There are many fascinating aspects to my job, and as any GPwill tell you, one is that we never know for certain what our next patient isgoing to want to talk about on any given day. Patients also ask a whole rangeof questions that can be very predictable or entirely unexpected, attracting awhole range of answers. ‘I’m in terrible pain and the painkillers you gave melast month were great, can I have some more please?’ Yes, absolutely you can.‘I’ve had this cough for 3 days, can I have some antibiotics?’ Maybe.  ‘My central heating is broken and I need aweek off so the plumber can fix it, but I don’t have any annual leave left sowork said I will need to take it as sick leave, so please can I have a sicknote?’ Umm, no.  That may sound heartlessbut it would actually be illegal and could end my career, and yes that reallyhappened.

One of the most common, which I hear at least once everyworking day is ‘And while I’m here please could you check my blood pressure?’Of course I can. High blood pressure or hypertension causes a great deal ofconcern in the UK today, and deservedly so. We have very high rates of heart disease and strokes in this country,and high blood pressure is a major contributor to these. And you guessed it, beingoverweight is a major cause of high blood pressure, so if you are on a Fit ForLife Forever journey and have high blood pressure then one of the benefits youcan expect as you begin to achieve your weight loss goals is that your bloodpressure should start to reduce, possibly even to normal.

So what is high blood pressure? Essentially it means havinga blood pressure which is higher than 140/85 according to the BritishHypertension Society. And the causes? Yes, it can run in families, but that isnot a reason to just sit back and accept your fate, there is much that can bedone. Other causes include the following

Drugs, including prescription orover the counter medication

Being overweight –see?

Drinking excessive alcohol, more than 21 units per week formen and 14 units for women

Stress – need I say more!

Too much salt in the diet

Lack of exercise

Other rare medical conditions – an assessment with yourdoctor will tell you whether you have these

What about the symptoms? Well, there are a whole range ofsymptoms attributed to hypertension but often there are no symptoms at all. TheBritish Hypertension Society recommends that everyone aged 45 or over shouldhave their blood pressure checked every 5 years regardless of symptoms. If youare in that age group and you think it has been more than five years since yourlast check then a visit to the practice nurse could be in order. For therecord, the symptoms of high blood pressure can be any combination – or none atall – of the following:

Long term headache

Dizziness or vertigo

Nausea

Blurred or double vision

Drowsiness

Shortness of breath

Palpitations

Fatigue

Nosebleeds

Tinnitus (ringing in the ears)

If you are one of the millions of people in this countrywith high blood pressure then help is at hand! The good news is that a greatdeal of this is self help. Lifestyle changes to lower your own blood pressureinclude-

Maintain a normal body weight –continue your Fit For Life Forever plan!

Reduce salt intake to no morethan 6g daily

Reduce alcohol intake to within recommended limits, seeabove

Undertake aerobic exercise (e.g. brisk walking) for 30minutes several times a week

Reduce stress if you arestressed

Eat the ‘DASH’ diet (Dietary Approaches to StopHypertension), that is plenty of fruit/veg, wholegrains, fish and olive oil.Google ‘DASH diet’ for more information

Also, stop smoking. It is unlikely to bring your blood pressure down but it is another causeof heart disease and stroke, so if you have hypertension then it makes sense tominimise all your other risks of suffering from these conditions.

If the above list looks at all familiar, it is because it isa recipe for minimising several other conditions such as many cancers anddiabetes, so is worth doing even if your blood pressure is normal. If  you have done all of this and your bloodpressure is still high then your doctor will probably want to start you onmedication and monitor your blood pressure regularly, but it is not my place toadvise about that, please consult with them!

If you do not think that you have hypertension but haveconcerns about any of this then it may be worth calling in to see your practicenurse for an MOT, your blood pressure will probably be normal and then you canjust get on with your life. And don’t worry. It will only put your bloodpressure up.....