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A pressure that does not hurt and is dangerous for exactly that reason — but it can be measured, and even small reductions protect heart, brain and kidneys.
Also known as: arterial hypertension · high blood pressure
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
High blood pressure does not hurt, and that is exactly its risk: it works quietly for years on heart, brain, kidneys and eyes. In practice the limit is 140 over 90 in the surgery, 135 over 85 measured at home — values are lower at home because the tension is missing. A single high reading is not a diagnosis; that rests on several measurements on different days, ideally self-measured or over twenty-four hours. Measuring is done sitting after five minutes of rest, with the arm supported at heart height and a cuff that fits; the first time on both arms, after that always on the higher one. In the great majority no single cause is found — it is the interplay of inheritance, age, weight, salt, alcohol, too little movement and poor sleep. In young people, with very high values or when several drugs fail, a cause is looked for: kidney disease, sleep apnoea, a hormone problem of the adrenal gland, certain medicines. The benefit of lowering it is well established and starts early: ten millimetres less already clearly reduces the risk of stroke.
Less salt lowers blood pressure — processed foods, bread and ready meals are the main sources.
A vegetable-, fruit- and potassium-rich diet (DASH) lowers blood pressure — potassium counters sodium.
Every kilo lost lowers blood pressure a little — one of the most effective levers when overweight.
Five minutes sitting, back supported, feet on the floor, arm at heart height, no talking. Measure twice a minute apart and note the second value. Morning and evening, for seven days.
Thirty minutes of brisk walking on most days lowers the upper value by about five to eight millimetres. Add strength training twice a week.
Regular alcohol raises the pressure measurably; less of it lowers it reliably. Six to eight hours of sleep count too — too short or broken drives the pressure up.
Lifestyle and medication do not exclude each other. Many need two drugs at a low dose rather than one at a high dose — that works better and is better tolerated.
High blood pressure and kidney weakness reinforce each other. Blood pressure that gets harder to control can come from the kidneys — filtration rate and urine protein settle it.
Blood pressure medicines act at different points: ACE inhibitors and sartans damp a hormone system that narrows vessels; calcium blockers relax the vessel muscle; diuretics flush out water. They lower the pressure for as long as they are taken — they do not rebuild the vessel wall. That is why salt, movement and weight keep working alongside.
About one adult in four has raised blood pressure, and from sixty-five roughly one in two. It does not hurt — so years often pass before it is measured. After a change in daily life the effect shows within four to twelve weeks.
The vast majority feel nothing — which is why it is found only by measuring. Contrary to its reputation, headache and nosebleeds are not reliable signs.
The white-coat effect is real and common. Conversely there is masked hypertension: normal in the surgery, too high in daily life. Only home measurement finds either.
Sleep apnoea drives the pressure especially at night and in the morning. Anyone not coming down despite several drugs should be asked about it.
That is the classic pointer to an adrenal hormone problem — in a young person with high pressure, a reason to look specifically.
Very high values together with chest pain, breathlessness, visual disturbance, weakness, confusion or a very severe headache belong in medical hands at once. A high reading alone, without symptoms, is not an emergency.
The nutrient with the best numbers for blood pressure: 3.5–4.7 g a day from food lowers the upper value by about 4–5 mmHg. With reduced kidney function and on certain blood pressure medicines the opposite applies — there too much potassium can become dangerous.
250–500 ml of beetroot juice a day lowers the upper value by about 4–5 mmHg in studies. The effect lasts while it is drunk and needs the bacteria in the mouth — antibacterial mouthwash cancels it.
300–500 mg a day over at least 3 months lowers the upper value by about 2 mmHg in the pooled studies. That is small, but it is reproducibly measured.
The one point that goes the wrong way here: real liquorice drives blood pressure up. From about 50 g of liquorice a day over two weeks the rise is measurable, and potassium falls with it. The DGL form without glycyrrhizin does not do this.
Endurance movement lowers the upper value by several mmHg — comparable to a low-dose medicine.
Less salt, more vegetables and potassium: the best-studied diet in high blood pressure.
Traditionally used as a heart remedy; in high blood pressure the effect is weak and the interaction with heart medicines matters.
Slow breathing over a few minutes measurably lowers the value — also studied as a daily exercise.
The classic heart plant; in high blood pressure the effect is weak and the interaction with heart medicines matters.
Traditionally used for high blood pressure; as a cold extract, because heating changes the substances.
In small studies blood pressure fell measurably during inhalation — and rose again afterwards. It relaxes for the duration of the application; it does not treat high blood pressure.
Here as a pointer the other way: rosemary counts as circulation-stimulating and is used sparingly with high blood pressure.
Ma huang contains ephedrine and drives blood pressure and pulse — restricted in many countries for that reason.
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