What is it?
Pressure is exerted by the heart contracting against the resistance of the smaller blood vessels. The peak pressure as the heart contracts is called the systolic blood pressure and the lower pressure when the heart relaxes is called the diastolic blood pressure. Thus, two measures are recorded. A typical pressure in a young man might be 120/80mmHg.

Blood pressure readings always have two numbers, one number on top of the other, for example 140/90.
The top number is your systolic blood pressure. (The highest pressure when your heart beats and pushes the blood round your body). The bottom number is your diastolic blood pressure(The lowest pressure when your heart relaxes between beats).

Both the systolic and diastolic pressure measurements are important - if either one is raised, it means you have high blood pressure (hypertension).

Blood pressure is important because high blood pressure is a risk factor for strokes and heart attacks. A 10mm rise in diastolic blood pressure is associated with approximately doubling the risk of stroke and a 50% increase in the risk of a heart attack. This is not as alarming as it may seem at first sight. If the risk of a heart attack or stroke is very low, as it is in young people without other risk factors such as high cholesterol or regular smoking, borderline blood pressure elevation dose not pose a significant threat. As individuals become older, however, or when these other risk factors are present, slightly elevated blood pressure presents a much greater risk. Blood pressure is not, therefore, treated in isolation.

There is no single value of blood pressure for healthy individuals since blood pressure changes with age and differs in the two sexes. Blood pressure normally gradually rises with age, so that the level at which your blood pressure will be considered high will change as you get older. The average blood pressure considered to be normal is 120/80 yet can reach 140/90 before being classed as special attention. There is however, a wide spread of values on each side of these but higher blood pressures may need treatment.

Categories for Blood Pressure Levels in Adults (in mmHg, or millimeters of mercury)

Category Systolic (top number) Diastolic (bottom number)
Normal Less than 120 And Less than 80
Prehypertension 120–139 Or 80–89
High blood pressure(hypertension)
Stage 1 140–159 Or 90–99
Stage 2 160 or higher Or 100 or higher

The ranges in the table apply to most adults (aged 18 and older) who don’t have short-term serious illnesses.

All levels above 120/80 mmHg raise your risk, and the risk grows as blood pressure levels rise. “Prehypertension” means you’re likely to end up with HBP, unless you take steps to prevent it.

If you’re being treated for HBP and have repeat readings in the normal range, your blood pressure is under control. However, you still have the condition. You should see your doctor and stay on treatment to keep you blood pressure under control.

Your systolic and diastolic numbers may not be in the same blood pressure category. In this case, the more severe category is the one you’re in. For example, if your systolic number is 160 and your diastolic number is 80, you have stage 2 HBP. If your systolic number is 120 and your diastolic number is 95, you have stage 1 HBP.

Preventing high blood pressure
Blood pressure is a characteristic of the individual, although one which can vary quite markedly on different occasions. Like height and weight it is the product of a mixture of factors. Inheritance is important and some patients with high blood pressure have a parent or sibling who has also suffered from elevated blood pressure, although this may not always be known by the individual.

More specifically, reducing stress, taking exercise and moderating your diet, particularly salt and alcohol, all contribute to lowering blood pressure.

There is an extremely wide choice of drugs which lower blood pressure, and effective control of blood pressure without unacceptable side effects is now possible in almost every patient. Except in patients at high risk, the accepted practice is to recommend ‘lifestyle’ changes and observe blood pressure over a period of several months.

Hypotension
Hypotension is usually associated with blood pressure that’s lower than 90/60 mmHg.

Your body is very sensitive to changes in blood pressure. Special cells in the arteries can sense if your blood pressure begins to rise or fall. When this happens, the cells trigger your body to try to bring blood pressure back to normal.

For example, if you stand up quickly, your blood pressure may drop. The cells will sense the drop and will quickly take action to make sure that blood continues to flow to your brain, kidneys, and other important organs.

Most forms of hypotension happen because your body can’t bring blood pressure back to normal or can’t do it fast enough.

Some people have low blood pressure all of the time. They have no signs or symptoms, and their low blood pressure is normal for them. In other people, certain conditions or factors cause blood pressure to drop below normal.

Hypotension is a medical concern only if it causes signs or symptoms, such as dizziness, fainting, or, in extreme cases, shock.

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Your resting metabolic rate (RMR) is the number of calories your body burns if you did absolutley nothing all day, i.e. lie down for 24 hours. It’s basically the energy used to keep your essential body functions ticking over and accounts to 60-75% of your total daily energy expenditure!

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Your Health

The idea of health is something black and white, you are either ill or well, is an out dated notion. Most people nowadays know that there are times when they feel ‘just fine’ and there are days when they feel ‘really well’. The difference usually has nothing to do with a doctor and far more to do with how they look after themselves, whether they are well rested, eating well and so on.

The concept of all of us being responsible for looking after our health on an ongoing basis makes a lot of sense. Wearing ourselves out with too much of this, to little of that, work, relaxation, food, exercise and the rest and then rushing off to the doctor to sort us out, is, to some extent , shutting the gate after the horse has bolted. We can all be much fitter and healthier if we take a proactive approach to our own health by leading healthier lifestyles, getting regular check ups and taking part in health assessment programmes designed to detect health problems at an early stage, before they are serious and when there’s still time to do something about them.

Taking care of yourself doesn’t mean never seeing a doctor, or seeking the advice of other health professionals. It is important to report any physical illness to your GP for treatment. Before starting on any exercise or weight loss programme it is suggested that you discuss this with him/her and ensure that there are no particular health reasons that would put you at risk.

Heart Disease

Heart disease is a major cause of disability in this country and is the single most common cause of death in men and women.

What is it?
The heart is a powerful muscular pump and the action of the heart muscle depends on its own supply of blood from the coronary arteries. The left and right coronary arteries provide essential oxygen to the heart muscle. The lining of these arteries is perfectly smooth at birth, but the development of the disease process called atheroma, which initially takes the form of a fatty streak on the lining of the coronary artery, leads to the development of symptoms of heart disease, either angina or heart attack.

As the coronary arteries get narrower with atheroma so the blood supply to the heart muscle is gradually reduced. When people exert themselves physically under these circumstances the heart’s muscle’s demand for oxygen cannot be met and this produces pain in the chest, the classical symptom of angina pectoris. There are now effective treatments for angina including drugs and surgery, which can relieve symptoms and increase life expectancy.

When someone has a heart attack the atheroma lining in the blood vessel wall ruptures and releases fat into the coronary artery, which can result in a blood clot completely blocking the blood supply to one part of the heart muscle. This causes severe chest pain and is a medical emergency requiring urgent admission to hospital.

This next section concentrates on the factors known to be associated with heart attacks. It tells you what these are, why you should take heart disease seriously, how it is detected and what you can do to change these risk factors.

Who is at risk?
Coronary heart disease causes approximately one in four deaths in men and one in five deaths in women. In women cardiovascular disease causes twice as many deaths as cancer.

What causes heart disease?
The way we live, the way our body works (which is partly the result of our lifestyle) and our family inheritance are the most important causes of this disease.

Lifestyle risk factors include:

• Smoking
Smoking dramatically increases your risk of developing heart disease. The greater the number of cigarettes smoked and the more years you have smoked, the greater the risk of developing heart disease.

• Diet
Eating too many foods rich in saturated fats, too few foods high in un-saturated fats, and too little fresh vegetables and fruit, increases your risk of developing heart disease.

• Physical exercise
Taking little or no physical exercise increases your risk of developing heart disease.

• Stress
Although it is more difficult to assess, too much stress in your life may increase your risk of developing coronary heart disease.

Other risk factors include:

• Family history
A family history of premature (before the age of 55 years) in a blood relative (e.g. a parent, brother or sister) increases your own risk of developing this disease. Whilst this may partly reflect the genetic inheritance, it can also be due to the social environment of families where a common lifestyle can pre-dispose to coronary disease.

• Blood pressure, blood cholesterol and blood glucose
These factors are all essential to the normal working of our bodies but the higher your blood pressure, the higher your blood cholesterol and the higher your blood glucose, so the risk of developing heart disease increases. Our diet and the amount of physical exercise we take can influence blood pressure, cholesterol and glucose levels.

Preventing heart disease
Reducing your risk of heart disease can mean making quite radical lifestyle changes and it may not be possible for you to attempt to make too many changes all at once. Work out a strategy for yourself which allows you to take in one step at a time and gradually introduce other changes as you feel confident to do so.

• Stop smoking cigarettes
Stopping smoking reduces the risk of coronary heart disease and other disease as well, and this benefit is quickly apparent. It is possible to return to the risk level of a life long non-smoker, although it may take several years. There are numerous tapes, books and videos available to help you quit. Try stopping with a friend or join a group.

• Take up regular exercise
Including exercise into your daily routine will not only reduce the risk of developing coronary heart disease, you will start to feel less tired, less stressed and more energised. It will take your mind off smoking if you are trying to stop and help you to shed pounds if you need to lose weight.

• Avoid diabetes
A high blood glucose increases your risk of heart disease. Risk factors for diabetes include family history and being overweight. Try to keep your weight under control.

• Learn to de-stress
Important for your well-being generally, de-stressing should be an important part of your daily routine and may help in the prevention of coronary heart disease. Again there are numerous books, tapes and videos available on how to deal with stress which you can use at home.

• Blood cholesterol
Your GP will advise whether you blood cholesterol should be lowered and if this cannot be achieved by lifestyle changes (losing weight, reducing saturated fat and increasing the consumption of polyunsaturated fats) then drug therapy may be required.

• Keep your blood pressure down
In susceptible people, salt, excessive alcohol consumption and being overweight can make your blood pressure go up. Some people just develop high blood pressure for other reasons.

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