My GP has diagnosed me with high blood pressure (hypertension). I read that this could increase my risk of developing cardiovascular disease or strokes. I’m a forty-year-old woman who is in otherwise good health. Could you please advise if this is correct and what treatment options are available?
Dr Klaus Witte, Consultant Cardiologist, Spire Leeds Hospital
High blood pressure (hypertension) is a leading cause of cardiovascular disease often presenting as angina, heart attacks, or strokes, and problems with the arteries of the legs. Other risk factors for developing these conditions include high cholesterol, diabetes, smoking and a family history of such events. The chances of developing cardiovascular disease multiply as the number of risk factors increase.
Hypertension contributes to the development of cardiovascular disease by increasing the work of the heart and increasing the stress on the arteries and is more common as people get older. In most people hypertension has no clear cause although your General Practitioner or consultant might do tests to rule out anaemia, kidney dysfunction, hormonal imbalances, and rare abnormalities of the aorta (the main artery of the body) and kidney arteries. These tests are more likely to identify a specific cause in younger patients and can help direct treatment.
Careful management of hypertension is clearly associated with a reduced risk of developing cardiovascular disease. Although many people will end up on life-long tablets, there are important and easy first steps that people can take to lower their blood pressure. Simple changes in lifestyle: increasing exercise, losing weight and stopping smoking are the most important ways to control blood pressure and overall risk of cardiovascular disease. For many people however, tablets are required. Modern blood pressure pills are well tolerated, with few side effects and work effectively. Combining tablets with lifestyle changes is often the best way to optimise blood pressure.
My advice is to check that the high blood pressure is not due to a specific problem, and whether it has already damaged your heart or kidneys. Then I would discuss with you the benefits of undertaking regular exercise, losing weight, stopping smoking and limiting your alcohol intake and organise a review at three months. If your blood pressure remains high, we would need to start thinking about tablet treatment. The ultimate aim is to prevent (or delay) manifestations of cardiovascular disease such as heart attacks and strokes.