High blood pressure: the condition you cannot feel

Blood pressure is the force of blood against the walls of your arteries. When it stays high over time, it quietly damages blood vessels and strains the heart, kidneys, eyes and brain. Most people have no symptoms at all until damage has been done.

Understanding the numbers

A reading has two numbers: the pressure when the heart beats, over the pressure when it rests. A single high reading does not mean you have hypertension. Diagnosis is based on repeated measurements, sometimes with readings taken at home, because a clinic visit itself can raise blood pressure.

What raises your risk

• Family history
• Excess weight, particularly around the waist
• A diet high in salt and processed foods
• Low physical activity
• Smoking and heavy alcohol use
• Long-term stress and poor sleep
• Some conditions, including kidney disease and diabetes

Changes that genuinely lower blood pressure

• Reduce salt. Most salt comes from cooking and from processed foods, seasonings and stock cubes rather than the table.
• Eat more vegetables, fruit and whole grains, and less fried and processed food.
• Move regularly. Brisk walking on most days has a measurable effect.
• Lose some weight if you carry extra. Even a modest reduction helps.
• Limit alcohol and stop smoking.
• Sleep. Untreated sleep problems, including heavy snoring with pauses in breathing, can keep blood pressure high.

About medicines

Many people need medication as well as lifestyle changes. Blood pressure medicines work while you take them, which is why treatment is usually long-term. Feeling well is a sign the treatment is working, not a reason to stop. If side effects bother you, there are several classes of medicine and alternatives can usually be found.

Checking at home

If you monitor at home, sit quietly for five minutes first, keep your back supported and feet flat, rest your arm at heart level, and do not take a reading straight after coffee, tea, smoking or exercise. Record readings with the date and time and bring them to appointments.

Seek urgent care for

• A very high reading with chest pain, breathlessness or severe headache
• Weakness or numbness on one side of the body, difficulty speaking, or sudden visual loss, which may indicate a stroke
• Confusion, vomiting or seizures
• In pregnancy: headache, visual changes or swelling with a raised reading, which needs same-day assessment

Staying on track

Hypertension care works best as a routine: regular reviews, repeat prescriptions ordered before you run out, and a care team who can see your readings over time rather than one isolated measurement.