Blood pressure - we ALL have it !

[Doc Alan]

It’s been some time since my original thread on this topic ( now closed ).


The systolic pressure is a measure of the force at which your heart pumps blood around the body ; diastolic pressure ( lower number ) is a measure of resistance to blood flow in your arteries. Averages around the world are ~127/79 mmHg for men, and ~122/77 mmHg for women.



Raised blood pressure / hypertension is the major risk factor for cardiovascular diseases and chronic kidney disease. One in eight deaths worldwide are due to hypertension, because of its effects on heart and kidneys and the increased chance of a stroke. Blood pressure is " continuously distributed " - meaning there’s no sudden " cut off point " above which there is hypertension. However, usually hypertension requiring treatment is taken to be 140/90 mmHg or higher.



I have a longstanding interest in hypertension, and much has changed over the past 40 years.


Numbers of adults globally with hypertension in 1975 was ~600 million ; by 2015 it had increased to ~1.13 billion - around a fifth of women and a quarter of men. It was commonly thought of as a disease of affluence - but the data says otherwise. Most of the increase in these four decades has been in low- middle income countries, largely driven by the growth and ageing of the population. Best estimates for its frequency in the Philippines show it to be ~20% and increasing each year. For the UK it’s now ~25%.


Of course the only way to find out if you have hypertension is to have your blood pressure checked. Hypertension itself doesn’t usually have symptoms, until it’s complicated by something like heart disease or a stroke. This is why a proportion of hypertensive people don’t know they have the condition. Once every 5 years is usually suggested.



Surprisingly in most cases we ( still ) don’t know the cause(s) of hypertension. It’s called " essential ", and only in a small proportion is there a ( treatable ) cause such as kidney or adrenal gland disease. This is despite a huge amount of research, some of which was done while I worked in Glasgow, at the MRC Blood Pressure Unit. We honestly thought in those days we would find the cause(s) of hypertension !


We DO know risk factors which make hypertension more likely. These include increasing age, which we obviously can’t control ; diabetes, and the " usual " culprits of unhealthy lifestyle ( such as lack of exercise, being overweight, smoking, diets including too much salt and alcohol and not enough fruit and vegetables ). Other factors may include early-life nutrition, and other air pollution.


There are also now many more medicines for reducing high blood pressure than 40 years ago. These are of several different types, based on our improved understanding of the factors involved in causing hypertension. At least eight varieties of medicines affect various biochemical systems.


" NHS Choices " gives a good account of high blood pressure and its treatment - see link.


A detailed study looking at hypertension around the world and how it has changed is in this link.


For the Philippines, see here ; South-East Asia, see here.

[Steve.r]

Nice update Alan, well worth the read. Thanks

[Arthur Little]

Thanks, Alan for your latest update on an extremely IMPORTANT
topic, which - as you've pointed out - affects us ALL.

Because I'm diabetic, my own blood pressure's monitored on a regular basis. And it has to be said, I am very fortunate, in that, almost invariably, the health professionals treating me remark on how *good mine is for someone of my years - *this in spite of my mother needing to take tablets for HBP from the age of 48 ... up until her passing at eighty-four.

Perhaps, as I say, I've just been lucky in that respect. Who knows? But then ... ... at the same time, I'm well aware there're far too many others for whom hypertension remains a very real problem! So once again,

[Doc Alan]

Thanks, Alan for your latest update on an extremely IMPORTANT
topic, which - as you've pointed out - affects us ALL.

Arthur is sadly missed. I was lucky to meet him and his wife Myrna in a "Forum meeting" at Scarborough a few years ago.

A recent study in "The Lancet" of worldwide trends in hypertension claimed that the number of people aged 30-79 with hypertension doubled from 1990 to 2019 ( https://www.thelancet.com/action/sho...2821%2901330-1 ).

Around a third of adults worldwide are thought to have hypertension, with a decrease in high income countries and an increase in other countries such as the Philippines ( almost 2/5 in 2021, see https://www.gmanetwork.com/news/news...in-2021/story/ ).

An estimated 8.5 million worldwide deaths / year from complications of hypertension could be reduced through better control of blood pressure.

There are often NO symptoms, and they're not specific even if present :-
*headaches
*dizziness
*blurred vision
*nosebleeds
*shortness of breath
*chest pain

The only way of knowing you have hypertension is to have a blood pressure test. While this may be done at GP surgeries, pharmacies or work places, it may be more convenient to check blood pressure at home. Monitors are cheap, from around £20 in the UK.

"Lifestyle changes" ( healthy diet with reduced salt, exercise, no smoking or excess alcohol ) may help prevent and lower high blood pressure.

One or more blood pressure medicines may also be needed to keep blood pressure under control.

[grahamw48]

At my Covid jab sessions, here in the Phils a couple of months ago, my BP was 110/80, which I suppose wasn't bad for a bloke of 70.

I did stop smoking in July 2014 though.

It's my abdominal aortic aneurysm I have to keep an eye on now.