High blood pressure without symptoms

Raised blood pressure does not hurt or tire you for many years. Headache, a flushed face or nosebleeds are not reliable signs, and many people with markedly raised values feel perfectly well. The only way to find out is to measure it.

Meanwhile the damage builds up quietly. Constantly higher pressure puts strain on the heart, blood vessels, kidneys and eyes, and the consequences only show years later – not as a raised number, but as heart failure, stroke or kidney damage. Often there is no warning in between. This silence is exactly why blood pressure is measured in people without symptoms too, and why the measurement is part of every preventive check-up.

Home measurement is useful if it is done consistently. For half an hour before measuring, do not drink coffee, smoke or exercise, and empty your bladder. Sit quietly for five minutes, with your back supported and your feet on the floor, without crossing your legs. Place the cuff on your bare upper arm at heart level and do not talk during the measurement.

The cuff must fit the circumference of your upper arm. One that is too small shows values that are too high, and this is one of the most common mistakes in home measurement. Devices with an upper-arm cuff are generally more reliable than wrist devices.

Measure twice in a row, with a minute’s pause, and write down both values. Repeat the measurement in the morning before your medicines and in the evening, for seven days in a row. A single high reading does not mean much, but the average of such a week tells you a good deal. The first day’s readings are usually left out of the assessment, as they tend to be the highest. Bring the record with you to the appointment, together with a list of your medicines and doses.

What you can do most yourself is eat less salt, move more, keep a healthy body weight, drink less alcohol, stop smoking and not sleep chronically too little. Most salt is hidden in bread, meat products and ready meals, not in the salt cellar on the table. For some people this is enough, for others it is not, and that is not a question of willpower. Do not stop medicines you already take on your own, even when your values are good; they are often good precisely because of them.

The cardiology clinic at the centre is self-pay and you do not need a referral for it. An assessment of the cardiovascular system with an ECG and a heart ultrasound makes sense if your blood pressure fluctuates despite medicines, if you feel pressure in the chest on exertion, if your ankles swell, or if someone in your close family developed heart disease at a young age. Long-term management of blood pressure stays with your personal doctor, so give them the report.

If you have pain or strong pressure in the chest that lasts more than a few minutes and spreads to the arm, neck or jaw, sudden weakness on one side of the body or difficulty speaking, or a sudden severe headache with vomiting or disturbed vision, call 112. Measuring your blood pressure at such a moment changes nothing.