High Blood Pressure
Usually causes no symptoms but raises the risk of stroke, heart attack, kidney disease and dementia. In Australia, high blood pressure means a clinic reading of 140/90 or more, or a home average of 135/85 or more. Lowering it reduces these risks at any age.
Measuring at home. Use a validated upper-arm monitor, not a wrist one. For 7 days, sit quietly for 5 minutes with your back supported, feet flat and arm resting at heart level, then take 2 readings a minute apart, morning and evening. Measure before food, medicines or caffeine. Write them down for your GP.
Treatment options
Ratings show how strong the research is.
- Strong evidenceLess saltAim for less than 5 g of salt (about a teaspoon) a day. Choose low-salt foods and check labels. Lowers blood pressure by about 5 points.
- Strong evidenceHealthy eatingPlenty of vegetables, fruit, wholegrains, legumes, nuts and low-fat dairy (a "DASH" style diet). Can lower it by up to 10 points, about as much as one tablet.
- Strong evidenceRegular exerciseAt least 150 minutes of moderate activity a week, plus some strength work. Lowers it by about 4 to 8 points.
- Strong evidenceWeight lossIf you’re above a healthy weight, it drops by about 1 point for each kilo lost.
- Strong evidenceBlood pressure tabletsUsually an ACE inhibitor or ARB, a calcium channel blocker or a thiazide-type diuretic. Low doses of two together often work better than a high dose of one. Usually long-term.
- Moderate evidenceLess alcoholNo more than 10 standard drinks a week. Less is better.
- Not recommendedStopping tablets when readings are normalNormal readings usually mean the tablets are working. Talk to your GP first.
What you can do
- Check labels on pharmacy medicines: anti-inflammatories and decongestants can raise blood pressure.
- Don’t smoke, and go easy on energy drinks.
- Have a Heart Health Check with your GP from age 45 (30 for Aboriginal and Torres Strait Islander people).
See your GP if
- Your home average is 135/85 or more
- You feel dizzy or faint on standing while on blood pressure tablets
- You snore loudly and are tired during the day (sleep apnoea can raise blood pressure)
- You’re pregnant and your blood pressure is raised
Call 000 for chest pain, sudden weakness, numbness or trouble speaking, or a sudden severe headache. See a doctor the same day if your reading is 180/110 or higher.
Evidence and more information
- Heart Foundation: Blood pressure and your heart
- MJA: Australian hypertension guideline (2016)
- Australian Prescriber: Home monitoring of blood pressure
maladywise.com/blood-pressure/