Hypertension, or high blood pressure, is often described as a silent killer. It’s thought that more than a quarter of adults in the UK – around 16 million people – have the condition, but in most cases there are no symptoms. Around a third of people with hypertension are not aware they have it.
As we age, our chances of having hypertension increase, which is why it’s important to have regular blood pressure checks – and to take action if it is above normal.
What are the effects of high blood pressure?
Hypertension can cause coronary heart disease, strokes, kidney disease and even contribute to dementia. Tens of thousands of people die every year from these diseases, which is why it’s important to get a medical diagnosis and take appropriate action and medication.
How can we reduce high blood pressure?
For around 90% of people with hypertension, there is no particular reason why they have the condition. For the other 10%, most have an underlying cause such as problems with the kidneys or adrenal glands.
In some cases, lifestyle changes such as improvements to diet or increasing exercise can help, for example, a programme of cardio-vascular intensity training or resistance training under the advice of a qualified professional personal trainer or fitness instructor.
However, a GP will recommend treatment with drugs for high blood pressure if the readings are particularly high, if the likelihood of developing cardiovascular disease in the next 10 years is above 20% or if the patient has diabetes, kidney disease, cardiovascular disease or damage to the blood vessels in the heart, brain, kidneys or eyes.
What drugs are recommended to treat high blood pressure?
There are five main groups of drugs prescribed for hypertension:
- ACE inhibitors
- Angiotensin II receptor blockers
- Calcium-channel blockers
- Alpha-blockers or Beta-Blockers
ACE (angiotensin-converting enzyme) inhibitors
Common names: enalapril, lisinopril, perindopril, ramipril
Suitable for: any age and any background apart from those of black African or Caribbean heritage
Angiotensin II receptor blockers (ARB)
Common names: candesartan, irbesartan, losartan, valsartan
Suitable for: those unable to take ACE inhibitors
Common names: amlodipine, felodipine, nifedipine
Suitable for: people over 55, people of black African or Caribbean heritage
Common names: chlortalidone, indapamide, bendroflumethiazide
Suitable for: those who need three or four drugs to reduce blood pressure levels; those unable to take calcium-channel blockers because of fluid retention or high risk of heart problems
Alpha-blockers or Beta-Blockers
Common names: doxazosin, prazosin (Alpha); atenolol, bisoprolol (Beta)
Suitable for: less commonly used than the drugs listed above, these are for people unable to take other drugs.