Around 30 per cent of people in England have high blood pressure - but many don’t realise it.
High blood pressure, or hypertension, is known as the “silent killer” because there are often no symptoms.  Left untreated the condition increases your risk of a heart attack, stroke or kidney disease.

Low blood pressure, or hypotension, on the other hand, usually does have symptoms. Normally lower blood pressure can be a sign you are healthy.  But if it is too low it can result in not enough blood flowing to your brain and other vital organs, leading to dizziness, blurred vision, fainting, nausea, a rapid or irregular heartbeat, or mental confusion.

The only way to find out if you have a problem either way, is to have your blood pressure measured.  And today, this service can often be offered by your local pharmacy, as well as by your GP.

Measuring blood pressure

Blood pressure is a measure of how strongly blood presses against the walls of your arteries as it’s pumped around your body by your heart. If this pressure is too high, for example, it puts a strain on your arteries and your heart, which can lead to heart or kidney disease.

The likelihood of high blood pressure increases as you get older, as does low blood pressure – sometimes older people experience symptoms of low pressure after changing positions, such as standing up, which is known as postural, or orthostatic hypotension.

Blood pressure is usually measured with electronic devices with an automatically inflating arm cuff. You don’t always have to see your doctor or nurse to have your blood pressure checked - you can monitor your own blood pressure at home. This is especially important if your doctor recommends your blood pressure be monitored on a regular basis.

Your local pharmacist may have a selection of different types of monitors for home use and can advise on which to choose.

Blood pressure readings are described with two numbers: systolic and diastolic. Systolic blood pressure is the pressure during a heartbeat. Diastolic blood pressure is the pressure between heartbeats. So your blood pressure is measured in millimetres of mercury (mm Hg) and is written systolic over diastolic (for example 120/80 mm Hg, or 120 over 80). Normal blood pressure is between 90/60mmHg and 140/90mmHg. If your results fall outside this range, your GP or health professional may discuss this with you.

Certain factors can cause blood pressure to temporarily rise, say as a result of stress, smoking, cold temperatures, exercise, caffeine or certain medicines. Try to avoid these factors when taking your blood pressure and also try to measure your pressure at the same time each day (you may need to take a reading several times a day to see if your pressure fluctuates).

Causes and treatment

In most cases, the cause of high blood pressure is unknown but several factors can increase your risk of developing the condition. Primary, or essential high blood pressure can be affected by your age, family history, high levels of salt in your food, lack of exercise or being overweight, stress and drinking large amounts of alcohol.

A small number of cases are due to underlying conditions like kidney disease, diabetes, some hormonal illnesses, lupus, the contraceptive pill and some pain killers and also illegal drugs such as cocaine.

Your doctor or health professional may recommend dietary and lifestyle changes to lower blood pressure. They may include:

• Regular exercise of at least 30 minutes a day, a minimum of five times a week.
• Losing weight if you're overweight.
• Cutting your alcohol intake to recommended levels (less than 21 units a week for men, and less than 14 units a week for women).
• Eating a healthy, low-fat, balanced diet.
• Restricting your salt intake to less than 6g (0.2oz) a day.
• Relaxation therapies, and reducing stress.
Your GP may also offer you blood pressure-lowering medicines. These medicines – also called anti-hypertensives – can help to lower moderately high or high blood pressure.
There are different kinds of blood pressure lowering medicines, including.
• Ace inhibitors. These work by blocking the action of some of the hormones that regulate blood pressure.
• Calcium channel blockers. These work by relaxing the muscles that make up the walls of your arteries. This causes the arteries to become wider, reducing your blood pressure.
• Thiazide diuretics. These work by reducing the amount of water in your blood and widening your arteries, thus reducing blood pressure.
• Beta-blockers. These reduce your heart rate and the force with which your heart pumps blood.

They are typically only used to reduce blood pressure when other treatments haven't worked.

Your GP will talk to you about the medicine that's right for you and how to take them. It's important that you stick to the advice that you're given. Remember, your local pharmacist is also a trained expert in medicines and can help give you advice.

While you’re asking your pharmacist for advice about blood pressure, you might be surprised at what else is on offer. All pharmacies can give advice on many common health problems, minor ailments and medicines. Some may also offer flu vaccinations, allergy screening and testing, and treatment for sexually transmitted infections as well as other services. To find out more, simply ask your pharmacist or visit 

Pharmacies are there to help you stay well, not just to treat you when you are sick.