3 SILENT KILLERS
About High Blood Pressure
High blood pressure, also known as hypertension, is usually defined as having a sustained blood pressure of 140/90mmHg or above.
The line between normal and raised blood pressure is not fixed and depends on your individual circumstances. However, most doctors agree that the ideal blood pressure for a physically healthy person is around 120/80mmHg.
A normal blood pressure reading is classed as less than 130/80mmHg.
The heart (blood pump)
The heart is a muscle that is designed to constantly pump blood around the body. It pumps blood that is low in oxygen towards the lungs, through the venous 'pipeline' (veins), where it receives a fresh supply of oxygen.
Once the blood is fully oxygenated, the heart pumps the oxygen-rich blood around the body so that the oxygen can be used by the body’s muscles and cells, through the arterial 'pipeline' (arteries).
How is blood pressure measured?
Blood pressure is defined as the amount of pressure that is exerted on the artery walls as blood moves through them. It is measured in millimetres of mercury, or mmHg.
A more detailed explanation is provided below.
Two measurements are used to measure blood pressure:
Systolic pressure - the measure of blood pressure exerted when your heart beats and forces blood around your body.
Diastolic pressure - the measure of blood pressure when your heart is resting in between beats.
Both the systolic and diastolic pressures are measured in millimetres of mercury (mmHg).
The figures are usually represented with the systolic pressure first, followed by the diastolic pressure. Therefore, if your GP says that your blood pressure is '120 over 80', or 120/80mmHg, they mean that you have a systolic pressure of 120mmHg and a diastolic pressure of 80mmHg.
Symptoms of high blood pressure
High blood pressure often causes no symptoms, or immediate problems.
The only way to find out whether you have high blood pressure is to have your blood pressure checked regularly. Ask your GP when you are next due for yours to be checked.
How common is high blood pressure?
High blood pressure is a common condition, it is estimated that 18% of adult men and 13% of adult women have high blood pressure but are not getting treatment for it.
In 90-95% of cases, there is no single identifiable reason for a rise in blood pressure. But all available evidence shows that lifestyle plays a significant role in regulating your blood pressure.
Risk factors for high blood pressure include:
age (the risk of developing high blood pressure increases with age. Half of people over 75 years have the condition.)
lack of exercise
excessive alcohol consumption.
Also, for reasons not fully understood, people of Afro-Caribbean and South Asian origin (Indian, Pakistani, and Bangladeshi) are more likely to develop high blood pressure than other ethnic groups.
What's the impact of having high blood pressure?
High blood pressure is a major risk factor for developing cardiovascular diseases such as:
coronary heart disease - where the main arteries that supply your heart (the coronary arteries) become clogged up with plaques (fatty deposits)
strokes- a serious condition where the blood supply to your brain is interrupted
heart attacks - a serious condition where the blood supply to part of your heart is blocked
Diabetes and kidney disease are also linked to high blood pressure complications.
Treatment and prevention of high blood pressure
High blood pressure can be managed or controlled by making changes to your lifestyle, such as:
eating a healthier diet
exercising more regularly
reducing the amount of alcohol that you drink.
Medication that can help you lower your blood pressure is also available.
Diabetes is a lifelong condition that causes a person's blood sugar level to become too high.
There are two main types of diabetes – type 1 diabetes and type 2 diabetes.
Type 2 diabetes is far more common than type 1.
By 2025, it is estimated that 5 million people will have diabetes in the UK.
Many more people have blood sugar levels above the normal range, but not high enough to be diagnosed as having diabetes.
This is sometimes known as prediabetes. If your blood sugar level is above the normal range, your risk of developing full-blown diabetes is increased.
It's very important for diabetes to be diagnosed as early as possible because it will get progressively worse if left untreated.
When to see a doctor
You should therefore visit your GP as soon as possible if you have symptoms, such as feeling thirsty, passing urine more often than usual, and feeling tired all the time.
Symptoms of diabetes
The main symptoms of diabetes are:
feeling very thirsty
urinating more frequently than usual, particularly at night
feeling very tired
weight loss and loss of muscle bulk
itching around the penis or vagina, or frequent episodes of thrush
cuts or wounds that heal slowly
Type 1 diabetes can develop quickly over weeks or even days.
Many people have type 2 diabetes for years without realising because the early symptoms tend to be general.
What causes diabetes?
The amount of sugar in the blood is controlled by a hormone called insulin, which is produced by the pancreas (a gland behind the stomach).
When food is digested and enters your bloodstream, insulin moves glucose out of the blood and into cells, where it's broken down to produce energy.
However, if you have diabetes, your body is unable to break down glucose into energy. This is because there's either not enough insulin to move the glucose, or the insulin produced doesn't work properly.
Type 1 diabetes
In type 1 diabetes, the body's immune system attacks and destroys the cells that produce insulin. As no insulin is produced, your glucose levels increase, which can seriously damage the body's organs.
Type 1 diabetes is often known as insulin-dependent diabetes. It's also sometimes known as juvenile diabetes or early-onset diabetes because it usually develops before the age of 40, often during the teenage years.
Type 1 diabetes is less common than type 2 diabetes. In the UK, it affects about 10% of all adults with diabetes.
If you're diagnosed with type 1 diabetes, you'll need insulin injections for the rest of your life.
You'll also need to pay close attention to certain aspects of your lifestyle and health to ensure your blood glucose levels stay balanced.
For example, you'll need to eat healthily and take regular exercise and carry out regular blood tests.
Type 2 diabetes
Type 2 diabetes is where the body doesn't produce enough insulin, or the body's cells don't react to insulin. This is known as insulin resistance.
If you're diagnosed with type 2 diabetes, you may be able to control your symptoms simply by eating a healthy diet, exercising regularly, and monitoring your blood glucose levels.
However, as type 2 diabetes is a progressive condition, you may eventually need medication, usually in the form of tablets.
Type 2 diabetes is often associated with obesity. Obesity-related diabetes is sometimes referred to as maturity-onset diabetes because it's more common in older people.
Diabetic eye screening
Everyone with diabetes aged 12 or over should be invited to have their eyes screened once a year.
If you have diabetes, your eyes are at risk from diabetic retinopathy, a condition that can lead to sight loss if it's not treated.
Screening, which involves a half-hour check to examine the back of the eyes, is a way of detecting the condition early so it can be treated more effectively.
Gestational diabetes (in pregnancy)
During pregnancy, some women have such high levels of blood glucose that their body is unable to produce enough insulin to absorb it all. This is known as gestational diabetes and affects up to 18 in 100 women during pregnancy.
Pregnancy can also make existing type 1 diabetes worse. Gestational diabetes can increase the risk of health problems developing in an unborn baby, so it's important to keep your blood glucose levels under control.
In most cases, gestational diabetes develops during the second trimester of pregnancy (weeks 14 to 26) and disappears after the baby is born.
However, women who have gestational diabetes are at an increased risk (30%) of developing type 2 diabetes later in life (compared with a 10% risk for the general population).
About Heart Attacks
Heart attacks are caused by atherosclerosis, which occurs in arteries around the body and is called cardiovascular disease. In heart disease, this is called coronary heart disease and is caused by the build-up of atheroma in the coronary arteries. This narrows the artery and causes a restricted blood flow. This process, known as atherosclerosis, can lead to angina and heart attacks
A heart attack (also known as myocardial infarction or MI) happens when the blood supply to your heart becomes completely blocked, either by the formation of a blood clot or by a loose piece of atheroma. This can result in damage to the part of your heart muscle, which that particular coronary artery was supplying.
Sometimes, when chest pain occurs suddenly, it is unclear if it is due to unstable angina or a heart attack. Until tests confirm the diagnosis, doctors sometimes call this Acute Coronary Syndrome (ACS).
Facts about heart attacks
Most people survive heart attacks and make a good recovery.
Your heart is one of the toughest muscles in your body – it's already healing itself.
Your heart hasn’t worn out – a heart attack is usually caused by a blockage in one small section of an artery.
Stress, shocks or surprises do not cause a heart attack.
It is normal to feel tired, weak and emotional after a heart attack – this will pass.
Many of the causes of heart attacks are under your control – it is never too late to reduce your risk of another heart attack.
The symptoms of a heart attack
chest pain - the pain is usually located in the centre of your chest and can feel like a sensation of pressure, tightness or squeezing
pain in other parts of the body - it can feel as if the pain is travelling from your chest to your arms (usually the left arm is affected but it can affect both arms), jaw, neck, back and abdomen
shortness of breath
an overwhelming sense of anxiety (similar to having a panic attack)
feeling light headed
Causes of a heart attack
Like all of the other tissues and organs in the body, the heart needs a constant supply of oxygen-rich blood to survive. If the blood supply to the heart is suddenly interrupted, the heart muscles may be damaged
Left untreated, the heart muscle will experience irreversible damage. Risk factors for heart attack relate to coronary heart disease (CHD) and its development.
There are certain things that increase your risk of developing coronary heart disease.
High blood pressure
High cholesterol level
When the cholesterol level in your blood is high, it contributes to the fatty build-up in the lining of your blood vessels, called atheroma, which increases your risk of heart disease and strokes.
Most doctors use risk assessment charts to help identify your risk in terms of how likely you are to develop heart or stroke problems in the future. Based on your other risk factors, your doctor will decide what cholesterol level is safe for you.
When you smoke, about 4,000 chemicals are released. These include at least 80 cancer-causing chemicals, hundreds of poisons and nicotine (a highly addictive drug). If you have a heart condition, smoking may make your symptoms worse.
Smoking makes the smooth lining of blood vessels rough. This encourages the build up of atheroma, the fatty material that narrows and blocks blood vessels.
Smoking increases the amount of fibrinogen (blood thickening agent) in the blood and makes it stickier. This increases the chance of blood clots forming that can cause heart attacks and strokes.
Smoking also increases blood pressure, speeds up the heart and increases the likelihood of heart disease, strokes and many cancers. It also damages the lungs, causing chronic lung disease.
The good news is that from the moment you stop smoking, the risks to your health start to decline.
Not getting enough exercise
Getting more exercise can:
increase your exercise tolerance which enables you to do more as you become fitter
help lower cholesterol levels
help lower high blood pressure
help you lose weight
keep you supple and more mobile
strengthen your muscles, joints and bones
reduce tension, encourage relaxation and promote sleep
give you a sense of wellbeing and confidence
help reduce anxiety and depression
Drinking too much alcohol
Some recreational drugs – like cocaine, amphetamines (speed) and ecstasy – can cause your blood pressure to rise.
Other risk factors
You may be one of the people who does not have any of these risk factors but still develops heart disease. You may have other genetic factors (that is, passed on through families) that may increase the likelihood of you developing coronary heart disease.
Rates of high blood pressure and diabetes are higher in people of African and Afro-Caribbean descent, which means that they also have an increase risk of CHD and heart attacks.