What is high blood pressure?
Blood pressure is the force of blood pushing against the walls of your arteries. It is written as two numbers, such as 120/80. The top number (systolic) is the pressure when the heart beats; the bottom number (diastolic) is the pressure when the heart rests between beats.
When readings stay at or above 140/90 on repeated checks, doctors call it hypertension. Readings between normal and this level are an early warning. Over years, high pressure stiffens and damages blood vessels, raising the risk of heart attack, stroke, kidney failure and eye damage. High BP is common in Indian adults, and many do not know they have it.
High blood pressure: causes and risk factors
In most adults there is no single cause; it develops slowly due to genes, age and lifestyle. This is called primary hypertension. In a smaller group, another problem such as kidney disease, thyroid or hormone disorders, sleep apnoea or certain medicines is the cause. This is more likely when BP is very high at a young age.
Some medicines can also raise BP. These include regular use of painkillers like ibuprofen or diclofenac, some cold and cough medicines that contain decongestants, steroids and certain hormone pills. Always tell your doctor or pharmacist that you have high BP before taking any new medicine.
- Too much salt: pickles, papad, chips, namkeen, processed and restaurant food
- Being overweight, especially around the belly
- Little physical activity
- Smoking, chewing tobacco and alcohol
- Stress and poor sleep
- Diabetes, high cholesterol or kidney disease
- Family history and older age
Symptoms of high blood pressure
Most people with high BP feel perfectly well. Headache, dizziness or nosebleeds are not reliable signs, and waiting for symptoms is dangerous. Very high BP can cause severe headache, blurred vision, chest pain, breathlessness or confusion, which needs urgent care. The only way to know your BP is to measure it. Every adult should get it checked at least once a year, and more often if at risk.
Pregnant women need BP checks at every antenatal visit, because high BP in pregnancy can harm both mother and baby. Children and teenagers who are overweight or have kidney problems may also need checks. Many chemists and clinics offer a quick BP reading, which makes regular monitoring easy.
How BP is measured correctly
Sit quietly for five minutes with your back supported and feet flat. Rest your arm at heart level and use the right cuff size. Do not talk during the reading, and avoid tea, coffee, smoking or exercise for 30 minutes before. Take two readings a minute apart.
A single high reading does not mean you have hypertension; doctors confirm it over several visits or with home readings. A validated digital upper-arm machine is useful at home. Write down your readings with the date and time and bring them to your doctor. Wrist machines and old or uncalibrated devices can give misleading numbers.
How high blood pressure is treated
Lifestyle changes are the first step for everyone, and they also help medicines work better. Many people also need medicines. BP medicines are taken only on a doctor's prescription and are usually lifelong. Never stop them when readings become normal; normal readings usually mean the medicine is working. Missing doses often is a common reason BP stays high.
Doctors often combine two BP medicines when one is not enough, sometimes in a single tablet. The choice depends on your age, kidney function, diabetes, heart health and whether you are pregnant or planning pregnancy, since some BP medicines are not safe in pregnancy. Tell your doctor about any painkillers or other medicines you take, as some raise BP.
Daily habits that lower BP
Cut down on salt: use less while cooking, keep the salt shaker off the table, and limit pickles, papad and packaged snacks. Eat more vegetables, fruits, dal and low-fat curd. Walk briskly or cycle for 30 minutes on most days. Lose weight if you are overweight, stop tobacco in every form and avoid alcohol.
Take your medicines at the same time each day and keep a small stock so you never run out. Check your BP regularly and keep follow-up visits, including yearly kidney and cholesterol tests. If you notice side effects such as ankle swelling, dizziness or a dry cough, speak to your doctor or pharmacist rather than stopping the medicine.
Medicines doctors commonly use
Only your doctor can decide which medicine, dose and combination is right for you.
- ACE inhibitors or ARBs such as ramipril or telmisartanRelax blood vessels and protect the kidneys, especially useful in diabetes.Not safe in pregnancy; your doctor will check kidney function and potassium.
- Calcium channel blockers such as amlodipineRelax the muscles of the blood vessel walls to lower pressure.Can cause ankle swelling; tell your doctor rather than stopping it.
- Thiazide-type diuretics such as chlorthalidone or hydrochlorothiazideHelp the kidneys remove extra salt and water.May affect sodium, potassium and uric acid levels, so blood tests are needed.
- Beta blockers such as metoprolol or bisoprololSlow the heart rate and are often used when there is also heart disease.Never stop suddenly; use with care in asthma.
See a doctor urgently if
- BP reading very high (for example 180/120 or above) with severe headache, chest pain, breathlessness or confusion
- Sudden weakness or numbness of the face, arm or leg, slurred speech or drooping face
- Sudden loss or blurring of vision
- High BP during pregnancy with headache, swelling of face or hands, or pain under the ribs
- Fainting or severe dizziness after starting a new BP medicine
Tests that may help
This article is general health information, not medical advice. Do not start, stop or combine medicines on your own — always follow your doctor's prescription and ask your pharmacist if unsure.