Hypertension
You have been sent a link to this page because you have had a raised blood pressure (bp) reading, or are known to have Hypertension.
High blood pressure (also called hypertension) is very common, affecting about 1 in 3 adults in the UK. The chance of developing high bp rises as a person gets older. It often has no symptoms so people can be unaware of it, but the higher a person’s bp the greater their risk of having a heart attack, stroke or other health problems. We can help people keep their bp to target level that reduces any risks using a combination of lifestyle changes and medicines – what works best is different for each person. Talking to your healthcare professional can help you decide about treatment.
Initially it is important to identify if you really do have high bp. Ideally, we recommend you buy your own machine to monitor your bp at home and feedback your results via the text BP 7-day monitoring questionnaire we will send you. Alternatively, you can pick up a paper form from Reception.
Monitoring your blood pressure resources
- Home_blood_pressure_diary.pdf (bihsoc.org)
- Blood Pressure UK (how to measure your BP)
- Manage your blood pressure at home - BHF
If you do not have your own machine we have bp machines in all our ‘health kiosks’ in the Reception area of each practice.
Occasionally your health care professional will ask you to wear a monitor for 24 hours (Ambulatory home bp monitoring/ABPM)
Lifestyle
Even if you start bp medications, making lifestyle changes are essential to controlling your bp.
Things you can easily do are:
- Reduce your intake of processed food and salt
- Have a healthy, well-balanced diet https://www.bloodpressureuk.org/media/bpuk/docs/HealthyEatingBloodPressure_web.pdf
- Ensure you are not overweight/obese
- Don’t drink too much alcohol
- Ensure you have enough exercise
For more information go to High blood pressure (hypertension) - Prevention - NHS (www.nhs.uk)
We also have an excellent lifestyle area on our website. Go to Health and Wellbeing Coaching (mendipvale.nhs.uk)
BP Targets
Once a plan has been made (lifestyle +/- meds) there are targets we are aiming for:
- Age <80 years:
- Clinic BP single result <140/90 mmHg
- Home average <135/85 mmHg
- Age ≥80 years:
- Clinic BP single result <150/90 mmHg
- Home average <145/85 mmHg
The target may be lower if you have diabetes or kidney disease but your GP will review the results.
The results can be reviewed as part of shared decision making with yourself for your individual situation and will also bear in mind frailty.
Read the document on controlling blood pressure - it also has more details about medications including side effects.
Follow up
When you start or increase your bp medication please do a home bp series 1 month after the change.
Ace inhibitors (eg Ramipril, Lisinopril) and Arbs (eg Losartan, Candesartan)
- Need a U+E kidney blood test checked after 10-14 days when started or every time the dose is increased.
Sick Day Rules
If you are on Ace inhibitors (eg Ramipril, Lisinopril) , Arbs (eg Losartan, Candesartan), diuretics (eg Furosemide, Bendroflumethiazide, Indapamide)
And have
- Any dehydrating illness, e.g. Significant vomiting or diarrhoea (more than 12-24h) Severe fevers / sweats. Any other illness that is stopping you taking in a good volume of fluids.
Pause these medication and restart them a day or two after you feel better.
Annual Review
- Home bp series
- Annual blood tests (please check your weight and height in our health kiosk)
- Urine for Albumin to creatinine ratio