Blood pressure is the force of blood pushing against the walls of arteries as the heart pumps it around the body, but what happens when it is higher than it should be? Paula Reeves reports
While most people have heard of high blood pressure many do not know what the causes are, what effect it has and the dangers it can bring.
Blood pressure is the force of blood on the walls of blood vessels that circulate around the body and pass through the heart. It is also referred to as arterial pressure or vascular pressure and readings are divided into two types; systolic, when the heart contracts; and diastolic, when the heart is filling.
The more blood the heart pumps and the narrower the arteries, the higher the blood pressure.
The symptoms of high blood pressure are not obvious and most people would not know they were at risk unless they had it checked. Symptoms include headaches, dizziness, nausea and blurred vision. If left undetected it can cause major organ damage and even death.
Organs affected include the heart, by failure or heart attack; and the brain; by stroke or transient ischemic attack. The kidneys may also be affected, potentially leading to renal failure, along with the eyes, which may lead to loss of vision.
If high blood pressure is undetected or left untreated it can result in a condition known as malignant hypertension. This may not show any symptoms but causes progressive damage to the major organs and blood vessels and will normally result in emergency hospital treatment.
A number of factors can cause high blood pressure, with 90% of cases resulting from someone's lifestyle choices or an unknown cause known as primary hypertension.
To help prevent the onset of high blood pressure people should:
- Look after their weight;
- Increase the amount of exercise they do;
- Reduce the amount of alcohol they drink;
- Reduce the amount of salt they consume;
Factors that can contribute to the cause of high blood pressure include:
- Age;
- Family history;
- Gender;
- Race.
For the remaining 10% of diagnoses, some form of disease is the cause of high blood pressure. This is called secondary hypertension. Common causes include kidney disease, thyroid dysfunction and some tumours. Pregnancy or use of birth control pills can also increase risk. When the cause is found and treated, blood pressure usually returns to normal.
Other end of the scale
As well as high blood pressure, people may not be aware that they can also have low blood pressure, hypotension.
This is normally associated with a physiological state rather than a disease. There are normally no symptoms, but signs may include light-headedness after urinating or defecating, or when changing position from lying to being vertical. The causes can be due to neurological conditions such as a stroke, shock or simple fright. Bleeding, infections, dehydration, prolonged bed rest, poisoning, toxic shock syndrome and reactions to blood transfusions can also cause low blood pressure. Only a small proportion of people have low blood pressure and, in past cases it has meant people live longer.
The first recorded blood pressure reading was taken from a horse in 1733. Readings were originally taken using a sphygmomanometer which used mercury, instead of today's equipment which is digital. With both versions, a cuff will be placed around the patient's arm or wrist which inflates with air until it is tight. A reading can be recorded by monitoring the effects on the pulse as the air pressure is released.
Older mercury sphygmomanometers required a stethoscope to listen to sounds of the heart. The mercury will start and finish at certain points on the scale giving a blood pressure reading. Digital sphygmomanometers do not require a stethoscope and give an automatic reading. Due to advances in technology, home blood pressure reading kits are now widely available in many shops.
Blood pressure is measured with two readings that are written as 120/80mmhg and are said as '120 over 80'. The systolic reading can range from 90 to 250 and the diastolic between 60 to 140.
Normal blood pressure is taken from the average reading for people living in the UK. A normal reading is 120 over 80 and high blood pressure is roughly 140 over 90. At this point treatment would be advised, as a lifestyle change, medical treatment, or both.
The Yamomamo Indians who live in the tropical jungle of Venezuela still lead the same lifestyle that all humans led up to 1,000 years ago, with a diet consisting of fruit, vegetables and roots and only small amounts of meat. By comparison, they have an average blood pressure of 96/62 mmhg which does not increase with age.
Of the 1.6 million people in the UK who know they have high blood pressure, only 10% have their blood pressure controlled to target levels. Failure to control it results in 62,000 unnecessary deaths every year. If everyone with high blood pressure lowered it to 140/90, their lives would be saved.
Did you know?
Up to the age of 64, there are higher rates of men with high blood pressure than women. Although the risks of getting high blood pressure increase with age, it can still affect young people. Some 5.2% of women aged between 25 and 34 years old have high blood pressure and the majority of that will be untreated. Some 11.3% of women aged between 35 to 44 years old have high blood pressure. Of those, 9% have untreated hypertension.
Another common cause for increases in blood pressure is salt intake. Men are greater users of salt than women with 24% of men and 15% of women adding salt to their food without tasting it first. Strangely enough, eating too much liquorice can also be a cause of high blood pressure.
The lower the blood pressure the better. With blood pressure at a normal level, people are healthier, have lower risk of heart disease and other organ problems and may even live longer. So when considering going on that diet (leaving out the liquorice) and getting into shape for the summer, think about the extra incentive of having healthy blood pressure.
- Paula Reeves is underwriting support at Aegon Scottish Equitable
Sources: www.bpassoc.org.uk; www.emedicinehealth.com
UNDERWRITING IMPLICATIONS
Insurance companies were the first to realise that blood pressure levels affect length of life. High blood pressure is one of the most common underwriting issues. Underwriters will always ask if a person has any issues regarding blood pressure and will investigate medical histories; the cause of high blood pressure; type of medication and length of time it is taken for; and the steps taken to improve health and lower blood pressure. Some common questions to arise could include:
- How old were you when diagnosed with high blood pressure?
- Do you take medication for high blood pressure? If yes, what do you take and what dosage?
- How long have you been taking blood pressure medication?
- Is your blood pressure controlled on the medication?
- Have you taken positive steps to improve your blood pressure?
- Do you smoke?
- Have you had any heart problems?
Each insurance company has its own set of underwriting guidelines and different rules depending on the answers given. However, those diagnosed with high blood pressure, as long as it is well controlled through either lifestyle changes or medication and with no complications should find that companies can generally offer their best rates.
Individuals with less well-controlled hypertension may still be offered terms,though these can be substandard resulting in an increase in premiums.
