Hypertension

Also known as: Mate pēhanga toto, High blood pressure

• Hypertension is another name for high blood pressure.
• Blood pressure measures the force with which the heart pumps blood around the body. Hypertension is what we call it when the force of the blood against the artery walls is consistently too high.
• Everyone’s blood pressure will fluctuate throughout the day, going up and down with their activity and brief periods of elevated blood pressure are completely normal. Hypertension is when the average blood pressure is consistently too high over a long period of time. Because of this hypertension is diagnosed over many blood pressure readings, usually over the course of a few months. A single high blood pressure reading doesn’t necessarily mean you have hypertension.
• Millimetres of mercury (mmHg) is the unit of measurement used to record blood pressure. The measurement consists of two parts:
• Systolic pressure – the peak blood pressure when your heart beats.
• Diastolic pressure – the blood pressure when your heart is resting between beats (and fills with blood).
• Your blood pressure is recorded as the combination of these two measurements: systolic blood pressure/diastolic blood pressure (e.g. 120/80)

The normal diastolic pressure is usually between 70–80 mmHg.

• A blood pressure that is consistently elevated above 140/90mmHg or higher is usually considered to be hypertension.
• Hypertension is very common affecting about 1 in 5 New Zealanders.
• You cannot ‘feel’ high blood pressure. Usually, those people who have hypertension will be unaware of it until they get tested by a doctor, nurse or pharmacist.

Prolonged hypertension damages your blood vessels, which can lead to complications like:

• Heart attacks
• Strokes
• Angina
• Heart failure
• Kidney failure
• Impaired eyesight
• Peripheral artery disease
• Erectile dysfunction
• Often, high blood pressure can be managed with lifestyle changes, but medication may be necessary to bring blood pressure down.

• Lifestyle is one of the main causes of hypertension, specifically high salt and alcohol intake, lack of exercise and being overweight.
• Smoking, having high cholesterol and eating a lot of saturated fats can also make hypertension worse.
• Kidney disease can sometimes lead to high blood pressure.
• Having a family history of high blood pressure (e.g. your Mum or Dad having high blood pressure) is also a risk factor.
• Every adult should have your blood pressure checked regularly. The age you are advised to start having heart and diabetes checks depends on your age, ethnicity and other risk factors.
• People assigned male at birth over 45 years old.
• People assigned female at birth over 55 years old.
• Māori, Pasifika and South Asian people assigned male at birth over 30 years old.
• Māori, Pasifika and South Asian people assigned female at birth over 40 years old.

• Usually, there won’t be any symptoms of hypertension, so most GPs will check your blood pressure when they see you just in case.
• They may also do a heart risk assessment based on factors such as your age, sex, ethnicity, cholesterol levels, smoking history, blood pressure and family history.

• High blood pressure is often managed with lifestyle changes, however, some people may need medication.

Medication

There are many medications that can help to lower blood pressure including:

• Beta-blockers
• Diuretics
• Calcium channel blockers
• ARBs
• ACE inhibitors
• Often those who need to take blood pressure medication will have to take it for the rest of their life. They may also need a combination of different types.
• People who have hypertension are more at risk of developing heart disease or having a stroke. To minimise this risk, they may also be prescribed aspirin or cholesterol-lowering medications.

Proactive protection

• Smokers are more at risk of having a heart attack or a stroke, so the best proactive prevention is to quit.
• Nutrition, weight management and physical activity play a big role in preventing high blood pressure. Exercising for 30–60 minutes most days is a good way to stay in shape and prevent hypertension.
• Limit your alcohol, salt and saturated fat intake.
• Eat whole grains, lots of vegetables and fruit (around 8 servings a day) and 2–3 servings of low-fat dairy products.
• Actively work on reducing your stress levels.  

Nutritional requirements

• A balanced diet
• Low salt intake
• Limited saturated fats

You should be getting regular blood pressure tests if you belong to one of the groups that are more prone to hypertension.

You should also be getting regular checks if:

• You or people in your family have diabetes, high cholesterol, heart conditions or have had strokes
• Have gestational diabetes
• Are prediabetic
• Have kidney disease
• Have a serious mental illness, such as major depressive disorder, bipolar or schizophrenia
• Smoke
• Are overweight

Which specialist should I visit?

• Nutritionist

• How long hypertension lasts depends on the cause of it. Some people whose high blood pressure is caused by lifestyle factors may be able to get it under control in a few months if they make lifestyle changes (e.g. by losing weight). Others who have more severe or other underlying issues may have hypertension for the rest of their life.