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Hypertension

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Hypertension or high blood pressure affects about a third of all adults and 65% of people aged over 75. It is a chronic condition that affects about 16 million people in the UK, but it can easily go undetected. People may not feel any symptoms but then suffer serious complications such as a heart attack or stroke.

The official definition of hypertension is blood pressure consistently over 140mmHg systolic (the force while the heart is relaxing and filling with blood again in preparation for the next contraction) or 90mmHg diastolic (the force of the blood as the heart contracts to pump it around the body).

It is one of the most commonly monitored clinical indicators for a range of conditions including diabetes and cardiovascular disease.

An estimated 62,000 people die every year needlessly because of hypertension and around one-third of people with the condition are unaware they have it.

The risks are high and people with hypertension are three times more likely to develop heart disease and stroke and twice as likely to die from these as people with normal blood pressure.

In 2000 the National Service Frameworks for coronary heart disease and diabetes both included guidance on hypertension, and in 2004 the British Hypertension Society (BHS) brought out general guidelines and the National Institute for Health and Clinical Excellence (NICE) issued guidelines for primary care.

Medications that help lower blood pressure include ACE inhibitors, beta-blockers, calcium channel blockers and diuretics.

The BHS and NICE guidance gave conflicting advice as to the best treatment approach, but in July 2006 new NICE guidance recommended treatment with newer drugs over beta-blockers, bringing it into line with the BHS’s advice from two years earlier.

It is recommended that all adults have their blood pressure checked at least once every five years.

There is no single underlying cause for the condition in more than 90% of cases, but contributory factors include being overweight or obese, drinking excess alcohol, eating too much salt and a lack of exercise. The condition can also run in families.

Several lifestyle changes can help lessen the risk of hypertension and high blood pressure such as a healthier diet, more exercise and reducing intake of salt and alcohol. Some relaxation techniques to reduce stress may also help people manage their blood pressure.

Smoking, although it is not a direct cause of high blood pressure, does increase the likelihood of heart attack, heart failure and stroke.

Updated: September 2006

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