Heart health
High blood pressure has no symptoms. That’s the problem.
It causes no headache, no dizziness and no warning. It is found on a quiet Tuesday in a GP room, in someone who came in about something else entirely.
The short version
- High blood pressure usually causes no symptoms at all. The only way to know is to have it measured.
- One high reading is not a diagnosis. Home readings over a week or two are more reliable than a single measurement in a clinic.
- It is one of the largest contributors to stroke, heart attack and kidney disease — and one of the most treatable.
- Lifestyle changes genuinely work. Medication is added when they are not enough, not as a failure.
Blood pressure is the force of blood pushing against the walls of your arteries. When it stays high over years, it quietly damages the vessels and the organs they supply — the brain, the heart, the kidneys and the eyes.
The difficulty is that it does this without producing any sensation whatsoever. People often assume they would feel it. Almost nobody does.
What the numbers mean
A reading has two figures. The top one is the pressure as the heart beats; the bottom one is the pressure between beats. Broadly:
- Below 120/80 — normal.
- 120–139 over 80–89 — higher than ideal, worth watching and worth addressing with lifestyle.
- 140/90 or above, confirmed on more than one occasion — high blood pressure, and worth treating.
Those thresholds are a guide rather than a verdict. What your GP does about a given number depends on your overall cardiovascular risk — your age, cholesterol, smoking, diabetes and family history taken together — rather than on the reading in isolation.
Why one reading is not enough
Blood pressure moves constantly. It is higher when you are stressed, in pain, having just hurried in from the car park, or sitting in a clinic room with a cuff on your arm. That last one is common enough to have a name: white coat hypertension.
This is why your GP will usually ask you to take readings at home over a week or two before deciding anything. A fortnight of home readings tells them considerably more than any single measurement here.
Taking a home reading properly: sit quietly for five minutes first, feet flat on the floor, back supported, arm resting at heart height. No caffeine or exercise in the half hour before. Take two readings a minute apart, morning and evening, and write down all of them — not just the good ones.
What actually lowers it
These are not token gestures. Each has a measurable effect, and together they are often enough:
- Salt. Most of it comes from processed food, bread and takeaway rather than the shaker. Reducing it lowers blood pressure in most people.
- Movement. Around thirty minutes most days. A walk counts. Around here, the beach and the foreshore make that easier than most places.
- Weight. Even a modest loss makes a measurable difference.
- Alcohol. One of the more reliable levers, and one of the least discussed.
- Smoking. Stopping helps cardiovascular risk enormously, and we can help with it.
- Sleep. Untreated sleep apnoea is a genuinely common and reversible cause of blood pressure that will not come down.
About medication
If lifestyle changes are not enough, medication is added. That is not a failure on anyone's part — blood pressure has a large genetic component, and plenty of people doing everything right still need treatment.
There are several classes of medicine and they suit different people. If one causes a side effect, say so rather than quietly stopping it. There is almost always an alternative, and a medicine you are not actually taking is doing nothing for you.
When to have it checked
Most adults should have blood pressure checked at least every two years, and more often if it has been borderline, if you are over 50, or if you have other risk factors. It takes a minute and it is done at almost any appointment if you ask.
If you are between 45 and 49, you may be eligible for a bulk billed health assessment that covers cardiovascular risk properly. From 75, there is an annual health assessment. Both are considerably more thorough than a standard appointment, and both are under-used.
Call 000 for chest pain, sudden severe headache, sudden weakness or numbness on one side, difficulty speaking, or vision loss. These are emergencies regardless of what your blood pressure has been doing.
Questions we get asked
How often should I have my blood pressure checked?
At least every two years for most adults, and more often if it has been borderline, if you are over 50, or if you have other risk factors. It takes a minute and can be done at almost any appointment.
Should I buy a home blood pressure monitor?
If your GP has asked you to track it, yes — an upper-arm monitor rather than a wrist one. Bring it to your next appointment and we can check it against ours.
Will I be on medication for life?
Not necessarily. Where blood pressure has been driven by weight, alcohol, salt or untreated sleep apnoea, addressing those can sometimes allow medication to be reduced or stopped. That is a decision to make with your GP rather than on your own.
General information only. This article is general health information for people in the Port Stephens area. It is not advice about your individual situation and it does not replace a consultation with a doctor. If you are worried about a symptom, book an appointment or call us on (02) 4008 4400. In an emergency, call 000.
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