Hypertension (High Blood Pressure)

Complications /Information to beware of/General tips:

Do not wait, phone for ambulance if have or develop:

• Hypertensive crisis: Stage 3 Hypertension and above: higher than 180/110 mmHg or higher and/or have history of  very high blood pressure.
• Angina
• Stroke
• Heart attack
• Sepsis
• Epiglottitis

This condition can lead to:

• Heart failure
• Herniated Disc
• Fibrillary glomerulonephritis
• Kidney failure
• Peripheral vascular disease

Pregnancy

Hypertension in pregnancy includes:

• Chronic hypertension: precedes pregnancy, develops before 20 weeks of gestation, persists for >6 weeks post-partum, and may be associated with proteinuria.

• Gestational hypertension: develops after 20 weeks of gestation and usually resolves within 6 weeks post-partum.

• Antenatally unclassifiable hypertension: BP is first recorded after 20 weeks of gestation, and hypertension is diagnosed but it is unclear if chronic or not; reassessment is necessary 6 weeks post-partum.

Developed by the task force on the management of elevated blood pressure and hypertension of the European Society of Cardiology (ESC) and endorsed by the European Society of Endocrinology (ESE) and the European Stroke Organisation (ESO)

• Pre-eclampsia

• Almost half of women who have pregnancy-related hypertension continue to have high readings at 6 weeks postpartum.

Ditisheim A, Wuerzner G, Ponte B, et al. Prevalence of hypertensive phenotypes after preeclampsia: a prospective cohort study. Hypertension. 2018;71:103-109.

Hauspurg A, Lemon L, Cabrera C, et al. Racial differences in postpartum blood pressure trajectories among women after a hypertensive disorder of pregnancy. JAMA Netw Open. 2020;3:e2030815. 

Driving Authority

• One should notify their driving authority if one has this condition/disease (there can be exemptions, please click the link)
• Blood pressure should be checked annually, more often if not controlled.
• Blood pressure should be checked on a daily basis and results should be recorded in a diary and should be shown to your medical doctor at your next appointment.

Over 40 years old (please make sure you have a blood pressure examination)?

Low blood pressure

• If one has low blood pressure (90/60mmHg or lower) and is fainting or feel like they will faint, please see your doctor on the same day, if one has no symptoms , do an annual blood pressure check up but please be aware of low blood pressure symptoms and if they do occur then see your doctor on the same day.

High blood pressure:

Average Normal blood pressure: Between 90/60mmHg and 134/84mmHg

Average Stage 1 Hypertension: Between 135/85 mmHg and 149/94 mmHg

• Please consider further blood pressure monitoring (Ambulance Blood pressure monitoring, this device measures your blood pressure during a 24 hour period) and one should make an appointment with a doctor with in two weeks (if you experience high blood pressure symptoms , do not wait, see your medical doctor on the same day).
  • The device must not get wet, baths and showers avoided during 24 hour period.
  • The device will take measurements every 30 minutes during waking hours and every 60 minutes during sleeping hours for 24 hours.
  • You will be alerted just before the monitor is about to take a reading, when this occurs:
    • Try to sit down, if possible
    • Position the arm that has the cuff on it at the same level as your heart and keep your arm still.
    • If you are not able to sit down, use your other arm to support you to achieve this position.
    • if you are sitting down, do not cross your legs during the measurement.
    • You are advised not to drive during the 24 hour period due to distraction of the cuff inflating.
    • Avoid vigorous exercise during the 24 hour monitoring period, this will help to avoid exercise related spikes in your blood pressure. A gentle or brisk walk is normally fine.
    • Monitoring will continue at night, so consider where you place the device if it is not directly attached to the cuff i.e. under the pillow or on a bedside table.
    • Please make a note of the time if one takes any type of medication and the time of any activities during the monitoring period.

Average Stage 2 Hypertension: Between 150/95 mmHg or higher:

• This is urgent and one should see their doctor on the same day.

This condition may show similar symptoms to:

• Acromegaly (especially if blood pressure is not in control)
• Dehydration
• Sleep apnoea

Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist) for further advice