealthy lifestyle choices, including leading a sedentary life, diet high in fats and sugars, smoking and high stress
  • Obesity
  • Conditions such as diabetes mellitus and kidney disease

There are also some other conditions which may cause hypertension, such as:

  • Pregnancy
  • Use of some medications
  • Rarer endocrinological and renal disorders

What are consequences?

Hypertension is often known as the ‘silent killer’ as it can affect a multitude of organs in our body and cause damage to these organs, impairing their function.

  • Heart and blood vessels: hypertension can cause ischaemic heart disease, leading to angina (temporary chest pain), myocardial infarction (heart attacks) and even, heart failure.
  • Brain: a background of hypertension can lead to ischaemic changes in the brain, stroke (bleeding in the brain). These can lead to cognitive decline, affect our memory and in a major stroke, cause disability.
  • Kidneys: the small blood vessels in our kidneys are acutely susceptible to changes in our blood pressure. A sustained high BP can lead to damage of the kidney and its key role in the elimination of waste products from our body, maintenance of fluid, electrolytes and hormone levels in our body.

Is high BP an emergency?

The good news is a high BP detected early can be lowered safely and reduce your risk of acquiring further significant diseases.

Early and routine screening is key. Your doctor will evaluate whether the high BP has caused any damage to key organs. This may be done by physical examination, blood tests and urine tests as the basic investigations. Your BP measurement together with the investigations will guide the treatment required and the urgency of treatment.

How will high BP be managed?

There are several ways of lowering high BP. These include:

  • Conservative changes to our lifestyle, such as modifications to our diet, exercise frequency, losing weight, not smoking and stress management.
  • If further treatment is required, your doctor will discuss the use of medications to lower your blood pressure.

Your doctor will recommend a follow-up plan, which may include home monitoring of BP, repeat of certain tests and return to clinic for further review.

At Osler Health International, we ensure screening regularly for high blood pressure and tailoring a holistic management best suited for our patients. If you have any further questions, please come and have a chat with us!

Dr Trisha is a UK and Singapore trained doctor based at Star Vista clinic. For appointments please call: 6339 2727