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Dr Diana R Holdright
MD, FRCP, FESC, FACC, MBBS, DA, BSc

Consultant Cardiologist

Dr Diana Holdright
 
 

Cardiac Conditions - Hypertension

High blood pressure (hypertension) is a very common condition, affecting 30 to 40% of all adults in the UK, and around 70% of people over 70 years of age.  There is a direct relationship between the incidence of coronary artery disease and stroke and high blood pressure readings; it is estimated that between 25 and 50% of coronary artery disease cases and 75% of stroke cases are due to raised blood pressure, and high blood pressure doubles a patient’s risk of a heart attack. Both the top reading (systolic) and bottom reading (diastolic) are important; for adults aged between 40 and 69 years every 20 mmHg increase in systolic or 10 mmHg increase in diastolic blood pressure doubles the risk of death from coronary artery disease. 

The latest British Hypertension Society guidelines* define normal blood pressure as <130/<85 mmHg. Optimal blood pressure level is now classified as <120/<80 mmHg, and people with high-normal blood pressures (130-139/85-89 mmHg) should be reassessed on an annual basis. Drug treatment should be considered for individuals with blood pressures of 140/90 mmHg or higher; for people on antihypertensive therapy targets are <140/<85 mmHg (<130/<85 mmHg in people with diabetes).

Blood pressure can be lowered by lifestyle changes and drug therapy.  In most patients there are aspects of lifestyle that can be improved to lower blood pressure, such as weight loss, an increase in physical activity, and a reduction in salt and alcohol intake.  There are also several different types of medicine which can lower blood pressure (antihypertensives); typically more than one drug is required to bring the blood pressure to within recommended limits, and treatment is generally lifelong.

* Bryan Williams, Neil R Poulter, Morris J Brown, Mark Davis, Gordon T McInnes, John F Potter, Peter S Sever, Simon McG Thom; the BHS guidelines working party, for the British Hypertension Society. Guidelines for hypertension management 2004 (BHS-IV): Summary

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