Most of us go about our daily lives not thinking about the inner workings of our circulatory system. We can sometimes be aware that we have a quickening heartbeat from exercise or when we are in stressful situations (the fight and flight response) but apart from that we don’t really give it a second thought.
Many of us visit our GP on an infrequent basis, the doctor hastily slips a cuff on our arm and you hear the drone of the machine whizzing into action whilst you desperately try to concentrate on keeping calm, saying to yourself in your head ‘please be low…please be low’ this unusual object is squeezing your arm tighter and tighter and you start to panic a little. Your pulse raises and you start to breathe more quickly. When the cuff is at its tightest you can hear your heart rate thudding in your ears. Eventually the cuff relinquishes its grasp on you, the tensions subsides to as a great sense of relief rushes over you. You then hear the doctor mutter a few words and numbers at you, mention something about reducing your caffeine or alcohol intake and you come out being none the wiser about what your blood pressure actually is or what it all means.
The intention in describing this scene is certainly not to put your off getting your blood pressure checked, in fact quite the opposite. It is merely to highlight that people often get quite anxious about having their blood pressure checked and don’t understand what those little blood pressure numbers mean and why should you be expected to? After all you are not a medical professional. With this I agree, but it is always good to have some understanding of what those numbers actually mean and how you can make positive steps towards maintain a healthy blood pressure.
Blood pressure is the measure of pressure exerted on your artery walls. It is measured in Millimetres of Mercury mmHg. You need some pressure to keep your blood moving and your blood pressure naturally fluctuates throughout the day but it’s a concern if it is consistently high even when resting. You might have heard high blood pressure referred to as Hypertension.
1 in 3 adults in the UK has high blood pressure and every day 350 people have a preventable stroke or heart attack caused by the condition. Blood pressure is often called the silent killer. Now that’s a cheery note to start on isn’t it. This is because unlike other diseases, when we have unusually high blood pressure it can often go undetected. Over 7 million people in the UK have high blood pressure and are not even aware of it. This means we are missing a vital warning sign from our body that there is a problem. What do we do about this, is our fate sealed then?
No of course not, the best thing to do is keep on top of having your blood pressure tested and understanding a bit more about what lifestyle factors can influence it.
There are multiple variables that influence your blood pressure and I would like you to ponder a while on my thoughts on this matter. A number of people that I have spoken to during my time carrying out health assessment have a very despondent attitude when they find out they do have high blood pressure. They often portray a feeling that nothing can be done about it and some like to suggest that it solely lies with their family history and genetic predisposition to high blood pressure which of course it may very well do!
However, I would like to take a more positive outlook and apply the theory of marginal gains that you may have heard from in relation to a sporting theory coined by the British Cycling team.
‘Marginal gains’ a theory that Dr Dave Brailsford applied to great success in the Olympics where if you can take a 1% improvement from each element you can achieve a significant aggregates improvement in performance. This resulted in multiple gold medals for the British team at the Olympics in 2012 and also back to back Tour De France champions! Now imagine the possibilities if you can apply that theory to your own health and wellbeing. If you start chipping away at small lifestyle changes that can add up to a great improvement in your overall health and work towards many of the variables that can improve your blood pressure mentioned in this blog. You would start to see a massive return on this investment in terms of your overall health and quality of life.
When our HSW team have delivered health checks and our blood pressure checks as part of the Know Your Numbers Campaign run by Blood Pressure UK for council staff we have picked up on a number of people with high blood pressure that were unaware of it. After seeing us they visited their GP who put them on medication to reduce it and were super thankful that it had been discovered and something could be done about it. This is why it is so important to raise awareness about blood pressure and get it checked regularly.
Also included in this blog is a case study from one of our very own Occupational health nurses Mark Newton-Livens who talks about his experiences being diagnosed with hypertension and highlights the importance of getting your blood pressure checked.
If you want to find out more about blood pressure, how to have it checked, what small changes you can make to your lifestyle and what support there is out there for helping you make those changes then read on!
Know Your Numbers: What is considered high blood pressure?
The top number on your blood pressure reading is called systolic pressure and is a measure of the pressure exerted on your arteries when the heart pumps blood around the body. The bottom number is known as your diastolic pressure and is a measure of the pressure exerted on the arteries when your heart is at rest between your heart beats. Overall this gives you 2 numbers!
- Ideal Blood pressure = 120/80mmHg or below
- High Blood pressure (Hypertension)= 140/90mmHg or above
What variables affect blood pressure?
There are multiple variables that can affect blood pressure. Some variables are fixed like our age or genetics, but the good news is that a lot of the variables can be controlled through small achievable lifestyle changes.
- Age: The older you get the higher the risk
- Ethnicity: African or Caribbean heritage can increase your risk of hypertension
- Family history:Having one or more family relative with high blood pressure before the age of 60 can increase your risk twofold.
- Activity/sedentary levels: Increasing physical activity levels and reducing sedentary behaviours can help reduce the risk of high blood pressure and mainta
in healthy blood pressure.
- Salt intake: High levels of salt in diet can cause your kidneys to work overtime to remove fluids and can result in increased blood pressure. Some people are more sensitive to salt than others and it can have more adverse effects on blood pressure than others.
- Alcohol intake: Can cause short term spikes in blood pressure but chronic binging drinking can also result in long term spikes that damage your circulatory system.
- Smoking: Causes your arteries to narrow and can inhibit flow of blood.
- Body Weight: Being overweight can increase the likelihood of high blood pressure.
- Sleep levels: Long term sleep deprivation or a sleep condition can increase blood pressure.
- Medical history: 1 in 20 cases of high blood pressure as a result of a long term health condition such as kidney disease, diabetes, thyroid problems and lupus.
- Medication: Some medications such as the contraceptive pill, steroids, ibuprofen and other types can increase blood pressure. Consult your doctor if you have any worries or problems.
- Stress levels: Stress alone can’t cause circulatory problems but is linked to habits that increase your risk such as drinking more alcohol, overindulging, not sleeping, smoking etc
What are the lesser known symptoms of high blood pressure?
- Blurred vision or blood shot eyes
- Nose Bleeds
- Shortness of breath
- Chest Pain
IMPORTANT: IF YOU EXPERIENCE ANY OF THESE SYMPTOMS VISIT YOUR GP OR HEALTHCARE PROVIDED STRAIGHT AWAY!!
High Blood Pressure (Hypertension) and its impact on our body:
Many cardiovascular diseases, like heart attacks and strokes are caused by the formation of obstructive blood clots in inconvenient places. When you have high blood pressure for long periods of time this can cause previously stretchy elastic artery walls to become stiff and narrow. This causes fatty deposits to build up and in arteries get damaged and clogged this can result in a heart attack or a blockage to brain causing a stroke. High blood pressure can cause a chain reaction of chronic effects on your body such as those listed below.
- High blood pressure is one of the biggest causes of renal failure and kidney disease.
- Lead to coronary heart disease, heart attacks and strokes
- Vision loss
- Increase risk of developing other chronic diseases such as Diabetes: Recent research carried out by the University of Oxford and the UK National Institute for Health Research showed that you were 50% more likely to develop diabetes type 2 if you have high blood pressure. Research is still looking into whether hypertension is risk factor for diabetes or a cause and effect relationship.
Top 8 Lifestyle Tips to reduce the likelihood of high blood pressure
- Drink LESS alcohol
- Drink MORE water
- Quit Smoking
- Exercise MORE: Note consult doctor If you already have high blood pressure
- Reduce your salt intake
- Manage your stress levels and sleep better
- Control your caffeine intake
- Lose weight
A Case Study Mark Newton-Livens (Occupational Health Advisor) in our HSW team: Living with Hypertension
Hi All, my name is Mark and this is my story about my blood pressure (hypertension) which I hope, will make you think about yours.
I am a 60year old Caucasian man. I say this as unfortunately ethnicity does increase the risk of high blood pressure in certain ethnic groups according to BHF and other sources.
Approximately 7 years ago I underwent a scan of my chest as the left side muscle was slightly enlarged compared to the right, the GP sent me to the Breast Clinic which was a bit embarrassing to exclude any form of breast conditions including cancer, as men can also develop breast cancer although relatively rare.
Fortunately, the scan was clear, but they also scanned my heart at the same time. The result was that they identified that the left ventricle of my heart was slightly enlarged, most likely due to undetected and untreated high blood pressure. This is the part of the heart that pumps the arterial blood around our bodies so does the most work.
As a result, I was commenced on medication and given lifestyle advice, re exercise diet, weight and alcohol all factors which can have a bearing on blood pressure.
Also, I have a strong family history of hypertension (high blood pressure), my father died aged 64 related to hypertension and high cholesterol and my mother had hypertension and a heart attack in her 70’s. (sadly also passed)
I now take anti-hypertensive medication to lower my blood pressure and statins to reduce the risk from too much Cholesterol as both these increase the risk of strokes and heart attacks.
My diet is reasonable, I exercise by swimming and will be going back to spinning classes when open. I am a little overweight and I do drink alcohol but limit that and only 3-4 times a week.
The lesson here is that we are affected by our family genes, environment but also by our own choices and when we are younger we believe we are indestructible and only worry about health issues later in life but if we take care of ourselves throughout our lives we are likely to live a healthier and longer life.
High blood pressure is an easily detected and treatable condition.
Healthy Eating for Blood pressure:
What you eat and drink can have a profound effect on your internal organs and your blood vessels. Your diet can directly affect your blood pressure and generally the healthier your diet is the lower your blood pressure. If you already have blood pressure problems or take medication for high blood pressure a healthy diet can help the effectiveness of the medication or reduce the amount of medication you need.
The main things to concentrate on in your diet are lowering the amount of salt, eating more fruit and vegetables and starchy wholegrains, drinking less alcohol and caffeine and reducing saturated fats and sugars.
- Eat more Fruit & Vegetables: These are naturally high in Potassium which can counteract sodium levels in blood and help lower blood pressure. Fruit and vegetables contain high levels of antioxidants that can help prevent heart disease. Best to eat freshly cooked, steamed or raw veg to maximise the nutrient quality but tinned and frozen is still better than nothing.
- Starchy wholegrain foods: Introduce more wholegrain options such as brown bread, pasta and rice, beans and pulses to your diet.
- Lowering your alcohol intake: Can dramatically help to maintain a health blood pressure and a healthy weight. Small changes like having drink free days, reducing your glass sizes and alcohol-free swaps can help with this. Visit Drinkaware Website for info on how to cut down and for drinks calculators.
- Lowering the levels of salt in your diet: A very easy way to help reduce your blood pressure. Remember salt is already in a lot of the ordinary products we buy and eat such as biscuits, bread and cereal. You should try and shop for lower salt foods and home make meals where you have more control over salt levels. Try using herbs and spices like garlic, ginger and chilli instead of salt to your cooking and avoid products that are known to be high in salt when eating out such as pizzas, cheese, pasta sauces, salad dressings etc. Visit the NHS website for more information and recipe tips and tricks to avoid salt.
- Drink less caffeine: When I used to work for Bupa doing health assessment for bankers in high powered job in London often their blood pressure would be through the roof. I would enquire as to how many cups of coffee they had, and they would nonchalantly tell me they have not that many maybe ‘10 a day’ and they wondered why their blood pressure was so high. Drinking more than 4 cups of coffee a day can cause your blood pressure to spike. Remember that if you are buying from a coffee shop or chain they often contain even higher amounts of caffeine then your home made one and keep an eye on energy or fizzy drinks that contain high amounts of caffeine and sugar. Try swapping one of your coffees or teas for a decaffeinated option or replace one of your usual coffees or teas with a glass of water.
- Cut down on saturated fats and sugars: Reducing food items with high amounts of saturated fats and sugars and swapping to more unsaturated fats found in things like avocado, plant oils, nuts and seed and oily fish can help to reduce bad cholesterol levels and reduce the chance of fats building up in your arteries. This will contribute to reducing your risk of hypertension as well as strokes and heart disease.
10 food groups that pack a punch & help lower blood pressure!
- Leafy Greens: Greens such as Romain lettuce, Kale, Spinach and Chard are rich sources of potassium they can help your kidney remove excess sodium. Tip: you could choose fresh or frozen green veg to whip up a healthy green smoothie!
- Berries: Certain berries such as blueberries and raspberries contain flavonoids that have been show in research to lower blood pressure. Tip: Add a handful to a smoothie or on your cereal or yoghurt as a snack or breakfast.
- Beetroot: source of nitrates than can widen blood vessels and lower blood pressure. Tip: eat as a whole beetroot ins salads or stir-fry’s or juice.
- Oats: high fibre low fat option and provides sustained slow release energy. Tip: try overnight oats with some added berries homemade granola and cinnamon or enjoy a bowl of porridge or you could combine oats and bananas to make tasty hearty pancakes!
- Bananas: Natural source of potassium Tip: add to a piece of wholemeal toast if you fancy something sweet to keep you going or enjoy as a lovely addition to a dessert.
- Unsalted Nuts & Seeds: Pistachios and sunflower seeds and other are high in potassium and magnesium that can help lower blood pressure. Tip: sprinkle on cereal, salads, eat a handful as midday snack!
- Dark Chocolate: Studies have found consuming dark chocolate is associated with a lower risk of coronary heart disease (CHD). Tip: grate some dark chocolate onto fruit puddings, it works very well with berries! Alternatively, you could treat yourself to a couple of blocks.
- Garlic: Contains antiinflammation properties that promote vasodilation (widening of arteries and vessels) and help prevent blood clotting. Tip: Add fresh garlic or garlic paste and herbs to your meals as an easy and tasty swap to usual seasoning of salt!
- Oily Fish: Mackerel, Sardines and other fishes containing high amounts of Omega 3 &6 Fatty acids that can help lower blood pressure, reduce inflammation and lower cholesterol. Tip: Fresh fish is always best, try placing a fillet of fish on parchment paper and season with herbs, lemons and olive oil and bake in the over. Tins such as those tinned in sunflower oil can also be a good addition to a meal if you can’t get hold of fresh fish and can be enjoyed as an on the go snack with some salad!
- Beans, Legumes and pulses: This food group including foods like lentils, chickpeas, kidney beans, peas etc rich in fibre, folate phytochemicals than can help prevent Cardiovascular disease. They are also excellent source of protein! Tip: Watch out for tinned bean products from supermarkets that contain high levels of salt. Find low salt options of baked beans for example or you will be undoing all your good work!
Take a look at the EATWELL guide for general guidance on what is considered a healthy diet and have a read of Eating healthy and blood pressure guide produced by blood pressure UK.
Physical activity to reduce blood pressure:
Research shows that being sedentary can increase mortality rates and increase your risk of high blood pressure. Exercise helps combat this and although exercise causes a momentary spike in blood pressure it overall has a positive impact on your heart health and blood pressure. Moderate intensity exercise of at least 15O mins a week and reducing your sitting time can help. Aerobic exercise helps improve circulation, reduces your resting heart rate and helps strengthen your heart muscle. Please not that if you have been diagnosed with high blood pressure and on medication you should always consult your doctor before starting a new exercise programme. Exercise can be enjoyed safely even if you do have high blood pressure. Take a look at Blood pressure UK’s information on what activity to try to help reduce blood pressure. You can also get inspiration on how to get fitter with the Better Health Campaign on the NHS website or check out how to improve your fitness from home with Our Parks Couch to Fitness Programme online . You should never stop taking blood pressure medication and use exercise as a substitute if you have been put on medication by your GP. Always consult your GP or a medical professional first.
Know Your Numbers Campaign 2020
Know Your Numbers Campaign is taking place 7th-13th September this year. Blood Pressure UK who run the campaign are doing it with a twist this year and instead of in person testing which unfortunately is not possible, they are encouraging home blood pressure monitoring and being healthy at home this year. The theme for 2020 is: 'You are in control'. This year, we want everyone to Know Their Numbers! You can register to take part today and get access to resources and the campaign toolkit. For 2020 The aim is to:
- encourage the nation to use a simple and reliable blood pressure monitor to measure their blood pressure at home
- take the necessary steps if their reading is considered high
- raise awareness about the risks of high blood pressure.
Signposting links and further resources:
Healthy Eating and Blood pressure online guide
Stress and Circulatory Disease BHF booklet
Healthy Lifestyle and Blood Pressure online guide