Sometimes known as the “silent killer”, high blood pressure is the biggest risk factor for death globally. Each year, it claims more than 10 million lives through conditions like heart disease and strokes, as well as increasing the risk of kidney disease, peripheral arterial disease and vascular dementia.
“Any increase in your blood pressure puts more pressure on your circulatory system, which circulates blood from your heart all around your body,” explains Joanne Whitmore, senior cardiac nurse at the British Heart Foundation (BHF). That pressure can cause damage to your blood vessels, and this can have an impact on your blood supply to any part of the body – but particularly your heart and brain, she adds.
During the Covid-19 pandemic, nearly half a million people in England, Scotland and Wales missed out on starting drugs to lower their blood pressure, putting thousands at risk of heart attack or stroke, according to new research published by the BHF and University of Liverpool.
Researchers examined records for 1.32 billion medications dispensed between 2018 and 2021c, and found 491,306 fewer people than expected started taking blood pressure-lowering medication between March 2020 and July 2021. If this high blood pressure remains untreated, it could lead to over 2,000 heart attacks and 3,000 strokes.
The problem is, high blood pressure (also known as hypertension) doesn’t really have any symptoms. If your blood pressure is very high you might experience things like headaches and dizziness, but equally you may not be aware your blood pressure is an issue until it’s too late, like after a stroke or a heart attack.
Fortunately, there are simple things most of us can do to try and keep our blood pressure in check. One recent small-scale study found that, for office workers, getting up and taking a five-minute stroll every 30 minutes could help to lower your blood pressure, undoing some of the harm done by our increasingly sedentary lifestyles.
It’s just one of several lifestyle tweaks that can make a difference, as experts from charities Blood Pressure UK, the British Heart Foundation and the Stroke Association explain.
Know your numbers
First thing’s first, Whitmore says it’s important to know your numbers – whether that’s by getting your blood pressure checked by your practice nurse or GP, or by testing it yourself. Home blood pressure monitors are now available to buy for around £20, and charity Blood Pressure UK recommends choosing one that is digital, with an upper arm cuff, and has been clinically validated. Even some smartwatches and fitness trackers can give you an indication if your blood pressure’s on the high side, although they shouldn’t be relied upon for an accurate reading.
“A third of the population have blood pressure that’s raised to a point where it’s necessary to consider whether they should be on treatment. So, if your blood pressure is consistently 140 (systolic) over 90 (diastolic), it’s beneficial to lower it using drugs to help prevent strokes, heart attacks and heart disease,” explains Graham Macgregor, chair of Blood Pressure UK and a professor of cardiovascular medicine.
More on Heart Attack
That said, he adds, even if your blood pressure falls within the normal range, you’re still at greater risk if it’s 130 over 80, for example, than if it’s 110 over 70. In other words, whether or not you need pharmaceutical intervention, we should all be looking to make lifestyle changes because there’s always room for improvement.
Eat a healthy diet
For professor Macgregor, losing weight and reducing your salt intake are two of the best things you can do for a healthy blood pressure – although, he adds, both can be easier said than done. Eating too much salt is a major underlying cause of hypertension, but so much of the salt in our diets is hidden in processed foods.
In an ideal world, he adds, you want to cook from scratch using fresh meat, rice, pasta, fruit and vegetables, without adding table salt or high sodium stock cubes. Of course, this isn’t always practical, but the traffic light labels on food packaging can help you to be more mindful about choosing lower salt convenience food options, as well as avoiding things like too much saturated fat.
Potassium has the opposite effect to salt, so incorporating more of that into your diet will also help. Leafy greens like spinach and broccoli are rich in potassium, as are pulses like beans and lentils, dried fruits, starchy vegetables like squash and potatoes, and bananas. The best option though is to “eat the rainbow, looking at different coloured fruits and veg which all contain different nutrients,” Whitmore says.
Quit smoking and cut down on alcohol
If you’re a smoker, Whitmore adds, quitting the habit is “probably the single best thing you can do for your heart health in general”. You can get support with this via local stop smoking services, as well as apps and digital platforms, and over the counter nicotine replacement products.
Similarly, avoiding excess alcohol and only drinking in moderation, if at all – the NHS recommends no more than 14 units of alcohol a week, spread across three days or more – will help reduce the pressure on your circulatory system.
Increase your physical activity
While a five minute walk around the office every half hour is one approach, experts say any increase in physical activity is good for lowering your blood pressure.
“That might look different for different people. Obviously don’t go from not doing any exercise at all to running a marathon. The best advice is just being a bit more active than you currently are, and taking it slowly,” says Clare Jonas, research communications and engagement lead at the Stroke Association.
Remember too that physical activity doesn’t have to mean a formal exercise programme, Whitmore adds. “People can consider things like gardening, putting out the washing, walking the dog, or getting off the bus a stop earlier. These are all good ways to gradually increase activity levels, and which are probably something most people can incorporate into their lifestyles,” she says. “It’s never too late to start, and doing something is always better than doing nothing.”
The official NHS guidelines recommend at least 150 minutes a week of moderate intensity exercise – swimming, brisk walks, cycling, or anything that gets you a bit out of breath but not so much that you can’t hold a conversation. Alternatively, the recommendation for vigorous exercise – things like running – is 75 minutes per week.
Reduce stress
Whitmore also recommends stress relieving exercises like yoga or Pilates, as well as activities like mindfulness, meditation, and connecting with other people through community groups.
Things like stress and loneliness aren’t direct causes of high blood pressure, she explains, but they can increase the risk of coping strategies like heavy drinking and unhealthy eating.
You can find more information, resources and advice at: bhf.org.uk, bloodpressureuk.org, and stroke.org.uk
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