2.1 Hypertension review

Put simply, blood pressure is the pressure of blood in your arteries  – the vessels that carry your blood from your heart to your brain and the rest of your body. You need a certain amount of pressure to get the blood round your body.

The pressure of the blood flowing through your arteries changes as your heart beats. The pressure in your arteries will be at its highest when your heart is contracting and pumping blood around your body and lowest as it relaxes while it fills with blood before pumping again

High blood pressure – or hypertension – means that your blood pressure is consistently higher than the recommended level. High blood pressure is not usually something that you can feel or notice, but over time if it is not treated, your heart may become enlarged making your heart pump less effectively.  This can lead to heart failure.

Having high blood pressure increases your chance of having a heart attack or stroke.

There isn’t always an explanation for the cause of high blood pressure, but these can play a part:

• not doing enough physical activity 
• being overweight or obese
• having too much salt in your diet
• regularly drinking too much alcohol or
• having a family history of high blood pressure.

Even if you don’t have high blood pressure, making some simple lifestyle changes may help prevent you developing it in the future

Your doctor or nurse will take your blood pressure. If your blood pressure is 140/90mmHg or higher you will probably have to have this rechecked several times.

Everyone’s blood pressure varies during the day. Some people have a condition known as ‘white coat hypertension’ or ‘white coat syndrome’. This is a condition where your blood pressure rises only because someone is taking your blood pressure, and not because you have an underlying medical problem.

If you have white coat hypertension, your blood pressure will return to normal when your doctor or nurse stops taking it. It can be very difficult to diagnose and this is why you may need to have your blood pressure rechecked several times, or you may be sent home with a 24 hour blood pressure monitor.

Every blood pressure reading consists of two numbers or measurements. They are shown as one number on top of the other and measured in mmHg, which means millimetres of mercury.  If your reading is 120/80mmHg, you might hear your doctor or nurse saying your blood pressure is “120 over 80”.

The first (or top) number represents the highest level your blood pressure reaches when your heart contracts and pumps blood through your arteries – your systolic blood pressure. An example might be 130mmHg.

The second (or bottom) number represents the lowest level your blood pressure reaches as your heart relaxes between beats – your diastolic blood pressure. An example might be 75mmHg.

Patients can have different blood pressure targets depending on their other health conditions and general well being. For example patients who are generally well and are at low risk of heart disease and stroke with no other health conditions may have a target of 140/90 mmHg. A patient with severe kidney disease and diabetes may have a much lower target of 120/80 mm Hg. Your health professional should have discussed your personalized target with you. If you are unsure what your target is please contact the surgery and we can send this to you.

Yes sometimes people on blood pressure tablets can find that their blood pressure becomes too low. Generally we would consider a blood pressure less than 100/60 to be too low however sometimes patients can have symptoms of low blood pressure with readings higher than this. It is important to see your health care professional promptly if you think that your blood pressure is low. Symptoms of low blood pressure might include

Light headedness feeling like you are going to faint. often worse when standing from a seated position

There are a number of other causes of low blood pressure beyond a side effect of medications some of which can be very serious. It is therefore important to contact the surgery urgently if you are unwell as your responses to this online form will not be looked at urgently.

If you have a home blood pressure monitor you can use this to record your reading. You can purchase these from most pharmacies or alternatively source online. Alternatively you can visit our health check room at the surgery and ask to use our machine. You could also check your weight at the same time if you do not have scales at home.

thrive.nel is a new social prescribing service available to anyone in North East Lincolnshire aged between 18 and 75, diagnosed with one or more of the following long-term health conditions:

• Asthma
• Atrial Fibrillation
• Chronic Heart Disease
• COPD
• Diabetes Type 1 and 2
• Epilepsy
• Fibromyalgia
• Hypertension
• Osteoarthritis
• Osteoporosis

Working alongside your GP, thrive.nel’s Link Workers can help explore what is important for your life, your health and your wellbeing by identifying local activities and services that you could benefit from.

An experienced Link Worker will spend time getting to know you on a confidential, one-to-one basis. Link Workers are practical and helpful and will not judge you. If you decide thrive.nel is right for you, your Link Worker will work with you to help you decide what you’d like to do to improve your health, wellbeing and independence.

Your Link Worker has experience of working in communities and will take time to find activities that are right for you. We understand that its’ not always easy doing things differently on your own and your Link Worker will be right there to support you along the way.

You might for example want to get a bit more active, learn new skills, eat more healthily, find or rediscover a hobby or simply get better connected with other people and your community. Your social prescription is personal to you and you will receive ongoing support for up to two years to help you meet your goals.

Here are a few examples of the kind of activities and support your Link Worker can help you connect with:

• Support with money management
• Getting more active
• Access to gym, walking clubs & keep fit classes
• Weight loss advice
• Stopping smoking advice
• Dietary advice
• Gardening and growing
• Social clubs and activities
• Community learning
• Help with welfare benefits, debt, housing

Some of the benefits could include:

• Improved fitness
• Better mobility
• Reduced anxiety levels
• Learning new skills
• Reduced isolation and loneliness
• Lasting friendships
• Reducing reliance on medication
• Overall better health and wellbeing