Japanese scientists say a six-monthly vaccine could one day spell the end for daily tablets. But if you already have high blood pressure, that’s too long to wait

Blood pressure testing

Blood pressure monitoring could save you from a heart attack or stroke (c) iStock

High blood pressure (hypertension) affects at least 30% of us in the UK (and more than twice as many people after the age of 75), but many of us don’t realise we have it, as it rarely causes symptoms.

Yet, early diagnosis and effective treatment can protect our arteries and reduce our risk of developing serious cardiovascular disease (CVD), including heart attacks, strokes, kidney failure and poor circulation.

It can run in families, especially African/Caribbean families and be worsened by our lifestyle.

The causes aren’t fully understood, but one in 10 cases is ‘secondary’ – linked to other conditions, such as kidney disease, diabetes, hormone disorders, lupus, pregnancy or drugs, including the contraceptive pill, ibuprofen, herbal medicines, decongestants, and amphetamines.

What should my blood pressure be?

Your two BP numbers, for example 120/80, reflect the maximum and minimum pressure in your arteries between heartbeats. It’s measured using a cuff around your upper arm and a stethoscope or automatic machine.

You’ll need several readings during ‘normal activities’, so your doctor may lend you a machine for home monitoring (HBPM) or arrange ambulatory blood pressure monitoring (ABPM), an automatic cuff that takes repeated readings over 24 hours. HBPM and ABPM can also check whether treatment is working. Visit bpassoc.
org.uk for advice on buying your own monitor.

Stage 1 hypertension means your blood pressure is greater than 140/90 at the surgery (135/85 if you’re using a home monitor or ABPM). Stage 2 is greater than 160/100 (150/95), and severe hypertension is 180/110 or higher.

Other tests

These check for underlying/treatable causes and organ damage. Your doctor will examine, weigh and measure you, and look at the arteries at the back of your eye.

You’ll need blood and urine tests to see how your kidneys are working or whether you have diabetes (which worsens artery damage), an ECG (heart tracing), and perhaps a heart or kidney scan.

Your doctor will use your blood cholesterol level and other factors, such as your age, family history, lifestyle and whether you have diabetes, to work out your risk of having a heart attack or stroke in the next 10 years (for example, 15%).

You may need to see a specialist if secondary hypertension is suspected or readings are very high/difficult to control.


This is recommended if you’re under 80 years old, and have stage 1 hypertension as well as known CVD, diabetes, or a 10-year CVD risk greater than 20%.

Some doctors think stage 1 hypertension should be treated anyway, and treatment is always recommended for stage 2.

You may want to try lifestyle changes first. However, Israeli researchers recently said that even a few months’ delay in controlling blood pressure can increase the risk of a damaging or fatal heart attack or stroke.

Several groups of drugs will be used alone or together, depending on your age, ethnic group and any other medical conditions you might have; you may be offered a cholesterol-lowering statin, and you’ll need regular blood pressure and blood checks from now on.

5 Natural Ways To Help Blood Pressure

1 Maintain a healthy weight and eat a balanced, ‘rainbow’ diet, including your five a day and fruit and veg in a variety of colours.

2 Limit salt to 6g (a teaspoon) daily; read labels, avoid processed foods and don’t add
salt in cooking/at the table.

3 Exercise for 30 minutes, five times a week – this helps arteries and aids weight loss, too.

4 Stick to recommended alcohol limits (14-21 units weekly for women, 21-28 for men).

5 Smoking damages arteries, too. See nhs.uk/smokefree for advice on stopping.