High blood pressure (hypertension)

What is high blood pressure

Blood pressure is the force that is exerted against the walls of the arteries by the blood when is pumped though by the heart. Blood pressure is at its highest when the heart pumps the blood and is at its lowest when the heart rests between beats.

High blood pressure is defined as the heart pumping blood with extra force/pressure on each beat and even when the heart rests, the pressure is still too high. High blood pressure puts a lot of strain on the heart as is pumps blood too hard through the arteries. It can lead to a variety of heart disease, stroke and kidney disease.

High blood pressure is defined as being higher than the highest figures below (for each of systolic and diastolic pressures):

• Systolic – heart beat pressure
  • Normal is 90-120mmHg
• Diastolic – resting rate between heart beats
  • Normal is 60-80mmHg

Facts about high blood pressure

• High blood pressure is know as the “silent killer” as it often presents with no symptoms prior to a person having a heart attack or stroke
• High blood pressure leads to a higher risk for developing heart disease, stroke and kidney disease
• Women taking the contraceptive pill can develop high blood pressure, which is reversible when the use of the birth control pills are discontinued
• Women who are pregnant can experience high blood pressure associated with a condition called pre-eclampsia, which is rare, but serious and only occurs towards the end of pregnancy. Pre-eclampsia can endanger the life of not just the unborn baby but the mother too
• High blood pressure can result from having a brain tumour as it can cause increased blood pressure in the brain
• Higher than normal blood pressure can occur directly after surgery, which can be relieved through medication
• Illegal street drugs, such as methamphetamine, speed and cocaine can cause a temporary rise in blood pressure and continued use of these illegal drugs may lead to kidney and other organ damage, as well as more severe hypertension
• A recent study showed that there is link between high blood pressure and distinct memory problems

Symptoms of high blood pressure

High blood pressure often does not present with any symptoms, which is why the effects of this condition (heart disease, heart failure, stroke, kidney disease) often come as an unexpected and unwanted surprise. This is the reason why high blood pressure is known as the “silent killer” – it does not often present with any symptoms until there are very serious complications.

Many people who have high blood pressure do not even know that they have this condition until they have a blood pressure check at the doctor’s office (or hospital or other medical facility).

Symptoms

If there are any symptoms of high blood pressure, they will be:

• Blurred vision
• Dizziness
• Feeling faint
• Headaches
• Nausea
• Nosebleeds is an early symptom of high blood pressure
• Ringing in the ears
• Urinating at night

Causes of high blood pressure

Scientists still do not know exactly what causes high blood pressure in the majority of cases (over 80%), although there are many known risk factors that can elevate blood pressure above normal levels.

There are 3 main types of high blood pressure (or hypertension) that are defined:

Primary (essential) high blood pressure

For the majority of people with high blood pressure, the cause is not known, but there are a number of risk factors that are associated with the development of high blood pressure. This type of high blood pressure cannot be cured, but is usually well controlled with medication and diet, as well as lifestyle modifications

Secondary hypertension

Some people’s high blood pressure can be attributed to known causes, such as:

• Adrenal gland problems – the adrenal glands increase blood pressure when we are faced with a stressful situation. If the adrenal glands are not functioning properly, they can cause a problem by elevating blood pressure too high
• Hormone problems – certain hormones produced by the body function by elevating blood pressure. If these hormones are not functioning normally, they could continue to elevate blood pressure too high
• Kidney disease – people with kidney disease can have high blood pressure. If the kidneys are not functioning properly, this can cause the re-absorption of sodium and higher blood pressure to develop

Malignant hypertension

This type of high blood pressure is very insidious as it usually presents with no symptoms even though blood pressure is really high (around 200/130Hg). This type of hypertension can sometimes be detected by a visual examination of the eye, which can display the haemorrhage and swelling of the optic nerve. Until anti-hypertensive medications were developed, people who were diagnosed with malignant hypertension would often die within 12 months of diagnosis. Malignant hypertension can ultimately case brain swelling, kidney damage and loss of vision.

Prevention of high blood pressure

Non-preventable risk factors

There is little that can be done to prevent any of the risk factors that are known to be unpreventable. These unpreventable risk factors are associated with the following:

• Age – higher blood pressure is associated with age, the older you are, the more at risk you are for developing high blood pressure, as the heart may not work as efficiently as the arteries may be more clogged up with plaque and cholesterol. People over 65 have more incidence of high blood pressure and this is difficult to prevent. The only way to reduce risk of complications is to take modify the diet and lifestyle and potentially take medication to reduce blood pressure
• Certain medications – some prescription drugs (and also non-prescription ones) such as antihistamines, cold and flu drugs, decongestants (especially if they contain pseudoephedrine) can raise blood pressure temporarily. If these medications are taken long-term, they can increase blood pressure long term too
• Family history – people with a mother or father with high blood pressure have a higher risk of developing it than people whose parents do not have hypertension. People with two parents that have high blood pressure have a much higher risk of developing it too. While it is known that people can inherit the disposition to develop high blood pressure from one or both of their parents, this does not necessarily mean that high blood pressure will develop in every case, as it seems that other factors also need to be present to trigger it
• Gender – men generally have a higher risk of developing high blood pressure (although women are quickly catching up with this risk)
• Genetics – some people are just genetically predisposed to developing high blood pressure irrespective of any other risk factors and there is very little that can be done to prevent it from occurring
• Sodium sensitivity – many people with high blood pressure (just under 50%) are sensitive to the effects that salt (sodium chloride) has on their blood pressure. These people’s blood pressure increases dramatically (to higher than normal levels) when they consume foods high in sodium (salt) and these are normally processed foods, take-away foods and fast foods. For some people, excessive amounts of salt in their diet is a risk factor that leads to the development of hypertension
• Type 1 diabetes – people who have type 1 diabetes, the form of diabetes where the body stops producing insulin for reasons yet unknown by science are more susceptible to developing high blood pressure, a highly unpreventable condition associated with all forms of diabetes. Type 1 diabetes is not caused by improper diet or lifestyle factors, it just occurs without any known reason, seemingly at random

Preventable risk factors

There are though, a number of risk factors which can prevented in order to possibly reduce the risk of high blood pressure (hypertension) developing in the first place:

• Body fat – when body fat is centered around the middle of the body, the stomach area, often called an “apple” body shape, is a much higher risk for developing high blood pressure
• Contraceptive pill – some women develop high blood pressure when they take the contraceptive birth control pill. This only happens to some women
• Do not smoke – studies show that people who smoke cigarettes have a higher risk of developing high blood pressure (hypertension); people who smoke and who have high blood pressure need to find a strategy which helps them give it up
• Do not drink excessively – studies show that drinking excessive amounts of alcohol is associated with high blood pressure (hypertension). All forms of excessive drinking, especially if it continues long term, is associated with the risk of developing high blood pressure; it is not recommended to drink more than 1-2 standard drinks for women and 2-3 standard drinks for men each day, 4-5 times per week and have 2-3 non-alcohol days per week
• Exercise regularly – studies show that people who exercise regularly are at a lower risk for all types of degenerative health conditions (of which high blood pressure is one). People should aim to exercise for at least 30 minutes a day to help keep their heart and blood pressure healthy
• Follow a healthy diet – a healthy diet is the best defence against most types of degenerative health problems (such as high blood pressure), because good nutrition is the basis of good health. A healthy diet, which is lower in saturated fat, lower in salt and higher in vegetables, fruit and wholegrains, with a small amount of animal-based protein mostly prevents the development of a number of degenerative health problems, including high blood pressure
• Obesity – people who are obese are at a much higher risk of developing high blood pressure because of the pressure that their extra weight causes on the blood vessels in their body and on the heart. The heart has to beat extra hard to push the blood through the blood vessels that are being constricted by the extra fat that surrounds them
• Reduce intake of processed foods – almost all processed foods are high in sodium (as well as being high in saturated fat and calories and low in nutrients). People with high blood pressure need to have less salt and not more, so reducing intake of processed foods also reduces intake of sodium (salt), saturate fat and calories
• Reduce salt intake – many people with high blood pressure have a sensitivity to salt (sodium), where their blood pressure rises in direct relation to eating foods high in salt. There are few natural, unprocessed foods that are high in salt
• Reduce saturated fat intake – studies show that a high intake of saturated fat is associated with plaque build up in the main arteries of the heart and high blood pressure. Saturated fat is found in: all animal meats, seafood, poultry, animal products such as eggs and full fat dairy (lower fat dairy still has some saturated fat, but not as much as full fat) and coconut
• Reduce stress – when people experience stress, it can cause a slight and temporary increase in blood pressure, which can be permanent if the stress is also permanent. The best ways to deal with stress are through meditation, yoga, tai chi and any other form of relaxation
• Type 2 diabetes – people with diabetes have a much higher risk of developing high blood pressure. Studies show that about 70% of all people with diabetes have high blood pressure and many of these people do not even that they have high blood pressure

Complications of high blood pressure

There are many very serious complications of undiagnosed and untreated high blood pressure, including the very serious risk of dying at an early age. Most of the complications of untreated high blood pressure are life threatening:

• Acute myocardial infarction – this is the official term for a heart attack. If there is inadequate blood supply (including oxygen) to the heart, due to inefficient function of the heart from high blood pressure, this can result in heart attack and significant parts of the heart can be destroyed, often resulting in death of the person experiencing the heart attack
• Angina – chest pain, which is referred to as angina (or angina pectoris) is a serious heart condition in which the heart may not be working as effectively as it should as it is not receiving adequate oxygen. High blood pressure can be directly involved in causing the type of pain that angina causes, since not enough oxygen is being delivered to the heart
• Aneurysm of the aorta – an aneurysm is an abnormal widening of a blood cells and if it occurs in the aorta (the larger artery in the body) and it ruptures, this could cause a catastrophic result due to the high level of blood flowing through at high volume through the aorta
• Atherosclerosis – this condition causes hardening of the inner walls of the arteries through the deposit of cholesterol, which happens gradually over time. Atherosclerosis is a serious heart disorder which is linked to high blood pressure and in fact some researchers believe that people with high blood pressure can be at a higher risk of development of atherosclerosis
• Heart failure – high blood pressure can cause heart failure because it prevents the heart from pumping the blood (and oxygen) properly around the body. This can then lead to a build-up of fluid in the lungs, legs and abdomen that develops over a number of years
• Kidney failure – high blood pressure makes the heart work unnecessarily harder than normal to push the blood out to the body and this can ultimately damage all the blood vessels throughout the body. If the blood vessels in the kidneys are damaged (due to high blood pressure), they wont be able to function properly – remove waste and extra fluid from the body – and this can cause the fluid levels in the body to be raised even more. This can lead to further high blood pressure as the heart pushes even harder get the blood to all the damaged blood vessels. Ultimately, this can cause kidney failure when the kidneys are unable to get rid of toxins and extra fluid in the body
• Stroke – also known as cerebrovascular accident, stroke is mainly caused by high blood pressure. If the brain cells do not have enough blood (and oxygen) they become damaged or die and can result in permanent disability (if not death). There are three main types of stroke:
  • Thrombotic stroke – is the most common type and occurs when fat (plaque) builds up in the blood vessels that supply the brain with oxygen and nutrients. This fatty blockage reduces the blood flow into the brain and ultimately a clot (or clump) forms in one of the blood vessels to the brain, which blocks the blood (and oxygen) supply and stroke ensues
  • Embolic stroke – this type of stroke happens when a smaller clot (or clump), called an embolus, forms in one of the arteries in the head or neck and then the clot travels to the brain’s smaller blood vessels and where it blocks the blood (and oxygen) supply and stroke ensues
  • Haemorrhagic stroke – the least common, but the most severe type of stroke. In this type of stroke, a blood vessel in the brain bursts open and allows the blood to rush out of the blood vessel and into the brain, outside normal channels. This type of stroke causes internal bleeding
• Vision problems – high blood pressure can lead to a thickening of the tiny capillaries in the eyes and this causes a restriction of the blood flow into the eyes. This can lead to vision problems such as blindness or tunnel vision

If high blood pressure is not diagnosed and treated quickly, it can lead to very serious health problems and ultimately death.

When to see a doctor about high blood pressure

While high blood pressure generally produced no (or little) symptoms, a family doctor should be consulted if a person experiences any of the symptoms of high blood pressure.

Anyone who is in one the groups at risk of developing high blood pressure should visit their doctor to check their blood pressure on a regular basis.

People who have diagnosed high blood pressure should visit their doctor regularly to monitor their blood pressure and the effect of the medication on their blood pressure.

Diagnosis of high blood pressure

High blood pressure is diagnosed mainly through one test:

• Blood pressure test – this is the only test which gives an accurate reading of blood pressure. This test should be used on a regular basis to provide readings of blood pressure. There are blood pressure monitors which can be purchased at pharmacies and which give an accurate digital reading of blood pressure that people can use at home between visits to the doctor to monitor their own blood pressure

The doctor will also ask a series of questions about symptoms (if there are any) and will recommend a series of blood tests to determine if there is an underlying heart condition or other condition.

Other tests

Other tests that can be used to diagnose high blood pressure:

• Blood tests – to determine levels of various hormones, electrolytes (including sodium), cholesterol, triglycerides, urea, creatine to determine if there is an underlying heart condition or another condition which is causing the high blood pressure
• Electrocardiogram (ECG) – this is a test to measure the electrical activity of the heart by wires which are attached to specific points on the body and then the heart’s electrical activity is measured to determine if it is functioning correctly, or if there is an underlying heart condition which is causing the high blood pressure
• Ultrasound – if necessary this test can identify problems with the kidneys and adrenal glands, both of which can cause higher blood pressure readings, if they are not functioning correctly and absorbing too much sodium (and not releasing it through the kidneys and urine)

Conventional treatment of high blood pressure

Conventional treatment for high blood pressure that is recommended today uses a combination of a number of different types of therapies. The combination of therapies used will depend on each case of high blood pressure:

Monitor blood pressure regularly

Blood pressure monitors can be purchased at pharmacies to enable close monitoring of blood pressure in between visits to the doctor

Lifestyle and dietary modifications

Doctors will usually recommend the following lifestyle modifications to assist with lowering blood pressure:

• Exercise – studies show regular exercise is as beneficial as anti-hypertensive medications, which may need to be reduced if they are taken
• Lose weight – people who are overweight or obese put a lot of stress on their heart and losing weight can lower risk for serious complications of high blood pressure
• Reduce alcohol intake – current medical guidelines recommend 1 alcoholic drink for women and 2 for men each day – drink in moderation
• Reduce salt – research shows that limiting sodium intake to 1.5g per day is effective in lowering blood pressure
• Stop smoking – while smoking may not directly cause high blood pressure, it does damage the walls of blood vessels and hardens arteries, it is recommended to quit

Medications

Various medications are prescribed for treating high blood pressure, sometimes more than one medication is prescribed to be taken together:

• ACE inhibitors – angiotensin converting enzyme (ACE) inhibitors block an enzyme that initiates production of aldosterone (a hormone released by the adrenal glands that increases blood pressure). This has the effect of dilating blood vessels and lowering blood pressure. ACE inhibitors are prescribed as a first medication of choice for people with diabetes and kidney damage and for some survivors of heart attack. ACE inhibitors can improve a patient’s survival of a heart attack
• Alpha blockers – these drugs block signals from the nervous system to the blood vessels and allow blood flow to be normalised and blood pressure reduced. Alpha blocker also reduce the effects of certain hormones that elevate blood pressure and narrow blood vessels (norepinephrine and epinephrine). Alpha blockers also lower blood cholesterol and triglyceride levels
• Alpha beta blockers – these drugs have a similar effect to alpha blockers, but have an added effect in that they slow the heart beat too (in a similar way to beta blockers), so less blood is pumped through the blood vessels, thereby lowering blood pressure
• Angiotensin antagonists – these drugs prevent angiotensin from working properly, widen blood vessels and reduce blood pressure
• Beta blockers – these drugs block specific nerve signals to the heart to reduce heart rate and force, which means the heart does not have to exert as much force to pump out blood and this reduces pressure. People taking beta blockers have a lowered risk for having a second heart attack or from dying from a first heart attack
• Calcium channel blockers (CCBs) – these drugs prevent calcium from entering the heart and the blood vessels, so they help to relax the smooth muscles surrounding the blood vessels, allowing better blood flow, dilation (widening of the blood vessels) and a reduction in blood pressure. There are two types of CCBs – short acting (for acute cases) and long acting, which work more gradually over a longer period. People taking calcium channel blockers should avoid drinking grapefruit juice, as it can boost the effect of the drugs and cause adverse effects
• Diuretics – these drugs flush out and remove sodium and water from the body, which reduces the amount of fluid in the body, reduces pressure on blood vessels and helps to dilate blood vessels back to a normal size and allow blood to flow more freely. Diuretics can be purchased without a prescription
• Nervous system inhibitors – these drugs block signals to the nerves and allow the blood vessels to to widened and allow normal blood flow, thus reducing blood pressure. These drugs are also called central adrenergic inhibitors and are not used as much these days because of the number of side effects they cause
• Vasodilators – these drugs open up arteries by relaxing the smooth muscle around the walls, allowing the blood vessels to be widened to a more normal size so blood can blood more freely through them, thus reducing high blood pressure. Vasodilators are usually prescribed with other drugs (especially beta blockers and diuretics)

All medications have some associated side effects. People who take any sort of medication for high blood pressure and experience any side effects should let their doctor know so that they can modify the dosage or type of medications.

Alternative / complementary treatment of high blood pressure

Anyone who suspects they may have high blood pressure, should never try to self-medicate

Any type of medical condition needs to be diagnosed by a medical professional as the same symptoms could be confused with many other heart disorders.

Always talk to your doctor about any supplements you want to take before trying them as they could interfere with the actions of any prescription medications.

Herbs

There are a number of excellent herbs which may help to reduce incidence of higher blood pressure:

• Garlic (Allium sativum) – several studies have suggested that fresh garlic or garlic supplements may lower blood pressure, by helping to reduce cholesterol levels, prevent blood clots by ensuring the blood is less “sticky” and thinned as well as dissolving plaque build-up. People taking any type of medications must not take garlic supplements without consulting their doctor first
• Olive leaf (Olea europaea) – some studies have shown that olive leaf extract may have potent antioxidant as well as anti-inflammatory effects on the arteries, which may reduce incidence of plaque build-up, lower cholesterol levels and helps to normalise blood pressure levels to normal
• Psyllium (Plantago psyllium) – studies show that psyllium, a “weed”, which is an excellent source of natural fibre, helps to reduce cholesterol levels (which are associated with increased levels of blood pressure) and also helps to normalise blood glucose levels, which means it may reduce risk of hypertension in people with diabetes. People who have diabetes and take insulin should discuss taking psyllium with their doctor before trying it

Vitamins

There are a number of vitamins which may help reduce symptoms and risk of complications of high blood pressure (but do not take these in supplement form unless you have approval from your medical specialist to do so):

• Folic acid – various studies show that folic acid lowers high blood pressure and reduces stiffness of the arteries. These studies showed that folic acid helps to keep the arteries more flexible and pliant, which prevents the increase in blood pressure. It is advised to incorporate foods rich in folic acid in the diet, foods such as leafy green vegetables (spinach, lettuce, kale), beans and other dark green vegetables, as well as nuts and seeds
• Vitamin B3 – studies show that vitamin B3 (niacin) is a vasodilator, which means that it opens up blood vessels so that blood can flow easily through them. Vitamin B3 helps to promote normalised blood pressure
• Vitamin B6 – studies show that vitamin B6 can help to reduce clotting, which is associated with heart disease. Other and may also lower blood pressure
• Vitamin B12 – studies show that vitamin B12 can help to reduce clotting, which is associated with heart disease. Other and may also lower blood pressure. The studies have suggested that vitamin B12 works even more effectively at reducing blood pressure when in conjunction with folic acid
• Vitamin C – studies show that vitamin C plays a role promoting a healthy heart and normal blood pressure levels. Aim to increase foods high in vitamin C (citrus fruits, stone fruits, leafy green vegetables)
• Vitamin D – studies show that vitamin D plays a role in regulation of blood pressure and they have suggested that lowered vitamin D intake is associated with risk for high blood pressure levels
• Vitamin E – studies show that the antioxidant vitamin E thins the blood, prevents blood clots and also lowers blood pressure. Aim to eat more foods rich in this vitamin, such as nuts, seeds, olive and sunflower oils

Minerals

There are a number of minerals which may help reduce symptoms and risk of complications of high blood pressure (but do not take these in supplement form unless you have approval from your medical specialist to do so):

• Calcium – studies show that calcium may be not be absorbed properly and so may cause a deficiency in people with hypertension. In addition to this, other studies have associated lowered calcium intake with higher blood pressure levels
• Magnesium – many studies show that the mineral magnesium relaxes smooth muscle tissue (which are basically the muscles that surround the arteries) and this allows blood to flow properly without restriction. Magnesium also works on the heart to normalise heart rhythm and heart beat
• Potassium – if sodium levels are elevated, blood pressure can increase, whereas potassium has the opposite effect by lowering and normalising blood pressure levels. Increased intake of foods high in potassium such as fruits (especially bananas) and all vegetables, but especially leafy green vegetables may help to reduce blood pressure

Other nutrients

There are a number of other nutrients which may help reduce symptoms and risk of complications of high blood pressure (but do not take these in supplement form unless you have approval from your medical specialist to do so):

• Carnitine – this amino-acid like substance has beneficial effects on the heart and some studies show that carnitine can lower blood pressure
• Fish oil – current research shows that the omega 3 fatty acids DHA and EPA in fish oil not only lower blood triglycerides but also decreases risk factors which increase blood pressure. The omega-3 fatty acids in fish oil are recommended by various authorities to keep the heart healthy
• Lecithin – studies show that lecithin could be deficient or not well absorbed and metabolised properly in people with high blood pressure. This means that intake of foods rich in lecithin should be increased in the diet: soy, eggs, beans and liver and even lecithin granules, but check to make sure that the lecithin or soy are GM free
• Lipoic acid – studies show lipoic acid, a potent antioxidant nutrient may prevent high blood pressure in some individuals, while other studies show that lipoic acid decreases high blood pressure in people who have salt sensitivity hypertension
• Methionine – studies show that methionine, an antioxidant amino acid lowers blood pressure and may prevent it from rising too high in the first place. Foods rich in methionine are – meats, beans, soy and soy products, vegetables, fruits, nuts
• Taurine – studies show that taurine may lower existing high blood pressure and may even prevent blood pressure from rising too high in the first place

Dietary modifications

• Avoid excessive salt intake – salt can elevate blood pressure in many people and should be limited by not adding any to food and not eating processed foods; instead of salt, use herbs, spices, lemon juice, balsamic vinegar
• Avoid processed foods – this means avoiding all soft drinks, all canned and processed meats from the deli, processed cheeses, instant soup, ice cream, toppings, puddings, cakes, pizza, take-away food
• Eat a large salad every day – studies show that people who eat a salad with leafy green vegetables every day, have lower incidence of high blood pressure. This could be due to the blood pressure lowering mineral potassium that is rich in just about all vegetables, as well as the mineral magnesium, which relaxes smooth muscle tissue (and that is what the artery and other blood vessel walls are made from)
• Eat less saturated fat – as saturated fat can block the arteries, causing high blood pressure and then this can lead to heart disease to develop; eat saturated fat in moderation
• Eat more beetroot – studies have shown that drinking 1-2 glasses of beetroot juice every day lower the blood pressure of people with existing high blood pressure
• Eat more fruit – fruit are essential in a healthy diet and will help to lower blood pressure due to the high potassium and low sodium levels that they contain
• Eat more garlic – studies show that garlic is excellent at reducing high blood pressure in people with existing hypertension, due to the active enzyme alinase which converts allin to allicin. The studies show that allicin is effective in relaxing the smooth muscles that surround the artery walls and widening the the arteries to let more blood flow freely, without the pressure that high blood pressure causes
• Eat more vegetables – vegetables are essential in a healthy diet and will help to lower blood pressure, as they contain the right ratio of potassium to sodium and will help to lower blood pressure. It is recommended to eat at least 5-7 portions of vegetables every day
• Increase water intake – water allows the body to be properly hydrated and dilutes the effects of high sodium, drink about 8-10 glasses of water each day
• Limit sugar intake – sugar may contribute to raising blood pressure; foods high in sugar should be limited, especially processed foods

Lifestyle modifications

• Avoid smoking – cigarette smoking damages the walls of blood vessels and hardens arteries, which can increase risk of blood pressure becoming high
• Drink less alcohol – too much alcohol can increase blood pressure due to the detrimental effect on the whole body, so limit alcohol to 1-2 glasses of red wine (made with no preservatives) 3-4 times per week
• Get adequate exercise – several studies show that regular, low intensity exercise is just as effective as medication to lower blood pressure which is too high, even in elderly people (suitable exercise – swimming, walking, aerobics, cycling)
• Lose weight – excess weight, especially around the middle (abdominal) area is a high risk factor for developing high blood pressure (as well as heart disease in general), so exercise is recommended for at least 30 minutes, every day. Exercise that increases the heart rate to about 75% of the maximum heart rate is recommended as this will help condition the heart and keep it healthy
• Reduce stress – strong emotions, anger and stress all can contribute to elevating blood pressure on a temporary basis, but if the stress is ongoing, this is a very high risk factor for high blood pressure. Stress reduction techniques that can be used to relax, include: meditation, yoga, visualisation, tai chi, socialising

Alternative treatments

• Naturopath – people with high blood pressure may benefit from a visit to a naturopath who can provide nutritional supplements and monitor progress. People who visit a naturopath must advise their doctor to ensure it does not conflict with any medications they are taking

Always ensure that you notify your medical practitioner of any supplements that you want to take – it may interfere with other medication or conditions you have. Confirm with your doctor it is safe to take before you try it.

Living with high blood pressure

Management of high blood pressure should be more focused on knowing what the risks of elevating blood pressure are, how much of an effect they have and ensuring they are avoided.

In general, the minimum strategies that should be achieved in order to live with high blood pressure to ensure blood pressure is maintained at a healthier level are:

• Medication – if medication is prescribed, it must be taken as prescribed and as often as prescribed. If you are travelling anywhere, always take enough medication with you to cover you while you are away
• Side effects to medications – if you experience any side effects to any medication you are taking (whether new or existing), you need to let your doctor know so that they can adjust the type and dosage of medication you are taking. Never just stop taking your usual dosage of medications, as it can cause serious and adverse health problems, such as an extreme rise in blood pressure in a very short term. Only your doctor can adjust your medication, never try it yourself
• Discuss any vitamins with doctor – people that want to try vitamins, minerals and/or other supplements to help reduce their high blood pressure need to discuss these with their doctor to ensure that these supplements do not interfere with any medications that are currently being taken
• Exercise more – ensure to engage in physical activity for at least 30 minutes, every day to help condition the heart and prevent the blood pressure from rising up
• Surgery – if you are going to have any surgery, you need to inform your specialist which medications you take so that they can adjust your anaesthetic and take proper care of you while you are unconscious
• Dental work – if you are going to have any dental work which require anaesthetic, you need to inform your dentist (or other oral specialist) who will need to ensure they provide appropriate care for you
• Diet – eat in moderation and enjoy a healthy diet that is full of vegetables, fruits, wholegrains, nuts, seeds and a small amount of low fat dairy and a little bit of red meat and some oily fish. Avoid processed foods as they provide little nutritious value and besides are too high in calories, saturated fat and salt, which is a definite no-no for people with high blood pressure
• Drink less alcohol – try to drink less alcohol each day and have at least 2-3 days that are alcohol-free each week
• Reduce stress – relax your mind and body, to help reduce any potential elevation in blood pressure. Constant stress is unnecessary for a healthy heart

Caring for someone with high blood pressure

Family, friends, parents or children

People who are caregiving for someone with high blood pressure can follow specific strategies to help them cope better with their condition:

• Eat in more – cooking your own food allows you to ensure that there is less salt, less saturated fat and less calories in the food
• Provide more fresh fruit and vegetables – fruit and vegetables are high in potassium and low in sodium, so they make excellent food snacks for people with high blood pressure – they will not elevate blood pressure and can only reduce it somewhat
• Encourage more exercise – sometimes its easier to exercise with a friend or partner and if you can be supportive by asking your partner/friend to join you when you partake in physical activity, this may encourage them to continue with the exercise
• Provide alternatives to alcohol – one really suitable alternative is red grape juice, which has the same benefits of red wine, without any of the alcohol, so it has no detrimental affects – just choose a juice with low sugar content and natural ingredients to ensure the most benefits
• Join in relaxation – there are a number of relaxation techniques that can be used to bring down blood pressure that has been temporary elevated. These activities are even more enjoyable with a partner or friend – yoga, mediation, tai chi, visualisation
• Support – the best thing that a partner or friend can do for someone with high blood pressure is just to provide support and be concerned

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Last reviewed and updated: 14 May 2024